School Nursing Services

COMMUNICABLE DISEASES

In order to prevent the spread of a communicable disease, it is advisable to keep a child home from school when he/she shows any of the symptoms listed:

• Unusual skin eruptions 

• Fever

• Chills

• Persistent cough

• Symptoms of whooping cough 

• Discharge or redness of eye(s) 

• A student absent from school because of the condition listed below may not return to school before the specified time period has passed.

• CHICKEN POX (VARICELLA) - - 5 days from the appearance of the first crop of vesicles, or when all the lesions have dried and crusted, whichever is sooner
• DIPHTHERIA - - 2 weeks from the onset or until appropriate negative culture tests
• HEAD LICE - - If the school nurse detects head lice on a student, the parents/guardians will be contacted immediately and the student will be excluded from school and riding the bus until they have received proper treatment and are deemed non-contagious by the school nurse. (See Head Lice )
• H. FLU (HAEMOPHILUS INFLUENZA) - - Until made noninfective by appropriate course of antibiotic and/or determined noninfective Medical provider
• IMPETIGO - - 24 hours after the institution of appropriate treatment
• LICE (BODY) - - After completion of appropriate treatment and judged non-infectious by physician or school nurse
• MEASLES - - 4 days from the onset of rash
• MENINGOCOCCAL MENINGITIS OR MENINGOCOCCEMIA - - Until made noninfectious by appropriate course of antibiotic and/or determined noninfectious by a medical provider
• MUMPS - - 9 days from the onset or until subsidence of swelling
• PINK EYE - - 24 hours after medication is started or until judged not infective (without a discharge)
• RINGWORM (all types) - - Until judged non-infectious by physician or school nurse which is usually immediately after the first treatment, if body lesions are covered. Neither scalp nor body lesions that are dried need to be covered
• RUBELLA/GERMAN MEASLES - - 4 days from the onset of rash
• SCABIES - - After completion of appropriate treatment and judged non-infectious by physician or school nurse
• SCARLET FEVER (RESPIRATORY STREP) - - At least 10 days from the onset if no physician is in attendance or 24 hours after medication is started
• SHINGLES (HERPES ZOSTER) - - 5 days from the appearance of the first crop of vesicles, or when all the lesions have dried and crusted, whichever is sooner
• STAPH INFECTIONS (including Mellicillin Resistant Staphlococcus Aureus MRSA) - - may attend school as long as lesion is covered with clean, dry bandage. Follow your healthcare provider ’s instructions on proper care of the wound. Pus from infected wounds can contain staph and MRSA, so keeping the infection covered will help prevent the spread to others. Bandages or tape can be discarded with the regular trash.
• TUBERCULOSIS - - May return to school when deemed non-contagious by a physician
• WHOOPING COUGH (PERTUSSIS) - - 3 weeks from the onset or 5 days from start of appropriate antimicrobial therapy.

A child with Head Lice (pediculosis capitis) will immediately be excluded from school. Head lice procedures can be found below or from the school nurse.

PROCEDURE:

• Parents will be promptly contacted and requested to pick up the student at school. 

• The child must have one adequate treatment with a pediculicide shampoo plus nit removal on the day they are sent home from school. 

• The parent/guardian will be advised that they can either obtain a non-prescription, a prescription pediculicide shampoo, or other approved method(s) as directed by their physician. The nurse may require that parents present a box top from the pediculicide shampoo upon re-admittance. 

• If the infested student has school-age siblings that attend Northeastern School District, the building school nurse will screen these children for head lice. If the sibling attends another school, the school nurse will be notified.

• Following the day of the exclusion, the child may be readmitted to school if he/she is judged non-infested by the school nurse. A parent or parent designee must bring the child to the nurse’s office with a note describing treatment. The child is not to ride the school bus or attend class until cleared for readmission by the school nurse.

Prevention and control of head lice begins in the home: parents should routinely check their children for head lice and not allow them to share hats, clothing, brushes, combs or sleeping bags with other children. Parents/guardians are to contact the school if their child is found to have head lice so the school nurse can discuss proper treatment to allow the student to return to school.

ILLNESS AND INJURY AT SCHOOL

Students who become ill or injured during the school day need to make an appointment and get a pass from their teacher to go to the health room. The school nurse will evaluate the concerns of students and provide services as needed. Parents will be notified by the school nurse in the event of any illness or injury that may require outside medical attention or if students are being sent home due to illness/injury. Students should not use their cell phone to call or text message a parent during the school day related to their illness or injury, they need to report to the health room. To be sent home by the school nurse due to illness or injury, the child needs to first be evaluated by the school nurse.

