Management of Prescribed Contagious Conditions

Version Number

5.0

Implementation Date

29/04/2015

Scope

All state schools

Purpose

This procedure outlines the responsibilities for the management of prescribed contagious conditions in accordance with the requirements of the Public Health Act 2005 (Qld) and the Public Health Regulation 2005 (Qld).​

Overview

Chapter 5 of the Public Health Act 2005 (Qld) aims to protect children by helping to control the spread of prescribed contagious conditions in schools.

Although there are many infectious diseases that are contagious and require a period of removal (or time out) from school to prevent their spread, not all diseases are covered by the Public Health Act 2005 (Qld). The responsibilities outlined below apply only to the specific conditions which are p​rescribed under the Public Health Act 2005 (Qld). The list of prescribed conditions may change from time to time and it is important to consult with the closest Public Health Unit (PHU) within Queensland Health if concerns are raised by the school community.

If a suspected outbreak of a contagious condition takes place within a school, it is vital that steps are taken by the principal and school staff to protect the health of the school community in a timely manner.

Some medical conditions require a period of removal from school to prevent the spread of infectious diseases among staff and students. A period of removal could apply to either the person with the infection and/or a person exposed to someone with the infection. Queensland Health recommends minimum periods of removal for infectious conditions in the Time Out poster.

The Minister for Health in consultation with the Minister for Education can order the closure of a school for up to one month if the Minister for Health is satisfied that:

  • there is an outbreak of a contagious condition at a school or in the community that puts the staff and students at significant risk; and
  • methods of controlling the outbreak will not be effective without temporarily closing the school. 

Responsibilities

​The principal is responsible for facilitating the management of prescribed contagious conditions within a school in accordance with the requirements of the Public Health Act 2005 (Qld) and the Public Health Regulation 2005 (Qld).

Principals are required to comply with directions given by the PHU including those about school attendance, information sharing and other actions to control contagious conditions e.g. the temporary closure of a school.

Process

Regional Directors (or Regional contact officer):
Out of school/office hours or incidents requiring regional office assistance

  • ​Facilitate contact between the PHU and Principals or regional contact officer by:
    • providing emergency contact information for principals and regional contact officers when requested by a PHU
    • providing the PHU with emergency contacts for relevant school staff and student contact information if requested to fulfil disclosure of information obligations under the Public Health Act 2005  
    • communicating requirements as may be requested by the PHU to the principal of the school where a student/staff member has been diagnosed with a prescribed contagious condition to fulfil public health obligations under the Public Health Act 2005. 

Principals: 

