Asthma is a disease that affects your lungs. It is one of the most common long-term diseases of children, but adults can have asthma, too. Asthma causes wheezing, breathlessness, chest tightness, and coughing at night or early in the morning. If you have asthma, you have it all the time, but you will have asthma attacks only when something bothers your lungs.
In most cases, we don’t know what causes asthma, and we don’t know how to cure it. We know that if someone in your family has asthma you are more likely to have it. (CDC.gov, 2016)
Communicating with Schools about Asthma
Managing a child's asthma is a team effort, involving you, your child, your child's healthcare providers and the school.
All members of the team want to be able to communicate, ask questions, and share information about your child's health and well-being.
Back-to-School with Asthma Checklist
Use the American Lung Association Back-to-School Asthma Checklist to make sure you and your child are ready for a safe and healthy school year.
You may have many questions and concerns about how your child's asthma can be managed while they are at school.
Here are some tips for effective communication:
At the beginning of the school year, make sure to contact school health services and let them know about your child's asthma. This provides you with the opportunity to get to know the school nurse and any other health services staff.
By law, the school needs your permission to communicate student health information to your child's healthcare provider. Find out from the school what they need from you to allow this important communication to happen. That way if prescriptions change, or if your child has an asthma emergency, everyone on "the team" can be kept informed.
Be sure your child has a recent Asthma Action Plan on file at the school. If for some reason you cannot get your child's doctor to complete one, talk to the school nurse about what to do.
Ensure that your child has immediate access to quick-relief medicine in case your child has an asthma flare-up while at school. In many schools districts, policies are in place that allows a student to carry and self-administer their own asthma medication. Contact the school health services staff to find out more about your school's policy and practice (lung.org, 2016).
If your child has asthma they may need medication while at school for before gym or as needed in the event their asthma flares up. Please provide a completed medication authorization form (link) for each medication that will be used while at school as well as the medication, including the box with pharmacy label, to your school nurse every school year.
In addition, it is recommended that students with asthma have an Asthma Action Plan on file at school
Links to more information about Asthma
Student Asthma History & Medication Authorization Form
Asthma Action Plan 11 and younger
Asthma Action Plan 12 and older
American Lung Association
Belly breathing technique for children
How to use an asthma inhaler
Inhaler/spacer fact sheet
Back to School Asthma Checklist
Please notify the school nurse if your child has a been diagnosed with a communicable disease such as
Connecticut Epidemiologist Reportable Diseases
Communicating with school nurse:
If you child has a communicable illness such as, but not limited to those listed above please notify the school nurse as soon as possible so steps can be taken to avoid an outbreak at school.
Link to Trumbull Schools Concussion Policy
Link to THS Concussion Information
Link to “A Parents Guide to Concussions”
Return to Play Form
Concussion Education Plan.
CDC, Heads Up: Concussion
Heads Up: Concussion Fact Sheet for Coaches
What is a Concussion?
Centers for Disease Control and Prevention (CDC) - “A concussion is a type of traumatic brain injury, or TBI, caused by a bump, blow, or jolt to the head that can change the way your brain normally works. Concussions can also occur from a blow to the body that causes the head to move rapidly back and forth.” -
Even a “ding,” “getting your bell rung,” or what seems to be mild bump or blow to the head can be serious” -CDC, - Signs and Symptoms of a Concussion: Overview
A concussion should be suspected if any one or more of the following signs or symptoms are present, or if the coach/evaluator is unsure, following an impact or suspected impact as described in the CDC definition above.
Symptoms of a concussion may include (i.e. what the athlete reports):
State law requires that a coach MUST immediately remove a student-athlete from participating in any intramural or interscholastic athletic activity who: a) is observed to exhibit signs, symptoms or behaviors consistent with a concussion following a suspected blow to the head or body, or b) is diagnosed with a concussion, regardless of when such concussion or head injury may have occurred.
Seventy percent of concussions occur without direct head impact but instead from rotational or velocity injuries that cause the brain to move quickly back and forth (Neurosurgery 2003; 4:799).
Each year, emergency departments in the United States treat an estimated 173,285 sports- and recreation-related traumatic brain injuries (TBIs), including concussions, among children and adolescents, from birth to 19 years (CDC 2014)
Concussions may affect a student's ability to learn. Because every brain and every student are different, every concussion is different. Recovery time will be unique to each student, requiring an individualized approach to determine when it is appropriate to begin to return to athletic activity and regular classes. Some students may not miss any school and may need accommodations no greater than for someone who has suffered a minor illness.
