Communicable Diseases in Ohio

Ohio Administrative Code (3701-3-02, 3701-3-05 and 3701-3-12) requires cases of certain communicable or highly contagious diseases to be reported to local health departments. Examples of communicable diseases include salmonella, hepatitis, rabies, crypto, tetanus, chickenpox, whooping cough and more.

Reporting Communicable Diseases

The Role of the Reporter
Identification of a suspected or confirmed case of an infectious disease is the first step. This can be done by physicians, laboratories, school nurses, nurse practitioners, infection control practitioners, and others. Suspected cases are to be reported so that prophylactic measures to protect contacts of the case can be planned and instituted as soon as the disease is confirmed. This is especially important in diseases which are easily spread, such as measles, or for which
exposure is particularly hazardous, such as meningococcal disease. Case reporting to a local health jurisdiction, and subsequently to the state, allows identification of related cases, or outbreaks, which might not be apparent to a practitioner seeing only one or two affected patients.

How to report 

1. Review specific reporting information and educational materials about the suspected communicable disease 
2. Complete the appropriate form: 
   Disease Reporting Form 
   Varicella Reporting Form 
3. Fax your report to (513) 946-7930 
4. Contact the Health District 
   General Communicable Disease Number: (513) 946-7923 
   Judith Beiting, Communicable Disease Nurse Investigators: (513) 946-7887 
   Lisa Craig, Communicable Disease Nurse Investigators: (513) 946-7849 
   After-hours Contact (weekends, holidays and after 4:30 p.m. M-F): (877) 774-4636

Communicable Disease Investigation

Once a reportable communicable disease diagnosis is verified, a public health nurse begins an investigation to: 

• Confirm each diagnosis and original source of the disease. 
• Verify the disease. 
• Locate affected persons. 
• Provide affected persons with information about the disease. 
• Look for potential common modes of transmission among affected persons. 
• Provide affected persons and the public with information about the disease including: symptoms, how diagnosis is confirmed, how the disease is spread, and prevention measures.

In some cases, communicable disease staff work with other public health staff to control or stop an outbreak. For example, when restaurants or day care centers are involved, communicable disease nurses and environmental health staff work together to develop a coordinated response.

For more information, please contact our staff at (513) 946-7923.

Controlling Diarrheal Illness in Daycares

Warm weather is fast approaching, and with it we will likely see an increase in diarrheal illnesses such as shigella, crypto, salmonella and E. coli. Diarrheal illnesses such as these spread easily among groups of small children because of their close contacts and lack of well-developed personal hygiene skills. A few simple precautions can help prevent these illnesses from occurring in our community and your center.

Diarrheal illnesses are caused by bacteria, parasites and viruses. Primary symptoms can include diarrhea, fever and vomiting. Such illnesses can be especially harmful to children and are often spread –by bacteria that passes from the stool or soiled fingers of one person to the mouth of another person. This happens when basic hygiene and proper hand washing habits are not used. Frequent and thorough hand washing – especially among children – is the number one thing individuals can to do prevent the spread of disease.

The following control measures will also help prevent diarrheal illnesses from occurring in your center: 

Exclude children and workers with diarrhea from your center 

• As outlined by the Ohio Administrative Code, child care center workers or attendees with diarrhea are not permitted to attend the child care center (see OAC 3701-3-13, I). 
• A child with diarrhea should be referred to medical care for testing. 
• Ask parents about any recent history of diarrhea prior to accepting all new children. 

Enforce strict hand washing for staff and children 

• Wash hands using warm water and soap for at least 20 seconds (sing Happy Birthday twice). 
• Observe children washing hands. 
• Hands must be washed upon entering the center, after using the bathroom, before eating meals and snacks, and before preparing meals. 
• Stress the importance of good hand washing with parents. 

Use good diaper changing practices 

• Change diapers in designated area only. 
• Assign specific, gloved staff person to diaper changing. This person cannot handle food. 
• Wash and sanitize diaper changing area after each diaper change. 
• Wash hands and change gloves after each diaper change. 
• Put soiled diapers and gloves in plastic bag. Dispose of them without contaminating your hands. 

