Student Health Concerns

Head lice are a common concern in school communities and are spread primarily through direct head-to-head contact during routine student interactions and activities. While they can cause discomfort and frustration for students and families, head lice do not spread disease and are not considered a medical danger.

Because head lice can spread easily in close-contact environments such as schools, they often result in questions about exclusion, treatment, and when students can safely remain in school. This guidance is intended to clearly outline both public health recommendations and Fairbanks North Star Borough School District protocols to ensure consistency across schools while supporting student health, dignity, and instructional time.

Public Health Guidance vs. District Protocol

National public health organizations, including the Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics (AAP), and the National Association of School Nurses (NASN), provide guidance that helps inform best practices in school settings.

To clarify how this guidance compares with district practice, the information below outlines both perspectives.

National Public Health Guidance (CDC, AAP, NASN)	Fairbanks North Star Borough School District Protocol
Head lice are a nuisance condition, not a disease.	The District recognizes head lice as a common school health concern requiring consistent management.
Students do not need to be sent home early for head lice.	Students identified with live head lice will be excluded from school until treatment is completed and no live lice are present.
“No-nit” policies are not recommended. Nits alone are not a reason for exclusion.	Students with nits only may remain in school and continue attending classes.
Emphasis is placed on minimizing missed instructional time.	Emphasis is placed on reducing live lice transmission while maintaining consistent school expectations across all sites.

District Protocol

Live Lice: Stay Home. Nits Only: Stay in School.

Students with live head lice will be excluded from school and may return after treatment is completed and no live lice are present.
Students with nits only may remain in school.
Families are encouraged to complete full treatment and nit removal to reduce reinfestation.
Health Services staff may recheck students upon return as needed.

School Screening Practices

Routine classroom-wide or school-wide head lice screenings are not conducted by the District.

According to guidance from the Centers for Disease Control and Prevention (CDC), mass screening programs for head lice are not recommended because they are not effective in reducing transmission and may result in unnecessary missed instructional time.

The National Association of School Nurses (NASN) also supports limiting exclusion to active infestations and discourages routine mass screening practices.

In addition, large-scale screenings can have unintended emotional and social impacts on students, including embarrassment, anxiety, stigma, or being singled out in front of peers. The District is committed to protecting student dignity and maintaining a respectful, supportive school environment.

Health Services staff may assess individual students when concerns or symptoms are identified, or when there is a known exposure or concern.

This approach supports a trauma-informed, student-centered practice that prioritizes both student health and emotional well-being while maintaining a safe and respectful learning environment for all students.

What Families Can Do

Families can help prevent the spread of head lice by:

Checking their child's hair and scalp regularly
Avoiding head-to-head contact during play and activities
Not sharing hats, helmets, hair accessories, combs, brushes, or other personal items
Promptly treating any active infestation and following treatment instructions carefully
Completing recommended follow-up steps to prevent reinfestation

Additional Resources

Website Resources

FNSBSD Head Lice Management Protocol PDF
Centers for Disease Control and Prevention (CDC): LINK
American Academy of Pediatrics (AAP): LINK
National Association of School Nurses (NASN): LINK

Handouts

Head Lice 101, What You Should Know About Head Lice PDF
EEK! My Kid Has Head Lice! (Printable Checklist)

Videos

Video - How to Spot and Treat Head Lice (nits)
Video - How to Comb Out Lice Eggs
Video - How to Clean Your House After Lice Tutorial
Video - 10 Facts You Don't Want to Know about Head Lice!

If you have questions regarding head lice identification, treatment, or return-to-school requirements, please contact your school's Health Office.

Bed Bugs

The Fairbanks North Star Borough School District is committed to managing bed bug concerns in a way that protects student health, preserves dignity, and minimizes unnecessary loss of instructional time.

Understanding Bed Bugs

Bed bugs are small insects that feed on human blood, most often at night. While their bites can cause itching or skin irritation, bed bugs are not known to spread disease.