Others may have months of enduring symptoms that can significantly affect academic performance and overall ability to function -
Mental and physical rest are essential to concussion recovery. If not properly managed from the time of initial injury, recovery time can be extended and the student may be exposed to increased risk of further injury and also adversely affect the student's academic progress (http://www.sde.ct.gov/).
Hand, foot, and mouth disease is a common viral illness that usually affects infants and children younger than 5 years old. However, it can sometimes occur in older children and adults. It usually starts with a fever, reduced appetite, sore throat, and a feeling of being unwell (malaise). One or two days after the fever starts, painful sores can develop in the mouth (herpangina). They begin, often in the back of the mouth, as small red spots that blister and can become ulcers. (CDC.gov, 2016)
See Pictures of these symptoms
Some people, especially young children, may get dehydrated if they are not able to swallow enough liquids because of painful mouth sores.
Not everyone will get all of these symptoms. Some children may also have rash appear on the knees, elbows, buttocks or genital area. Some people, especially adults, may show no symptoms at all, but they can still pass the virus to others.
Hand, foot, and mouth disease is caused by viruses that belong to the Enterovirus genus (group), including polioviruses, coxsackie viruses, echoviruses, and enteroviruses.
Coxsackie virus A16 is the most common cause of hand, foot, and mouth disease in the United States, but other coxsackie viruses can also cause the illness.
The viruses that cause hand, foot, and mouth disease can be found in an infected person’s:
An infected person may spread the viruses that cause hand, foot, and mouth disease to another person through:
Generally, a person with hand, foot, and mouth disease is most contagious during the first week of illness. People can sometimes be contagious for days or weeks after symptoms go away. Some people, especially adults, may not develop any symptoms, but they can still spread the virus to others. This is why people should always try to maintain good hygiene (e.g. handwashing) so they can minimize their chance of spreading or getting infections.
There is no vaccine to protect against the viruses that cause hand, foot, and mouth disease.
A person can lower their risk of being infected by
Washing hands often with soap and water, especially after changing diapers and using the toilet. Visit CDC’s Clean Hands Save Lives! for more information.
Cleaning and disinfecting frequently touched surfaces and soiled items, including toys.
Avoiding close contact such as kissing, hugging, or sharing eating utensils or cups with people with hand, foot, and mouth disease.
If a person has mouth sores, it might be painful to swallow. However, it is important for people with hand, foot, and mouth disease to drink enough liquids to prevent dehydration (loss of body fluids). If a person cannot swallow enough liquids, they may need to receive them through an IV in their vein.
There is no specific treatment for hand, foot, and mouth disease. However, some things can be done to relieve symptoms, such as
People who are concerned about their symptoms should contact their health care provider.
Returning to school:
Always talk with your healthcare provider if you are not sure when you should return to work or school.According to the American Academy of Pediatrics (2013), students may return to school when other exclusion criteria such as fever and behavior changes are resolved.
If a child does not feel well enough to participate due to discomfort from sores in mouth or other areas your health care provider should be contacted for recommendations on how best to control the discomfort.
Excluding children from the group setting does not reduce disease transmission as some children may shed the virus even when not recognizably ill and the virus may be shed for weeks. Good cough and sneeze etiquette as well as good hand hygiene is the best way to reduce transmission (Aronson, s & Schope, T, 2013, Managing Infections Diseases in Child Care and Schools)
Links to more information
CDC on Coxsackie Virus
Hand, Foot & Mouth Disease
Why is handwashing so important?
Information on Dehydration
Fifth disease is a mild rash illness caused by parvovirus B19. This disease, also called erythema infectiosum, got its name because it was fifth in a list of historical classifications of common skin rash illnesses in children. It is more common in children than adults. A person usually gets sick with fifth disease within 4 to 14 days after getting infected with parvovirus B19. See pictures of Fifth Disease rash...
Signs & Symptoms: The first symptoms of fifth disease are usually mild and may include fever, runny nose, and headache. Then you can get a rash on your face and body After several days, you may get a red rash on your face called "slapped cheek" rash. This rash is the most recognized feature of fifth disease. It is more common in children than adults. See photo of "slapped cheek" rash.
