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Communicable Disease Response Protocols

Chicken Pox

  1. Diagnosis will be confirmed by a medical provider (exposure, history of disease/vaccine, s/s). 
  2. Treatment/cultures will be utilized at the medical providers discretion. 
  3. Students will be excluded from class until all lesions have crusted over, usually 5-7 days 
  4. With student permission, the Office of Student Affairs and Residential and Commuter Life will be notified to inform professors of absence as well as arrange for contact isolation for the effected student if they cannot go home. 
  5. Student is contagious 1-2 days before lesions appear and until all lesions are healed or crusted over. 
  6. Roommates and close contacts should monitor self closely for signs of chicken pox for 10-21 days after contact. 
  7. Any students concerned about possible chicken pox may be evaluated at the CHW. 
  8. If possible, student will go home until fully recovered.

Screening for Ebola

Ask the student:

  1. Have you traveled to the Liberia, Sierra Leone or Guinea in the last 21 days?
  2. Have you been exposed to body fluids (blood, vomit, sweat, urine, saliva, feces) from an individual infected with Ebola?

If the student answers “NO” to question 1 or 2, then follow normal protocol of an ill student (no Ebola risk).
If the student answers “YES” to question 1 or 2, then ask question 3 of Ebola screening:

Are you experiencing ANY of the following symptoms?  

  • Fever over 100.4 F 
  • Muscle aches 
  • Headache 
  • Diarrhea 
  • Vomiting 
  • Unexplained bleeding 
  • Abdominal pain 
  • Weakness 

If the student answers “yes” to question 3 regarding symptoms, then the screening is considered positive.

If positive screening:

  • Isolate the student from others in a private area and shut door (do not allow student to be around others). 
  • Notify the AD on duty immediately. 
  • The ill student needs to put on mask, gloves and gown located in the Ebola kit. 
  • Anyone who enters the room with the ill student must put on the mask, gown and gloves located in the Ebola kit. 
  • Notify the CHW or Safety and Security of positive screen to verify symptoms and exposure. 
  • Transport to closest Emergency Department (student may drive if able or call 911). 
  • Leave all discarded items, towels, gowns, gloves etc. in the isolated room and close door. Do not enter until properly cleaned by Housekeeping via recommendations by the Columbus Health Department. 

Patient will be transported via squad (911) to closest Emergency Department (Emergency personnel and Emergency Department should be notified of the possible Ebola patient so that appropriate measures can be taken). If the patient is well enough to drive to the hospital, they may do so but the hospital Emergency Department should be notified of arrival.
Emergency Room Telephone Numbers (EMS will determine which hospital to transport patient)

  • OSU Main Campus 614-293-8333
  • OSU East 614-257-3000

If a student is suspected to have Ebola, the CHW will notify the Columbus Public Health Department Report Line at 614-525-8888.

Exposure/Quarantine

  • Any students exposed to an individual with active Ebola must be quarantined for 21 days. 
  • If at all possible, exposed students should go home and be monitored by their local health department. 
  • If unable to return home, students will need placed in an alternate room with personal bathroom facilities. 
  • The Columbus Public Health Department will monitor the individual and check a temperature a least once daily for 21 days. 
  • If the student becomes symptomatic, the student will be transferred to the hospital for treatment. 
  • The Columbus Health Department will then be directly involved with disinfecting of room and disposal of items. 
  • The Columbus Health Department will “clear” the patient after 21 days. 

Influenza Protocol

  1. See communicable disease reporting/Intervention Protocol. 
  2. If Flu A or B is diagnosed via point of care testing or off site testing, treat according to CDC guidelines. 
  3. Determine if the student is able to go home or will remain on campus. 
  4. Roommate should keep a distance of 6 feet from the infected student. 
  5. Roommate should self- monitor symptoms for next 7 days and report to CHW for evaluation if becomes symptomatic (fever, chills, body aches, cough). 
  6. Alert/Email director of the Center for Health and Wellness.
  7. Alert/Email director of Residence Life, as she will notify cleaning facilities if necessary and will arrange for alternative isolation room if ill student remains on campus. 
  8. Alert/Email vice president for Student Affairs , who will email student’s professors stating the student will not be in class until further notice. Professors will work with students to make up work as this is an excused absence. 
  9. Ill students should not return to campus or classes until fever free without fever reducing medication for 24 hours. 
  10. Diagnosed cases will be reported to the Columbus Health Department if the number of cases is excessively high as compared to the number of diagnosed cases in the past. 

Pertussis Protocol

  • See communicable disease reporting/Intervention Protocol 
  • Begin medical treatment according to CDC guidelines (i.e. Azithromycin). 
  • Roommates or close contacts should self-monitor symptoms for next seven days and report to CHW for evaluation if becomes symptomatic. 
  • Alert/Email director of the Center for Health and Wellness. 
  • Alert/Email director of Residence Life, as she will notify cleaning facilities if necessary and will arrange for alternative isolation room if ill student remains on campus. 
  • Ill students will remain off campus or isolated as well as out of classes until five days after onset of antibiotic therapy. 
  • Prophylaxis of asymptomatic close contacts within 21 days of onset of cough and symptomatic contacts should be treated as if they have pertussis and excluded until five full days of antibiotic therapy is completed. 
  • The Director of the Center for Health and Wellness will notify the provost, the vice president for Student Affairs, the director of Media Relations and any designees, that the medical staff at the Center for Health and Wellness has diagnosed a suspected/confirmed case of reportable communicable disease. It will then be determined if and what specific student body will be notified of the diagnosis via email. 