Clean surfaces and toys 

• Wash, sanitize and rinse mouthed toys after a child has played with it. 
• Wash and sanitize counter tops, tables and chairs before preparing/eating food. 
• Clean bathroom and toilet areas 
• Continue general sanitation procedures.

Also, be sure to have updated exclusion policies and contact information of parents readily available. This will help facilitate management of diseases, should they occur in your center.

For additional information, refer to your copy of the Handbook on Common Childhood Illnesses for Child Care Centers 2006. This handbook contains a fact sheet on diarrheal illnesses in children. It can be viewed or printed at http://jfs.ohio.gov/cdc/condensedccdhandbook.pdf.

If you have any questions or concerns, please contact us at (513) 946-7923. We are available 8 a.m. – 4 p.m., Monday through Friday. Thank you for your cooperation.

Daycare Control Measures for Prevention of Communicable Diseases
Cleaning and Sanitizing Guidelines

MRSA: What you need to know about antibiotic-resistant bacteria

MRSA (pronounced MER-sa), is the abbreviation for Methicillin-resistant Staphylococcus aureus, one of several types of bacteria that can cause serious health complications and may be difficult to treat. Common signs of a skin infection include redness, warmth, swelling and tenderness. Often a MRSA infection will look like a spider bite, boil, abscess or pimple. If left untreated, it could progress into a more serious illness. In outbreak situations, the environment has not played a significant role in the transmission of MRSA. Studies in health care and community settings show skin-to-skin contact, direct contact with the infected wound drainage or contact with contaminated surfaces or things such as sports equipment as the likely source of transmission. MRSA skin infections are not spread through the air.

Antibiotics are typically used to fight bacterial infections, but some, such as MRSA, have grown resistant to this medicine. There are things you can do to reduce the risk of infection. The links below include information from ODH and CDC that may be helpful in reducing your risk.

For additional information, click on the links below.

MRSA Fact Sheet

MRSA in Prison Settings

CDC - Community-Associated MRSA Information for the Public

Ohio Department of Health

Gastroenteritis (Stomach Flu) in Hamilton County

Noroviruses are a group of viruses that cause gastroenteritis (GAS-tro-en-ter-I-tis), in people. Norovirus is known incorrectly as the “stomach flu”. Norovirus is NOT related to the flu (influenza), which is a respiratory illness caused by a different virus. The term norovirus was recently approved as the official name for this group of viruses; previously it had been referred to as “Norwalk virus” or “Norwalk-like virus.”

Norovirus illness usually begins 24 - 48 hours after exposure, but can appear as early as 10 hours after exposure. Symptoms usually include nausea, vomiting, diarrhea and stomach cramping. Sometimes people have a low-grade fever, chills, headache, muscle aches and a general sense of tiredness. The illness is usually brief, with symptoms lasting only 1 or 2 days.

Norovirus disease is usually not serious, but people may feel very sick. Most people get better within 1 or 2 days, and have no long-term health effects from the illness. Sometimes people are unable to drink enough liquids to replace what they lose from vomiting and diarrhea, and they can become dehydrated and need to see a doctor. This problem usually occurs only among the very young, the elderly, and persons with weakened immune systems.

Noroviruses are very contagious and spread easily from person to person. Because anyone can become infected with these viruses, hand washing is essential. Proper hand washing, cleaning and sanitizing should be practiced at all times to prevent diarrhea and other illnesses.

Hand washing is the single most important way to stop the spread of disease. Hands should be washed using soap and warm water. Scrub hands until a good lather is present then rinse and towel them dry. 

For additional information, please click on the links below.

Gastroenteritis and Norovirus Fact Sheet
Controlling Norovirus in Nursing Home Settings
Guidelines For Environmental Cleaning and Disinfection of Norovirus 
Gastrointestinal Illness in Retirement Communities
Norovirus in Schools