Some people may get a second rash a few days later on their chest, back, buttocks, or arms and legs. The rash may be itchy, especially on the soles of the feet. It can vary in intensity and usually goes away in 7 to 10 days, but it can come and go for several weeks. As it starts to go away, it may look lacy.
You may also have painful or swollen joints People with fifth disease can also develop pain and swelling in their joints (polyarthropathy syndrome). This is more common in adults, especially women. Some adults with fifth disease may only have painful joints, usually in the hands, feet, or knees, and no other symptoms. The joint pain usually lasts 1 to 3 weeks, but it can last for months or longer. It usually goes away without any long-term problems.
Complications: Fifth disease is usually mild for children and adults who are otherwise healthy. But for some people fifth disease cause serious health complications. People with weakened immune systems caused by leukemia, cancer, organ transplants, or HIV infection are at risk for serious complications from fifth disease. It can cause chronic anemia that requires medical treatment.
Transmission: Parvovirus B19—which causes fifth disease—spreads through respiratory secretions (such as saliva, sputum, or nasal mucus) when an infected person coughs or sneezes.
You are most contagious when it seems like you have "just a cold" and before you get the rash or joint pain and swelling. After you get the rash you are not likely to be contagious, so then it is usually safe for you or your child to go back to work or school.
People with fifth disease who have weakened immune systems may be contagious for a longer amount of time. Parvovirus B19 can also spread through blood or blood products.
A pregnant woman who is infected with parvovirus B19 can pass the virus to her baby. Parents and teachers of child bearing years are at risk for exposure to the virus that causes Fifth Disease and should contact their doctor for specific concerns related to this virus.See the CDC information on Pregnancy and Fifth Disease.
Once you recover from fifth disease, you develop immunity that generally protects you from parvovirus B19 infection in the future.
Diagnosis: Healthcare providers can often diagnose fifth disease just by seeing "slapped cheek" rash on a patient's face. A blood test can also be done to determine if you are susceptible or immune to parvovirus B19 infection or if you were recently infected. The blood test may be particularly helpful for pregnant women who may have been exposed to parvovirus B19 and are suspected to have fifth disease.
Prevention: There is no vaccine or medicine that can prevent parvovirus B19 infection. You can reduce your chance of being infected or infecting others by washing your hands often with soap and water covering your mouth and nose when you cough or sneeze not touching your eyes, nose, or mouth avoiding close contact with people who are sick staying home when you are sick (After you get the rash, you are probably not contagious). So it is usually then safe for you to go back to work or for your child to return to school or a child care center.
Treatment: Fifth disease is usually mild and will go away on its own. Children and adults who are otherwise healthy usually recover completely. Treatment usually involves relieving symptoms, such as fever, itching, and joint pain and swelling. People who have complications from fifth disease should see their healthcare provider for medical treatment.
Link to CDC information about Fifth Disease
More information for parents about Fifth Disease at KidsHealth.org
While the timing of flu season is unpredictable, seasonal flu activity often begins to increase in October, most commonly peaks between December and February, but can last as late as May. CDC recommends that everyone ages 6 months and older get a flu vaccine by the end of October.
It takes about two weeks after vaccination for antibodies to develop in the body to protect against flu virus infection. Although it's best to get vaccinated as soon as the flu vaccine is available, getting the vaccine later can still be helpful.
Influenza is Dangerous for Children
Children younger than 5 years of age –especially those younger than 2 years old– are at high risk of serious flu-related complications. Flu illness is more dangerous than the common cold for children. Each year, millions of children get sick with seasonal flu; thousands of children are hospitalized and some children die from flu. Children commonly need medical care because of flu, especially children younger than 5 years old who become sick with flu.
Preschool Flu Immunization Requirements:
- All children aged 24–59 months who have never previously received vaccination against influenza are required to receive 2 doses of vaccine the first influenza season that they are vaccinated.
- Children aged 24–59 months enrolled in Pre-K who have previously received flu vaccinations are required to receive at least one dose of influenza vaccine between August 1 and December 31 of the current school year.
- Parents must submit proof of immunization for flu to the school nurse prior to December 31 of the current school year.
- Pre-K children who do not have the required flu vaccine documentation on file with the school nurse will not be permitted to return to school after January 1 of the current school year.
This season, any licensed, age-appropriate flu vaccine is recommended. The nasal spray flu vaccine is an option for children ages 2 years and older this season. Ask your health care professional which vaccine is right for your child this year.
