MCC Operating Procedure – Communicable Diseases

A communicable disease is one spread from person to person through direct or indirect contact. Some of the most serious reportable communicable diseases include, but are not limited to, AIDS, Hepatitis B, Hepatitis C, meningococcal disease, measles, mumps, rubella and tuberculosis. Massachusetts law requires medical clinicians, laboratories, local boards of health, etc. to inform public health officials of newly confirmed cases of serious communicable diseases. The full list of communicable diseases that must be reported by medical professionals to the Massachusetts Depart of Public Health and the reporting procedure can be found here: http://www.mass.gov/eohhs/gov/departments/dph/programs/id/epidemiology/rdiq/reporting-diseases-and-surveillance-information.html

Because MCC does not employ any medical professionals in a diagnostic capacity on site, the College is typically notified of a student or employees diagnosis of a communicable disease from the student or employee, a family member of the student or employee, and/or the Massachusetts Department of Public Health.

Communicable Disease Notification Protocol

Identification of Student:

  1. Self-Reported to either a doctor/medical facility; or the College or
  2. Department of Public Health.

 

Identification of Employee:

  1. Self-Reported to either a doctor/medical facility; or the College or
  2. Department of Public Health.

Department of Public Health Contact at MCC:

Patrick Cook

Executive Director of Public Affairs 

Work- 978-656-3134

Cell- 781-760-4450

cookp@middlesex.mass.edu

 

Notification to a College office (via phone):

If Human Resources, the Center for Health & Wellness, the Dean of Students Office or any other MCC office receives notification that a student, employee or community member visiting our campus from the Department of Public Health OR the individual, the person should be immediately directed to contact and the phone call transferred to Patrick Cook, Executive Director of Public Affairs.

Notification to a College office (via e-mail):

If Human Resources, the Center for Health & Wellness, the Dean of Students Office or any other MCC office receives notification that a student, employee or community member visiting our campus from the Department of Public Health OR the individual, the e-mail should be forwarded to Patrick Cook, Executive Director of Public Affairs.

The employee should reply to the person sending the e-mail notifying them who the College’s contact person is and their contact information. The employee shall also put the following statement in the e-mail: All further communication regarding this matter should go through the contact listed above. The employee shall copy the contact person on the e-mail.

Notification to a College office (in person):

If Human Resources, the Center for Health & Wellness, the Dean of Students office or any other MCC office receives in person notification that a student, employee or community member visiting our campus, the person should be asked to leave the campus until they are cleared by a medical professional or the Department of Public Health to come to campus. If the person has been cleared, the person should be referred to the contact person, Patrick Cook, Executive Director of Public Affairs.

Interview of Reporting Party:

The person reporting the communicable disease may be asked to provide the following information:

  • Name of individuals involved
  • Contact information- phone, e-mail & emergency contact
  • Class schedule- including campus locations
  • Work schedule- including campus locations
  • Co-curricular activities- including campus locations
  • Any other campus contact
  • Meeting schedule of employee
  • Date and time of diagnosis, symptoms, treatment, & clearance to return to school or work

Notification to the College community or specific members of the community:

Students & Employees:

  • Confirmed or probable cases of communicable diseases may require a notification alert from the campus to students, employees, vendors, etc.  depending on the severity of the organism, the nature of the exposure and outbreak concerns.
  • These notifications will be distributed by the Department of Public Health and/or Middlesex Community College.
  • Notifications may include notification of possible exposure, instructions to be evaluated by a medical professional, which may include testing or treatment, prevention measures to avoid exposure, information about signs and symptoms or other education as deemed appropriate by the Department of Public Health and/or Middlesex Community College.
  • Suspected cases typically do not activate full protocol until the illness is confirmed. The Department of Public Health and/or Middlesex Community College will base this decision on the probability of diagnosis, the severity of the communicable disease and the risk of transmission.