Infection control for all contagious conditions
  • implement local standard infection control practices in Infection Control procedure.
Actions for suspected prescribed contagious conditions 
  • ​If there is a reasonable suspicion that a student attending the school may have a prescribed contagious condition and other students may be at risk of contracting the condition:
    • contact the local PHU for general advice on the prescribed contagious condition and strategies to manage the condition, e.g. communication to school community
    • advise the parent of the student of the suspected prescribed contagious condition to seek medical advice, providing this advice in writing (unless it is not practicable to do so)
    • notify the parent, in writing (unless not practicable to do so), of their legal obligation to observe the prescribed period of removal from school if the student’s condition is medically confirmed
    • keep written records of all advice given and received regarding contagious conditions
    • if the student continues to attend the school or the parent advises that they still intend to send the student to school, seek advice from the PHU to determine if the parent should be directed to remove the student from school and not send them to school during the prescribed period (s.164(3) Public Health Act 2005 (Qld))
    • if advised by the PHMO or another person authorised by Queensland Health, direct the parent to remove the student from school and not to send the student to school during the prescribed period by using the completed Direction to parent not to send child to school letter
    • take reasonable steps to allow the student subject to a direction to not attend school to access an educational program for the period of removal.
  • Refer to the Exemptions for Compulsory Schooling and Compulsory Participation procedure for information about exemptions when a student is subject to a direction to not attend school.
Specific actions for prescribed vaccine-preventable conditions (currently limited to measles) 
  • If there is a reasonable suspicion that a student attending the school may have a prescribed vaccine-preventable condition:
    • ​contact the PHU to determine the information to communicate to staff, parents and school community
    • provide the PHU with class lists of students enrolled at the school, if requested, to assist them to identify which students are unvaccinated 
    • if the PHU has identified unvaccinated students attending the school, advise the unvaccinated student's parent using the completed Direction to parent of unvaccinated child letter
    • keep a written record regarding all advice given and received regarding management of the prescribed vaccine-preventable condition 
    • if the unvaccinated student continues to attend the school or the parent advises that they still intend to send the student to school, seek advice from the PHU to determine if the student needs to be removed from the school setting for their own health and safety (s.166(3) Public Health Act 2005 (Qld))
    • take reasonable steps to allow the student subject to a direction to not attend school to access an educational program for the period of removal.
Allowing a student to return to school before the end of the prescribed period 
  • ​allow a student to return to school if the student has a medical practitioner's certificate stating that:
    • ​the student does not have a contagious condition, or
    • the prescribed period of time out of school has ended
  • ​allow an unvaccinated student to return to school if satisfied, on reasonable grounds, that the student is no longer at risk of contracting the condition
  • allow a student to return to school on direction of the PHMO.
Disclosure of information to Queensland Health
  • the Education (General Provisions) Act 2006 (Qld) (EGPA) allows information to be shared with another party e.g. Queensland Health, when required to do so by another Act e.g. Public Health Act 2005
  • if requested, provide the PHMO with the following information:
    • ​the amount of contact a particular student suspected of having a contagious condition has had with other students at the school
    • names of all students suspected of having had contact with the person who has contracted the contagious condition
    • places and dates of birth and home addresses of all these students
    • contact details of a parent for each student to enable the PHU to confirm the vaccination status of the student and/or to provide public health advice.
Enabling a medical examination of students to be conducted at school 
  • ​allow the PHMO to conduct medical examinations at the school (see PHMO process below) when: 
    • ​appropriate details have been provided by the PHMO to the school and to the parents 
    • parent permissions have been obtained.
Specific actions for temporary school closure
  • ​comply with all written notices made by the Minister for Health, in consultation with the Minister for Education, to close the school in the interests of public health.

Staff:

  • ​refer to Communicable Diseases Fact Sheets for symptoms of contagious conditions
  • refer to Time Out​ poster for periods of removal from school 
  • refer to the Roll Marking in State Schools procedure for detail about absence codes while a student is subject to a direction to not attend school
  • advise the principal if it is known or reasonably suspected that a student may have a contagious condition
  • communicate, promote and follow standard infection control practices 
  • preserve privacy and confidentiality of information and documentation about a student and his/her family regarding suspected/confirmed contagious conditions
  • do not attend the workplace if you know or reasonably suspect that you may have a contagious condition and follow advice as per the Infection Control procedure
  • refer to Queensland Health contagious conditions fact sheet and Public Health Act 2005 fact sheet for further information about the legal framework for prescribed contagious conditions. 

Public health medical officer (PHMO):