Flu: A Guide for Parents
Flu Shot Locations: For a link to where you can get a flu shot in the community
Who should be immunized?
Is it a Cold or the Flu?
First aid for the flu
What to do if your child gets the flu (fact sheet from CDC)
Cleaning to prevent the flu (fact sheet from CDC)
The Flu and You (CDC fact sheet)
Talking to children about the flu
Connecticut Department of Public Health information on Seasonal Influenza
Trumbull Schools have a strong commitment to maintaining the health and safety of every child in the district. The prevention and management of exposure to life‐threatening allergies for students with diagnosed allergic conditions is a paramount student safety concern. In order to manage the care of students with life‐threatening allergies the school nurse will develop an Individual Health Care Plan.
The following items are required in order to develop the Individual Health Care plan:
Emergency Care Plan for Food and or Insect Allergy‐to be completed by physician and parent.
Authorization for the Administration of Medicine by School Personnel‐for each medication that must be administered daily or on an as‐needed basis. The parent must obtain the written medication order from an authorized prescriber. A new medication order is required every school year for each medication prescription and non‐prescription (over the counter) medication prescribed. Please follow the Trumbull Schools Procedure for requesting medication administration.
Prescription Medication must be in the ORIGINAL PHARMACY LABELED CONTAINER and must be in clearly labeled with the student’s name, the authorized prescriber’s name, and the prescription. Over‐the‐counter (OTC) medications must be delivered in an unopened, properly labeled container.
Two photographs of the student (one will be for the medication order and one will be for cafeteria staff)
ALL medications must be delivered to school the school nurse by a responsible adult.
Please allow at least fifteen minutes to meet with the school nurse prior
to the first day of school to review all information necessary.
A student can be eligible for self‐administration of medication with the collaborative input from the parent/guardian, authorized prescriber, student and school nurse to develop an individual medication plan for self‐administration of medication when applicable.
Please be aware that school nurses are not available to provide health services before or after regularly scheduled school day hours. Emergency medication will not be available beyond the regular school day, except as otherwise determined by a student’s emergency care plan.
If your child has a life threatening allergy which warrants emergency medication as ordered by his/her authorized prescriber and will be participating in a Board of Education interscholastic athletic event before or after school, please contact the school nurse so appropriate accommodations and individual medication plan can arranged.
Every effort will be made to provide the safest environment possible. Your cooperation and support is greatly appreciated. If you have any questions or concerns please call your school nurse or, Director of Nursing Services, at 203-452-5091
Trumbull Schools Food Allergy Policy
Medication Authorization Form
Allergy Management Plan
Head lice prevention, and management of head lice among students in Trumbull Schools relies on current standards in public health as well as scientific research to guide its practices related to communicable disease and infestation.
Head Lice can occur at any time of year. Children can get head lice any time they are in close contact with others such as during summer camp, playing at home, at school, slumber parties or sports activities.
In keeping with current standards and research, mass screenings for head lice are not conducted in our schools. Rather, our emphasis is on prevention through parental education, and home/school communication and collaboration.
Current public health standards and research-based recommendations indicate that routine screening by parents and management at home are the key factors to effectively control head lice.
It is recommended that parents screen their children once a week throughout the year in order to reduce the spread of this pest within the school, your family and the community.
Communication with the school nurse when a student is diagnosed with an active case (even if the child has already been treated) is important. Children who have been identified as having head lice must be checked by the school nurse prior to returning to school.
Respect for the privacy of those who may have become infested is always a priority.
Approaching the problem of head lice collaboratively, learning the facts, and focusing on containment and prevention will help minimize the incidence and spread in our schools and community.
Because head lice are ever-present in humans, and will probably never be eradicated, anyone can become infested with them. Preventing infestation and treating appropriately requires knowledge, on-going vigilance, and attention to detail.
For additional information click on the following links:
CDC: Head Lice Information for Schools
CDC Guidelines for Treatment of Head Lice
FDA Consumer Health Info on Head Lice
No-Panic Guide to Head Lice Treatment
Kidshealth.org (Head Lice)
American Academy of Dermatology: How to treat head lice - video
Head Lice Identification - Video
The Life Cycle of Lice - pdf
Schoolnurse.org Article on Head Lice -pdf
Please contact your school nurse directly if you have any questions or concerns.