Bed bugs are not a sign of poor hygiene and can be found in any home or community setting. They are hitchhiking pests and are typically introduced into schools through personal belongings such as backpacks, clothing, coats, or bedding items.

Unlike head lice, bed bugs do not live on the human body or in hair. They do not spread from person to person through casual contact.

Public Health Guidance vs. District Protocol

National public health organizations, including the Centers for Disease Control and Prevention (CDC), and Alaska public health guidance recognize bed bugs as a pest concern rather than a public health threat. Management focuses on identification, containment, and environmental control rather than exclusion from school.

To clarify how this guidance compares with district practice, the information below outlines both perspectives.

Public Health Guidance (CDC / Alaska DOH)	Fairbanks North Star Borough School District Protocol
Bed bugs are a pest concern, not a disease risk.	The District recognizes bed bugs as an environmental concern requiring appropriate response and communication.
Bed bugs do not require school exclusion.	Students are not excluded from school due to bed bugs or bites alone.
Focus is on identification and home/environmental treatment.	Focus is on discreet identification, family communication, and prevention of spread through belongings.
Schools should avoid alarm, disruption, and stigma.	The District prioritizes student dignity, confidentiality, and minimizing unnecessary concern while maintaining a safe and respectful learning environment.

District Protocol

Students will not be excluded from school due to bed bugs or suspected exposure.
When bed bugs are suspected or identified, Health Services staff will complete an individual assessment in a calm and discreet manner.
Large-scale screening or classroom-wide disruption is not conducted in alignment with NASN and CDC recommendations.
When concerns are identified, staff may complete a discreet assessment of personal belongings when appropriate, using minimal handling and prioritizing student privacy.
Families may be contacted to support home-based evaluation and treatment when needed.
When environmental follow-up is necessary, custodial services or district maintenance staff may be engaged.
All responses prioritize student dignity, confidentiality, and continuity of learning.

School Response Practices

Bed bug concerns are managed in a calm, discreet, and supportive manner to avoid unnecessary disruption or stigma.

When concerns arise, Health Services staff will complete an individual assessment and determine appropriate next steps in collaboration with school administration as needed.

If bed bugs are suspected in personal belongings, the response will focus on discreet review and supportive guidance, with minimal handling and maximum respect for student privacy. Families may be contacted to assist with home-based evaluation and treatment when appropriate.

When environmental follow-up is needed, custodial services or district maintenance staff may be engaged to assess and address concerns.

All responses prioritize student dignity, confidentiality, and minimizing unnecessary concern while maintaining a safe and respectful learning environment for all students.

What Families Can Do

Families can help prevent and manage bed bug concerns by:

Inspecting clothing, backpacks, and personal items regularly
Avoiding bringing bedding or soft furniture items to school
Washing and drying clothing on high heat when exposure is suspected
Communicating promptly with the school if bed bugs are identified at home
Following guidance from pest management professionals when applicable

Additional Resources

Website Resources

FNSBSD Bed Bug Management Protocol PDF
Centers for Disease Control and Prevention (CDC) - LINK
State of Alaska, Dept of Health, Bed Bugs - LINK
US Environmental Protection Agency, Bed Bugs and Schools - LINK

Handouts

Bed Bugs in Schools, Guidance for Parents PDF
DIY Bed Bug Management PDF
BEDBUGS! PDF

Videos

Video - Bed Bugs, National Geographic
Video - Bed Bugs- What You've Been Told is Totally False

If you have questions regarding bed bugs, exposure concerns or school procedures, please contact your school's Health Office

Respiratory Illness

The Fairbanks North Star Borough School District is committed to a coordinated approach to respiratory illness management that prioritizes student health and maintains a safe, healthy school environment.

Common Symptoms

Respiratory illnesses such as COVID-19, influenza (flu), and Respiratory Syncytial Virus (RSV) are common in school settings and can spread easily when people are in close contact indoors. These illnesses often share similar symptoms and are typically managed with rest, fluids, and supportive care at home.