Occasionally, it may be necessary for a student to remain home from school due to illness. The following guidelines should be followed when determining if he/she should stay at home.

• Following a nighttime vomiting, diarrhea or fever; student should stay at home and be watched for further symptoms. Fever is defined as a temperature 100° or above without the use of fever-reducing medication. The student’s temperature should remain normal without the use of fever-reducing medication for 24 hours prior to returning to school.
• It is also advisable for the student to stay home from school if any of the following symptoms are exhibited: unusual skin eruptions, chills, discharge or redness of eye(s), or persistent cough.
• A student should not be sent to school to be evaluated by the school nurse with an illness or injury that occurred at home. Any serious illness or injury occurring at home must be evaluated by the student’s healthcare provider.

A certified school nurse or a staff nurse supervise health services. Nurse are available during school hours to handle the routine administration of medication and medical emergencies.

Required Exams for Entry

The intent of immunization regulations is to keep children healthy and in school. 28 Pa.Code, Chapter 23, Subchapter C requires all children in any grade, kindergarten through 12th, including all public, private, parochial, intermediate unit, and home schooled students, show proof of immunization before they can attend school in the Commonwealth.

The certified school nurse is required to ensure all students’ immunizations are in compliance with 28 Pa. Code, Chapter 23, Subchapter C in regard to minimum requirements, scheduling, and proper spacing between immunization doses.

Immunization Compliance

PA Immunization Regulations require additional immunizations for attendance in all grades K-12. (please click Here for parent flyer noting new requirements) 

Current regulations now require:

• 4 doses of tetanus, diphtheria and acellular pertussis(1 dose on or after the 4th birthday)

• 4 doses of polio (4th dose on or after the 4th birthday and at least 6 months after previous dose given)

• 2 doses measles, mumps, rubella (usually given at MMR)

• 3 doses of hepatitis B

• 2 doses of varicella (chickenpox) or evidence of immunity

 For attendance in 7th grade:

Children entering 7th grade will be expected to have the required Tdap dose at 11-12 years of age. Those not meeting this immunization schedule will risk exclusion from attending school. Proof must be provided by the first day of school:

• 1 dose of tetanus, diphtheria and pertussis (Dose must be given at 11-12 years of age)

• 1 dose of meningococcal conjugate vaccine

For attendance in 12th grade:

• 1 dose of meningococcal conjugate vaccine

All students must meet the Pennsylvania School Immunization Regulation and Schedule.  If these requirements are not met, your child in grades K-6 must receive the immunization(s) within the first 5 days of school or risk exclusion (except where noted differently). If the next dose is not the final dose of the series, the child must also provide a medical certificate/plan (see link below) signed by your physician within the first five days of school for obtaining the required immunizations or risk exclusion. Your child in grades 7-12 must have one dose of the required immunization(s) on the first day of school or risk exclusion. Please provide an updated immunization record to the school nurse with the completed immunizations. 

The only exceptions to the school laws for immunization are as follows: medical reasons and religious beliefs. If your child is exempt from immunizations, your child may be removed from school for up to 21 days during a disease outbreak.

• Medical exemption. Children are exempt if a physician or the physician's designee provides a written statement that immunizations may be detrimental to the health of the child. When the physician determines that the immunization is no longer detrimental to the health of the child, the child shall be immunized according to 28 Pa. Code, Chapter 23, Subchapter C.
• Religious/moral exemption. Children are exempt if the parent, guardian or emancipated child objects in writing to the immunization on religious grounds or on the basis of a strong moral or ethical conviction similar to a religious belief. 

 Keep a record of your child’s immunizations. Provide a copy of your child's record, keep the original record in a safe place. Your doctor’s office, medical clinic, or hospital may ask for this record. As your children become adults, they may need the record for college, for their job or if they travel out of the country.

If you have questions about the new immunization requirements, please contact your health care provider or the York County Department of Health at (717)771-4505. 

Dental Exams- Grades K, 3, and 7

Private Dentist Report

Physical Exams- Grades K, 6, and 11

Phsyical Exam Form

Pennsylvania Tick Policy

In Pennsylvania,  Act 120 of 2024 mandates that school entities remove ticks found on students, notify parents in writing, and provide information on Lyme disease, while also allowing parents to send the tick for testing.

Health Room Tick Removal Reporting Form