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Information for Schools and Child Care Providers


When to Report: Cluster/Outbreak only or if an influenza case requires hospitalized in the intensive care unit and/or dies. To report a cluster, outbreak, or increase in influenza-like illness

What to Do If You Are Experiencing Influenza Cases: For General Health Information on Monitoring, Identifying Cases, and Decreasing Transmission:

Template Letters for School Parents

Additional Influenza Resources

Viral Gastroenteritis (including Norovirus)

What Is It: Gastroenteritis means inflammation of the stomach and small and large intestines. Viral gastroenteritis is an infection caused by a variety of viruses that results in vomiting or diarrhea. It is often called the "stomach flu," although it is not caused by influenza viruses

Information for Physicians / Health Care Providers


When to Report: All suspect and confirmed pertussis cases must be reported to the OC Health Department within one (1) working day. Even during an outbreak, complete information on each individual case must be reported.

What is Pertussis? Pertussis, commonly called “Whooping Cough,” is highly contagious and is spread through the respiratory route.
HCA Epidemiology Pertussis Webpage

* High-risk conditions for pertussis include infants less than one year of age, pregnant women, persons with chronic lung conditions (including asthma) or immunocompromise, un- and under-vaccinated persons, household contacts of infants or pregnant women in the third trimester, childcare providers, and persons who work with infants or pregnant/postpartum women.

Alert to Schools - AB354 - New Pertussis Booster Vaccine Requirement

More information on AB354 and the SB614 grace period is available on the Shots for Schools website.

Template Letters for Daycare – Pertussis

Schools and daycares may use the template letters below for children with pertussis. Note that children in daycares are to be excluded for 5 days after antibiotics are begun, while children in Kindergarten through Grade 12 are to be excluded for 3 days after the start of antibiotics.

Template Letters for Schools – Pertussis

Pertussis Resources

Chickenpox (Varicella)

When to Report: Individual cases of chickenpox are not reportable unless the case is hospitalized or dies.

What is Chickenpox? Chickenpox is an infectious disease caused by the varicella-zoster virus, which results in a blister-like rash, itching, tiredness, and fever. HCA Epidemiology FAQ about Chickenpox

Recommendations for Schools with Suspect or Confirmed Chickenpox Cases: The identification of a single case of varicella should trigger intervention measures to prevent an outbreak. If still infectious, the case should be excluded or isolated from the school immediately. Next, a notification letter can be sent to those that may have been exposed to the case. The letter could be sent home with the children in the same classroom as the case. However, how broadly to distribute the notification letter for a single case may vary depending on the specific situation.

*High-risk conditions for chickenpox include being immunocompromised and pregnancy.

For schools with three or more chickenpox cases in two months, call Communicable Disease Control at 714-834-8180 and ask to speak to a PHN.

Template Letters for School Parents

Chickenpox (Varicella) Resources

Reporting of increased absenteeism, outbreaks or clusters at K-12 schools

When to Report: Please use the following criteria to report respiratory or gastrointestinal (GI) illnesses:

  1. At least 10% of average daily attendance is absent, OR

  2. 20% of classroom or group ill with similar symptoms, with a minimum of 5 ill.

    (Example of increase in absenteeism: Average daily attendance may already be calculated for your school. If not, you can approximate on your own for reporting increases. For school with 1,000 kids; if absenteeism is usually 15%, or 150 absent each day, baseline attendance would be 850 (1,000 minus 150). An additional 10% of 850, or 85 students, would need to be absent to meet this increase in absenteeism criteria).

Please call Communicable Disease Control immediately at 714-834-8180 if a large number of students in affected classroom(s) or other exposed group(s) are high risk students, or any hospitalizations/deaths. In general, high risk conditions include immunocompromise and pregnancy but may also include other underlying diseases.

IMPORTANT Note: This mechanism of reporting is for increased absenteeism, outbreaks or clusters due to non-specific respiratory, influenza-like illnesses (ILI), or gastrointestinal (GI) illnesses. It is NOT to be used for diseases that are reportable as individual cases (e.g., pertussis, meningitis). To report suspect chickenpox illnesses, see above under Chickenpox.

To report increased absenteeism outbreaks at K-12 schools, including COVID-19, complete the online intake form for school reporting.

Hand, Foot, and Mouth Disease

What is Hand, Foot, and Mouth (HFM) disease: HFM is caused by enterovirus, a common virus that most children are exposed to in childhood. HFM infection is characterized by a rash on the hands, feet, and inside of the mouth. Fever and sore throat often accompany the rash. Almost all HFM infections in children are mild, though severe illness is seen occasionally. The most important treatment is assuring that an infected child does not become dehydrated. For more information, please visit Schools with multiple cases can utilize this letter.

How to Receive CD Health Alerts

In case of a public health emergency, Orange County Public Health would like to be able to reach child care providers with critical information. Please provide your contact information by completing this survey.  This information will only be used to contact you with public health alerts and notifications.


Page Last Updated: 12/6/2023