Information for Schools and Child Care Providers


        Individual cases of influenza or influenza-like illness are not reportable unless the influenza case is hospitalized in the intensive care unit and/or dies.

        *List of high risk conditions for influenza is included in "Recommendations for Schools...." below.

        Template Letters for School Parents

        Influenza Resources

        Viral Gastroenteritis (including Norovirus)

        Gastroenteritis means inflammation of the stomach and small and large intestines. Viral gastroenteritis is an infection caused by a variety of viruses that results in vomiting or diarrhea.
        It is often called the "stomach flu," although it is not caused by influenza viruses.

        Physicians / Health Care Providers


        All suspect and confirmed pertussis cases are reportable to the health department within one (1) working day. Even during an outbreak, complete information on each individual case must be reported.

        * High-risk conditions for pertussis include infants less than one year of age, pregnant women, persons with chronic lung conditions (including asthma) or immunocompromise, un- and under-vaccinated persons, household contacts of infants or pregnant women in the third trimester, childcare providers, and persons who work with infants or pregnant/postpartum women.

        Alert to Schools - AB354 - New Pertussis Booster Vaccine Requirement

        More information on AB354 and the SB614 grace period is available on the Shots for Schools website.

        Template Letters for Daycare – Pertussis

        Schools and daycares may use the template letters below for children with pertussis. Note that children in daycares are to be excluded for 5 days after antibiotics are begun, while children in Kindergarten through Grade 12 are to be excluded for 3 days after the start of antibiotics.

        Template Letters for Schools – Pertussis

        Pertussis Resources

        Chickenpox (Varicella)

        Individual cases of chickenpox are not reportable unless the case is hospitalized or dies.

        *High risk conditions for chickenpox include immunocompromise and pregnancy.

        Recommendations for Schools with Suspect or Confirmed Chickenpox Cases: The identification of a single case of varicella should trigger intervention measures to prevent an outbreak. If still infectious, the case should be excluded or isolated from the school immediately. Next, a notification letter can be sent to those that may have been exposed to the case. The letter could be sent home with the children in the same classroom as the case. However, how broadly to distribute the notification letter for a single case may vary depending on the specific situation.

        For schools with ≥3 chickenpox cases in 2 months, call HCA Epidemiology at 714-834-8180 and ask to speak to a PHN.

        Template Letters for School Parents

        Chickenpox (Varicella) Resources

        Reporting of increased absenteeism, outbreaks or clusters at K-12 schools

        Note: This mechanism of reporting is for increased absenteeism, outbreaks or clusters due to non-specific respiratory, influenza-like illnesses (ILI), or gastrointestinal (GI) illnesses. It is NOT to be used for diseases that are reportable as individual cases (e.g., pertussis, meningitis). These reportable diseases should be reported to Epidemiology as required using the methods and time frames specified on the reportable disease list. To report suspect chickenpox illnesses, see above under Chickenpox. For all other outbreaks or clusters, call Epidemiology at 714-834-8180.

        Please call Epidemiology immediately at 714-834-8180 if a large number of students in affected classroom(s) or other exposed group(s) are high risk students. In general, high risk conditions include immunocompromise and pregnancy but may also include other underlying diseases. See specific illnesses (e.g., influenza) for a list of high risk conditions by illness type.*

        Please use the following criteria to report respiratory or gastrointestinal (GI) illnesses:

        1. At least 10% of average daily attendance is absent, OR

        2. 20% of classroom or group ill with similar symptoms, with a minimum of 5 ill.

          (Example of increase in absenteeism: Average daily attendance may already be calculated for your school. If not, you can approximate on your own for reporting increases. For school with 1000 kids; if absenteeism is usually 15%, or 150 absent each day, baseline attendance would be 850 (1000 minus 150). An additional 10% of 850, or 85 students, would need to be absent to meet this increase in absenteeism criteria).

        To report unusual absenteeism or increase in respiratory or GI illness OR to report clusters of respiratory or GI illness, complete the following:

        1. On-line Intake Form for School Absenteeism Reporting* OR School Cluster Reporting*

        2. Line List (Word Form)

        3. Weekly Updates (PDF Form; Word Form) to monitor activity until back to baseline for one week

        *If unable to complete on-line, please print and fax Intake Form (PDF Form; Word Form) for initial notification (both increased absenteeism or clusters) to 714-564-4050.

        Please notify Epidemiology immediately by phone at 714-834-8180 of any hospitalizations or deaths.

        Hand, Foot, and Mouth Disease

        Orange County Public Health has had multiple reports of clusters of hand, foot, and mouth (HFM) disease in Orange County schools. HFM is caused by enterovirus, a common virus that most children are exposed to in childhood. HFM infection is characterized by a rash on the hands, feet and inside of the mouth. Fever and sore throat often accompany the rash. Almost all HFM infection in children are mild, though severe illness is seen occasionally. The most important treatment is assuring that an infected child does not become dehydrated. For more information, please visit Schools with multiple cases can utilize this letter

        Additional Information for Child Care Providers

        In case of a public health or bioterrorism emergency, Orange County Public Health would like to be able to reach child care providers with critical information through "Blast Faxes" or email distribution lists.

        Please provide your contact information through the following link:  This information will only be used to contact you with public health alerts and notifications.  Additional Resources for Child Care Providers about Influenza:

        Page Last Updated: December 10, 2019