When children are not feeling well parents struggle with the decision: should they keep their sick children at home or send them off to school? Often the way a child looks and acts can make the decision an obvious one. There are also times when a student may have a communicable illness, which requires they stay home for a period of time.
Please notify the school nurse if your child has a been diagnosed with a communicable disease such as
Connecticut Epidemiologist Reportable Diseases
Communicating with school nurse:
If you child has a communicable illness such as, but not limited to those listed above please notify the school nurse as soon as possible so steps can be taken to avoid an outbreak at school.
Please reinforce with your child the importance of frequent hand washing, covering coughs and using tissues for clearing nasal congestion as a matter of routine health hygiene throughout the year. See the CDC page on Hand Washing
Should my child stay home or go to school?
When making the decision whether or not to send your child to school, please observe the following guidelines:
Fever: Students with a temperature of 100.4 are considered to have a fever. The child may return to school after they been fever free for 24 hours, without the use of fever reducing medication. See the CDC link to treating fever
Diarrhea/Vomiting: A child with diarrhea and/or vomiting should stay at home and return to school only after being symptom free for at least 24 hours. Below are some age dependent considerations for this exclusion criterion:
Young children with gastroenteritis (vomiting and or diarrhea) who are toilet trained should have no vomiting, and enough control of intestinal symptoms not to interfere with staying in class as well as being able to tolerate a near normal diet before they return to school.
A teenager or older child with intestinal symptoms do not need to be excluded if they are able to tolerate a normal diet, have intestinal symptoms which are manageable and they able to function appropriately throughout the day without excessive trips to the bathroom.
Link to information for Parents about Diarrhea
Link to information for Parents about Vomiting
Conjunctivitis (Pink eye): Following a diagnosis of conjunctivitis by a health care practitioner, the child may return to school 24 hours after the first dose of prescribed medicine. See more information about Pink Eye...
Lice: Children who have been treated for lice may return to school. Students must be checked by the school nurse prior to returning to school. Please notify the school nurse if your child has head lice or has been recently treated for head lice prior to returning to school. See the LICE section above.
Rashes: A child with a suspicious rash should return to school only after a health care provider has made a diagnosis and authorized the child’s return to school. Some infectious diseases are most contagious in the early stages and the child may present with a rash. Some rashes are not due to infections and many are not contagious or occur at the end of the illness. See more information about rashes...
Colds/Sore Throats/Cough: Children average 6 to 8 colds a year. If your child is fever free and their cold symptoms are well controlled they may attend school. If your child is experiencing such things as purulent (thick) nasal discharge, or uncontrolled cough you may consider keeping them home until their symptoms are better controlled. If your child is experiencing other signs of illness associated with green nasal discharge including any of the following: fever, earaches, headaches, cough, nasal congestion, productive “barky” cough, persistent cough, please consider having the child seen by your health care provider.
See more information about Colds...
See more information about Cold Sores...
See more information about Coughs...
Guide for returning to school after some common communicable illnesses:
Chicken Pox - When all lesions scabbed over
Scarlet Fever - 24 hours after first dose of medication prescribed by treating practitioner
Strep Throat - 24 hours after first dose of antibiotics
If your child is being treated for an illness (i.e. pneumonia, bronchitis, ear infection, asthma exacerbation), even if they don’t need medication while at school, please let the nurse know so she can help care for your child while at school
The Trumbull Schools Department of Nursing aims to help keep students physically, mentally, and socially able to attend school in order to be educated, participate in athletics, extra-curricular programs, and student activities
The goal of the school nurse is to facilitate keeping the students in school and ready to learn. However, there may be times when students may not feel well enough to be in school. A sick child is less able to learn effectively or to participate in class in a meaningful way. If your child is not feeling well, please exercise your best judgment and do not send him/her to school ill. Keeping your sick child home prevents the spread of illness in our school community and it allows your child to rest and recover.
How to handle a school sick day for parents
Is my child too sick to go to school (kidshealth.org)
Stay or go? When to keep your child home from school (Children's Hospital of Philadelphia)
Zika is a virus transmitted by mosquitoes.
Zika originated in Brazil
Symptoms include a mild fever, skin rash, joint pain and conjunctivitus, notmally lasting 2 - 7 days.
Zika can be passed from a pregnant woman to her fetus. Infection during pregnancy can cause certain birth defects.