  • ​provide relevant information to the principal if satisfied that:
    • ​a student attending the school is suspected of having a vaccine-preventable condition
    • another student attending the school has had contact with the student
    • the information about the second student is necessary for the principal to discharge responsibilities outlined in this procedure.
When conducting a medical examination of students at school:
  • ​provide written notice to the principal of:
    • ​the date and time of the examination
    • the contagious condition for which examinations are to be conducted
    • the students, or class of students, to be examined
    • the name and contact details of doctor who is to conduct the examinations.
  • ​advise the parent of the student:
    • the date and time of the examination
    • the contagious condition for which examinations are to be conducted
    • the name and contact details of the doctor who is to conduct the examinations
    • that the student's parent may be present
    • that the examination cannot take place without the consent of the parent
    • alternatively, that a parent can have a student examined by another doctor and provide a medical certificate to the principal stating whether the student has the contagious condition and if so, whether the recommended period of removal from school has ended
    • that a parent may be directed to remove a student from school, and not send the student to school if the student has not been examined by a doctor, or the examination reveals that the student has, or may have, a contagious condition.
When providing directions to principals: 
  • ​give the direction in writing (unless it is not practicable to do so)
  • instruct the principal to direct a parent to remove a student from, and not send the student to, school for the prescribed period of time out of school for the contagious condition if:
    • ​a doctor has examined the student and has advised the PHU that the student has, or may have, a contagious condition and the prescribed period for the condition has not ended
    • the parent of the student has been advised that the student should be examined by a doctor arranged by the PHU (or by another doctor chosen by the parent) to obtain a certificate stating that the child does not have the contagious condition or the prescribed period for the condition has ended
    • the PHMO reasonably suspects that the student has, or may have, a contagious condition and the prescribed period for the condition has not ended
    • the PHMO reasonably suspects that a child attending the school has not been vaccinated for a vaccine preventable condition and will be at risk of contracting the condition if the child continues to attend the school
  • ​instruct the principal to direct a parent to: 
    • ​remove an unvaccinated student from the school
    • not send an unvaccinated student to school for the prescribed period of removal from of school for the contagious condition
  • ​direct the principal to minimise the risk of the condition spreading if satisfied there is an outbreak of a contagious condition at a school, for example, by:
    • ​not sharing eating utensils, cups, clothing, bed linen 
    • disinfecting the above
    • requiring procedures for cleaning and disinfecting be followed
    • requiring the principal to give information to staff, students and parents about the condition including the way it may be treated and measures to reduce its spread.
Out of school/office hours or incidents requiring regional office assistance:
  • ​contact the Regional Director to advise of public health issue affecting a school in their region
  • request relevant school staff and student contact information from the Regional Director (or regional contact officer where the Regional Director is unavailable) to fulfil public health obligations under the Public Health Act 2005.

Online Resources

Review Date

29/04/2017
Attribution CC BY

Direction
A written or verbal instruction given by a person who is recognised under the Public Health Act 2005 as a person with authority to provide the direction e.g. a Queensland Health public health medical officer.

Prescribed contagious condition
A medical condition that has been prescribed under the Public Health Regulation 2005, Schedule 2A, Part 1 because it is considered to be a serious condition that may put the community at some risk. The currently prescribed contagious conditions within the Regulation are – diphtheria, enterovirus 71 neurological disease, gastroenteritis, haemophilus influenza type b, hepatitis A, human influenza with pandemic potential, measles, meningococcal infection (invasive), paratyphoid, pertussis (whooping cough), poliomyelitis, rubella, tuberculosis, typhoid, varicella – zoster virus infection (chickenpox).

Prescribed period
Queensland Health’s recommended minimum period of removal from school for children with a prescribed contagious condition, or for unvaccinated children at risk because they may be in contact with a child with a prescribed vaccine-preventable condition.

Prescribed vaccine-preventable condition
A contagious condition identified in the Public Health Regulation 2005, Schedule 2A, Part 2. Measles is currently the only prescribed vaccine-preventable contagious condition.

Public health medical officer (PHMO)
For the purpose of this procedure, a PHMO is a doctor or a nurse, working in a Public Health Unit or the Communicable Diseases Unit who has delegated authority from the chief executive, Queensland Health, to discharge duties of the Public Health Act 2005 (Qld) related to this procedure.

Public Health Units within Queensland Health
Public Health Units (PHU) focus on protecting health; preventing disease and outbreaks, illness and injury; and promoting health and wellbeing at a population or whole of community level. They are located within various Hospital and Health Services across the state. Key activities for Public Health Units include: disease control, environmental health, public health programs, immunisation and vaccination programs.

Regional contact officer
For the purpose of this procedure, a regional contact officer is a regional office staff member, determined by the Regional Director, who may be contacted out of office hours to assist the public health medical officer with urgent public health communications to the principals of affected schools to fulfil public health obligations under the Public Health Act 2005.