Tuberculosis Screening of International Students

Capital University must comply with certain health requirements for international students attending classes on the residential campus. Screening and targeted testing for tuberculosis (TB) is a key strategy for controlling and preventing infection on campus. Early detection provides an opportunity to promote the health of affected individuals through prompt diagnosis and treatment while preventing potential spread to others.

Who to Screen

International students arriving from countries with an increased incidence of TB should be tested because this subpopulation has been identified epidemiologically as having a higher incidence of LTBI and increase risk for developing active TB disease. While all incoming students should be screened, only those students with identifiable risk factors for exposure to TB and/or TB disease should be tested. Incoming student at low risk should not be tested. Students with a documented previous positive test should not be retested.

Persons at Higher Risk for Exposure to and/or Infection with M. tuberculosis 2

  • Close contacts of persons known or suspected to have active TB disease 
  • Foreign-born persons from areas that have a high incidence of active TB disease (e.g., Africa, Asia, 
  • Eastern Europe, Latin America, and Russia) 
  • Persons who visit areas with a high prevalence of TB disease, especially if visits are frequent or prolonged 
  • Residents and employees of high-risk congregate settings (e.g., correctional facilities, long-term care facilities, and homeless shelters) 
  • Health-care workers who serve clients who are at increased risk for active TB disease 
  • Populations defined locally as having an increased incidence of latent M. tuberculosis infection or active TB disease, possibly including medically underserved, low-income populations, or persons who abuse drugs or alcohol 
  • Infants, children, and adolescents exposed to adults who are at increased risk for latent tuberculosis infection or active TB disease 
  • High-incidence areas are defined as countries with an annual incidence of TB disease of greater than or equal to 20 cases per 100,000 population. Most countries in Africa, Asia, Central America, Eastern Europe, and South America are included in this group. Refer to low and high incidence countries which are identified by the World Health Organization (WHO) Global Health Observatory or access Stop TB Partnership website www.stoptb.org/countries/tbdata.asp

When to Screen and Test

TB screening should occur by questionnaire prior to arrival on campus. TB testing of high risk students only should take place no sooner than 3-6 months prior to college entrance and should be completed by the second semester registration. The testing must occur in the United States.

How to Test

Interferon Gamma Release Assays (IGRA) sensitivity is to that of the Tuberculin Skin Test (TST) in infected persons with culture positive TB and are thought to be more specific than the TST because they do not cross react to the BCG vaccine or to the many commonly encountered non-tuberculous mycobacteria. Examples of IGRA testing include Quantiferon Gold or T-SPOT. Updated 2010 guidelines by the MMWR suggest that IGRAs may be preferred for testing persons who have received BCG and persons unlikely to return for TST testing. 

Students may obtain an order for the Quantiferon Gold testing from the Center for Health and Wellness. Blood work will be performed at The Ohio State University Care Point East outpatient laboratory located at 543 Taylor Ave. Columbus, Ohio 43203 ( 614)-688-6400. Students must provide photo ID and insurance card at this time. No appointment is necessary. Results will be sent to the Center for Health and Wellness from the laboratory and students will be notified of results by a medical provider.

What to do When the TST or IGRA is Positive

See ACHA Guidelines -Tuberculosis Screening and Targeted Testing of College and University Students
If the student has already had a TB test (or treatment), they may provide the following documentation in ENGLISH

  • Negative Quantiferon Gold or T-SPOT test within the last year 
  • Positive Quantiferon Gold test or T-SPOT test AND normal chest xray report within the last year (report only, film is not necessary) 
  • Completed treatment report for active or inactive TB 
  • TB skin test (PPD), Tine test, or Chest xray only are not acceptable

References

CDC. Controlling Tuberculosis in the United States: Recommendations from the American Thoracic Society, CDC, and the Infectious Diseases Society of America. MMRW November 2005; 54
Centers for Disease Control and Prevention (CDC), Division of Tuberculosis Elimination. Core Curriculum on Tuberculosis: What the Clinician Should Know: Chapter 1, Table 1.3 Persons at higher Risk for Exposure to and /or Infection with M. Tuberculosis. 5th edition (2011).http://www.cdc.gov/tb/education/corecurr/pdf/chapter1.pdf. Accessed May 9, 2013
Updated Guidelines for Using Interferon Gamma Release Assays to Detect Mycobactrium tuberculosis Infection-United States, 2010. MMWR 2010;59 (RR-5); 1-25
American College Health Association (2012) Tuberculosis Screening and Targeted Testing of College and University Students.

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