There is no vaccine or medicine for Zika.
Prevent transmission by avoiding mosquitoes altogether. Use insect repellent and cover skin with long sleeves.
West Nile Virus was identified in Connecticut in 2000. This virus is caused by mosquitoes. The elderly and those with compromised immune systems are most at risk. You can reduce your risk of being infected with WNV by using insect repellent and wearing protective clothing to prevent mosquito bites. Learn more about West Nile Virus - Fact Sheet from the Centers for Disease Control and Prevention.
Eastern Equine Encephalitis Eirus
Eastern Equine Encephalitis Eirus (EEEV) is transmitted to humans by the bite of an infected mosquito. EEEV is a rare illness in humans, and only a few cases are reported in the United States each year. Most cases occur in the Atlantic and Gulf Coast states See the CDC map.
Most persons infected with EEEV have no apparent illness. Severe cases of EEE (involving encephalitis, an inflammation of the brain) begin with the sudden onset of headache, high fever, chills, and vomiting. The illness may then progress into disorientation, seizures, or coma.
EEE is one of the most severe mosquito-transmitted diseases in the United States with approximately 33% mortality and significant brain damage in most survivors.
There is no specific treatment for EEE; care is based on symptoms. You can reduce your risk of being infected with EEEV by using insect repellent, wearing protective clothing, and staying indoors while mosquitoes are most active. If you think you or a family member may have EEE, it is important to consult your healthcare provider for proper diagnosis.
Pink Eye (Conjunctivitis)
According to KidsHealth.org (2017):
What Are the Signs and Symptoms of Pinkeye?
Besides the telltale red or pink color that gives pinkeye its name, eye discomfort is a common symptom. Kids might say that it feels like there's sand in the eye. Often, there's some discharge from the eye, and pain and swelling of the conjunctiva. Some kids have swollen eyelids or sensitivity to bright light. Pinkeye can affect one or both eyes.
In cases of allergic conjunctivitis, itchiness and watery eyes are common symptoms.
Is Pinkeye Contagious?
Pinkeye is contagious if it's caused by bacteria or a virus:
Pinkeye that's caused by bacteria can spread to others as soon as symptoms appear and for as long as there's discharge from the eye — or until 24 hours after antibiotics are started.
Pinkeye that's caused by a virus is generally contagious before symptoms appear and can remain so as long as the symptoms last.
Allergic conjunctivitis and irritant conjunctivitis are not contagious.
A child can get pinkeye by touching an infected person or something an infected person has touched, such as a used tissue. In the summertime, pinkeye can spread when kids swim in contaminated water or share contaminated towels. It also can spread through coughing and sneezing.
Also, someone who has pinkeye in one eye can spread it to the other eye by rubbing or touching the infected eye, then touching the other eye. Kids Health.org
CDC info on Pink EyePink Eye
See more information preventing the spread of Pink Eye
General Public Health Information & Resources
Town of Trumbull Department of Public Health
State of Connecticut Department of Public Health
FDA Website for Medication Disposal information
Did you know that:
70% of people who abuse prescription pain relievers get them from friends or relatives,
1 in 5 high school students have abused prescription drugs,
EPA studies have detected pharmaceutical drugs in our water supply
Medicines play an important role in treating certain health conditions and diseases, but they must be disposed of with care to avoid harming the environment or others.
Now Available 24/7 in lobby of Trumbull Police Department-158 Edison Road, Trumbull CT
This program is anonymous; no questions are asked or requests for identification will be made by law enforcement personnel. So bring in your expired, unused, or unwanted medication for safe disposal
For more locations go Medreturn
Additional Information about Medication Take Back
National Prescription Drug Take Back Day Information
According to the CDC, almost 1 out of every 3 people in the United States will develop shingles, also known as zoster or herpes zoster, in their lifetime. There are an estimated 1 million cases of shingles each year in this country. Anyone who has recovered from chickenpox may develop shingles; even children can get shingles. However,the risk of shingles increases as you get older. About half of all cases occur in men and women 60 years old or older.
Some people have a greater risk of getting shingles. This includes people who:
have medical conditions that keep their immune systems from working properly, such as certain cancers like leukemia and lymphoma, and human immunodeficiency virus (HIV), and
receive immunosuppressive drugs, such as steroids and drugs that are given after organ transplantation.