Definitions

Communicable disease- an infectious disease that is spread from person to person or from animal to person. The spread or transfer can happen through the air, through contact with contaminated surfaces, or through direct contact with blood, feces, or other bodily fluids.

Communicable period- the time, usually measured in days, between exposure to an illness and the onset of symptoms.

Quarantine- Restriction of movements and/or action of individuals who are know to have been exposed to or may reasonably be suspected to have been exposed to a communicable disease and who do not yet show signs or symptoms of the infection.

Isolation- Restriction of movement and/or action of individuals infected with a communicable disease to reduce the change of spreading disease. A decision to allow or restrict any campus or classroom activity for students/staff/faculty will include, but is not limited to, the following considerations:

  1. The nature of the risk (how the disease is transmitted)
  2. The duration of the risk (how long is the carrier infectious)
  3. CDC and or the DPH recommendation for prevention
  4. The severity of the risk (what is the potential harm for third parties)
  5. The probability that the disease will be transmitted and will cause varying degrees of harm to surrounding students, faculty and staff’s academic and employment community

Federal Isolation and Quarantine are authorized for the following communicable diseases:

  • Cholera
  • Diphtheria
  • Infectious Tuberculosis
  • Plague
  • Smallpox
  • Yellow fever
  • Viral hemorrhagic fevers
  • Severe Acute Respiratory Syndromes
  • Flu that can cause a pandemic


Common Communicable Diseases

Please note that this list is not exhaustive but contains the most common communicable diseases

Chicken Pox

 

Pathogen:

Varicella-zoster virus

Transmission:

Direct contact, airborne

Incubation:

Two to three weeks

Communicability:

One to two days prior to rash until lesions scabbed- usually five days after onset of vesicles.

Diagnostics:

Centripetal, Monocular vesicles in successive crops; culture, smear, serology.

Therapy:

Immune globulin VZIG; Varicella vaccine x 2

Public Health Concern:

Isolation; susceptible adults; immune-compromised; report to Public Health.

Isolation:

Yes- Airborne precautions

 

Influenza

 

Pathogen:

Influenza A (widespread)- Pandemic Flue

Influenza B (regional or widespread)

Influenza C (Sporadic, localized)

Transmission:

Droplets, Direct contact, airborne

Incubation:

1-3 days

Communicability:

5 days from clinical onset (10 days for children- longer for immunocompromised)

Diagnostics:

Nasopharyngeal swab

Therapy:

Anti-viral medications within 48 hours; vaccine, Flu Mist.

Public Health Concern:

Pandemic, high-risk individuals; surveillance by CDC and WHO.

Isolation:

Impractical- Seasonal Flu, may be important onset of virulent Pandemic Flu Symptoms headache, sore throat, cough, fatigue, weakness, aching muscles, fever and runny nose.

 

Measles

 

Pathogen:

Measles virus

Transmission:

Airborne by droplets, nasal and throat secretions

Incubation:

7 to 18 days

Communicability:

At onset of disease until lesions scabbed- usually 4 days after appearance of rash.

Diagnostics:

Clinical findings; Koplik spots on buccal mucosa, red blotchy rash.

Therapy:

Supportive care, immunization x 2; immune globulin for high risk household contacts

Public Health Concern:

College Outbreaks: immunize all without documentation of two doses of MMR

An outbreak is considered to be 3 or more linked cases.

Report to Public Health within 24 hours.

Isolation

No school attendance for 4 days after onset of rash

 

Mumps

 

Pathogen:

Mumps virus

Transmission:

Airborne by droplets, nasal and throat secretions

Incubation:

16 to 18 days

Communicability:

3 days before to 5 days after symptom onset

Diagnostics:

Clinical findings; Nasopharynx and regional lymph nodes are primary sites of infection; then spreads to meninges and glands (salivary, pancreas, testes, ovaries).

Therapy:

Supportive care, immunization x 2; immune globulin for high-risk household contacts.

Public Health Concern:

College Outbreaks: immunize all without documentation of two doses of MMR

An outbreak is considered to be 3 or more linked cases.