People who develop shingles typically have only one episode in their lifetime. However, a person can have a second or even a third episode.
Shingles is caused by the varicella zoster virus (VZV), the same virus that causes chickenpox. After a person recovers from chickenpox, the virus stays dormant (inactive) in the body. For reasons that are not fully known, the virus can reactivate years later, causing shingles. Shingles is not caused by the same virus that causes genital herpes, a sexually transmitted disease.
Signs and Symptoms
Shingles is a painful rash that develops on one side of the face or body. The rash forms blisters that typically scab over in 7 to 10 days and clears up within 2 to 4 weeks. Before the rash develops, people often have pain, itching, or tingling in the area where the rash will develop. This may happen anywhere from 1 to 5 days before the rash appears.
Other symptoms of shingles can include
Most commonly, the rash occurs in a single stripe around either the left or the right side of the body. In other cases, the rash occurs on one side of the face. In rare cases (usually among people with weakened immune systems), the rash may be more widespread and look similar to a chickenpox rash. Shingles can affect the eye and cause loss of vision.
Can shingles be spread to others? Shingles cannot be passed from one person to another. However, the virus that causes shingles, VZV, can be spread from a person with active shingles to a person who has never had chickenpox through direct contact with the rash. The person exposed would develop chickenpox, not shingles. The virus is not spread through sneezing, coughing or casual contact. A person with shingles can spread the disease when the rash is in the blister-phase. Once the rash has developed crusts, the person is no longer contagious. A person is not infectious before blisters appear or with post-herpetic neuralgia (pain after the rash is gone). Shingles is less contagious than chickenpox and the risk of a person with shingles spreading the virus is low if the rash is covered.
If you have shingles:
Until your rash has developed crusts, avoid contact with:
pregnant women who have never had chickenpox or the chickenpox vaccine;
premature or low birth weight infants; and
people with weakened immune systems, such as people receiving immunosuppressive medications or undergoing chemotherapy, organ transplant recipients, and people with human immunodeficiency virus (HIV) infection.
Half of persons living until age 85 years will develop shingles. The only way to reduce the risk of developing shingles and the long-term pain from post-herpetic neuralgia (PHN) is to get vaccinated.
CDC recommends that people aged 60 years and older get one dose of shingles vaccine. Shingles vaccine is available in pharmacies and doctor's offices. Talk with your healthcare professional if you have questions about shingles vaccine.
Important information for school staff who elect to get the vaccine
Tell your health care professional if you will be in close contact with newborn infants, someone who may be pregnant and has not had chickenpox or been vaccinated against chickenpox, or someone who has problems with their immune system.
Your health care professional can tell you what situations you may need to avoid.
You should not get ZOSTAVAX if you are allergic to any of its ingredients, including gelatin or neomycin, have a weakened immune system, take high doses of steroids, or are pregnant or plan to become pregnant.
You should not get ZOSTAVAX to prevent chickenpox.
Several antiviral medicines are currently being used for treatment: acyclovir, valacyclovir, and famciclovir. These medicines will help shorten the length and severity of the illness. To be effective, the medication must be started as soon as possible after the rash appears. People who have or think they might have shingles should call their healthcare provider as soon as possible to discuss treatment options.
Analgesics (pain medicine) may help relieve the pain caused by shingles. Wet compresses, calamine lotion, and colloidal oatmeal baths may help relieve some of the itching. Please consult your primary care practitioner for treatment options.
Link to information page about shingles vaccine
State of Connecticut Department of Public Health Information Sheet on Shingles - pdf
Zostavax shingles vaccine
Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected blacklegged ticks. Typical symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system. Lyme disease is diagnosed based on symptoms, physical findings (e.g., rash), and the possibility of exposure to infected ticks. Laboratory testing is helpful if used correctly and performed with validated methods. Most cases of Lyme disease can be treated successfully with a few weeks of antibiotics. Steps toprevent Lyme disease include using insect repellent, removing ticks promptly, applying pesticides, and reducing tick habitat. The ticks that transmit Lyme disease can occasionally transmit other tickborne diseases as well(CDC.gov, 2016)
Links to more info about lyme disease:
Kidshealth.org information for parents on Lyme Disease
CDC Fact Sheet for Parents "Ticks & Lyme Disease" - pdf
CDC Informational Page on Lyme Disease
CDC Informational Page on Ticks
CT Department of Public Health information about Ticks