Report to Public Health within 24 hours

Isolation:

No school attendance for 5 days after onset of rash

 

Meningitis (Bacterial)

 

Pathogen:

Nesseria meningitides, groups A, B, C, W-135, X, Y, Z (group B and C most common in USA & Latin America, Group A in Asia & Africa) Streptococcus pneumoniae

Transmission:

Direct contact: respiratory droplets from nose and throat

Incubation:

2-10 days (commonly 3-4)

Communicability:

Until no meningococci in secretions (24 hours after starting antibiotics).

Diagnostics:

Clinical; fever, headache, stiff neck, rash, gram stain of spinal fluid, culture, coagglutination.

Therapy:

Broad spectrum antibiotics; meningitis vaccine for Groups A, C, W-135, Y

Prophylactic Antibiotics, Vaccine to control outbreaks.

Public Health Concern:

Asymptomatic carrier rate high (<5-10%) Case fatality 5-15% in invasive disease

High occurrence in winter and spring

Increased risk among newly aggregated adults and individuals who have had their spleens removed.

Report to Public Health within 24 hours

Isolation:

For 24 hours after start of antibiotic therapy

 

Mononucleosis (Mono)

 

Pathogen:

Epstein Barr Virus (EBV), a member of the herpes virus

Transmission:

Via saliva (on hands or toys or by kissing)

Incubation:

Four to six weeks after exposure

Communicability:

The period of communicability is prolonged. Pharyngeal excretion may persist for a year or more after infection. Twenty per cent or more of EBV antibody–positive healthy adults are long-term oropharyngeal carriers.

Diagnostics:

Blood tests to check for signs of mono and the Epstein Barr Virus.

Therapy:

No treatment other than rest is needed in the vast majority of cases.

Public Health Concern:

Avoid activities involving the transfer of body fluids (commonly saliva) with someone who is currently or recently infected with the disease. At present, there is no vaccine available to prevent infectious mononucleosis.

Isolation:

No

 

Pertussis (Whooping Cough)

 

Pathogen:

A bacterium that is found in the mouth, nose and throat of an infected person.

Transmission:

Spread of direct contact with discharges from the nose and throat of the infected individual.

Incubation:

5 to 10 days but may be as long as 21 days

Communicability:

A person can transmit Pertussis from onset of symptoms to three weeks after the onset of coughing episodes.

Diagnostics:

The diagnosis can be made from the clinical history

Therapy:

Antibiotics

Public Health Concern:

Report to DPH within 24 hours

Treatment of people who are in close contact of pertussis cases is also an important part of prevention.

Isolation:

Per supervising physician

 

H. SARS

 

Pathogen:

SARS- associated coronavirus

Transmission:

Respiratory droplets (hand to nose), questionable fecal transmission

Incubation:

2-10 days

Communicability:

Usually becomes infections during 2nd week of symptoms

Diagnostics:

Suspect case: Temperature >100.4 and cough, shortness of breath and history of exposure.

Therapy:

Supportive care; no vaccine available

Public Health Concern:

Hospital associated spread; intentional spread by travelers (campus international travel by students, faculty, staff, visitors)

Report to Public Health.

Isolation:

Quarantine in suspected cases- Isolation with negative pressure ventilation until 10 days after resolution of symptoms in probable cases.

 

Tuberculosis

 

Pathogen:

Mycobacterium Tuberculosis

Transmission:

Airborne droplets

Incubation:

4-12 weeks

Communicability:

With infectious disease or active TB until sputum is free from tuberculosis bacteria. Generally after a few weeks of effective treatment.

Diagnostics:

Sputum Culture

Therapy:

4 drug combination (INH) for latent tuberculosis infection, isoniazid for 6-9 month

Public Health Concern:

Investigate contacts; initial tuberculosis testing of contacts, repeated in 2-3 months chest x-ray of those with positive tests.

Isolation:

Yes with negative pressure ventilation

Last Modified: 7/2/20