Common Symptoms

Symptoms may include:

Fever or chills
Cough
Sore throat
Runny or stuffy nose
Fatigue
Headache
Muscle or body aches
Decreased appetite
Nausea, vomiting, or diarrhea (more common in children)

Because symptoms overlap, it can be difficult to tell which virus is causing illness without testing. Families are encouraged to focus on symptom care, monitoring, and keeping children home when sick.

Caring for Your Child at Home

Most respiratory illnesses improve with supportive care. Families can help by:

Encouraging rest and increased fluids
Using fever-reducing medication as directed by a healthcare provider
Monitoring symptoms closely
Seeking medical care if symptoms worsen or are severe
Keeping children home when they are not well enough to participate in learning

When to Stay Home

Returning to School

Prevention

Additional Resources

Website Resources

Alaska Department of Health – Respiratory Illness Information - LINK
Alaska Department of Health – Influenza (Flu) - LINK
Alaska Department of Health – RSV Guidance - LINK
Cure&Cure Pediatrics - LINK
Centers for Disease Control and Prevention (CDC) – Respiratory Viruses - LINK

Handouts

How can I keep from getting sick with a respiratory illness this season? PDF
IS IT ASTHMA, ALLERGIES, A COLD, COVID-19, THE FLU, OR RSV? PDF

Videos

Families are encouraged to contact their healthcare provider or school health office with specific questions about symptoms or return-to-school decisions.

Infectious Diseases

What are Infectious Diseases

What are Infectious Diseases

Infectious Diseases

Healthy Students. Bright Futures.

Infectious diseases are illnesses caused by viruses, bacteria, fungi, or parasites that can spread from person to person. Because students learn, play, eat, and interact closely throughout the school day, schools can be environments where communicable illnesses spread more easily.

The Health Services Department works to support healthy school communities by monitoring illness trends, promoting prevention strategies, providing health education, and responding to communicable disease concerns in partnership with families, healthcare providers, and public health agencies.

Many infectious diseases are mild and resolve with routine care at home. Others may require exclusion from school, medical evaluation, or public health follow-up to help prevent additional spread.

Common Infectious Diseases Seen in Schools

School-aged children commonly experience a variety of infectious diseases, including

Respiratory Illnesses

COVID-19
Influenza (Flu)
Respiratory Syncytial Virus (RSV)
Pertussis (Whooping Cough)
Common cold viruses

Gastrointestinal Illnesses

Norovirus
Salmonella
Shigella
Certain strains of E. coli

Childhood Communicable Diseases

Hand, Foot, and Mouth Disease
Fifth Disease (Parvovirus B19)
Conjunctivitis (Pink Eye)
Streptococcal Infections (Strep Throat)

Preventing the spread of infectious diseases is a shared responsibility. Families can help by keeping children home when they are ill, encouraging good hand hygiene, covering coughs and sneezes, and following recommendations from their healthcare provider

Reportable Infectious Diseases

When a reportable disease is identified or suspected, Health Services works closely with public health officials to ensure appropriate follow-up and prevention measures are in place. Depending on the disease, this may include:

Public health reporting
Guidance regarding exclusion from school
Monitoring for additional cases
Communication with affected families when appropriate
Recommendations for testing, treatment, vaccination, or other preventive measures

Examples of reportable diseases that may require school involvement include:

Measles
Mumps
Rubella
Varicella (Chickenpox)
Pertussis (Whooping Cough)
Tuberculosis (TB)
Hepatitis A
Meningococcal Disease
Certain gastrointestinal infections, including Salmonella, Shigella, and E. coli
Other conditions identified by the Alaska Department of Health

All health information is handled confidentially and in accordance with state and federal privacy laws.

How Families Can Help

Families play an important role in protecting the health of our school communities. If your child is diagnosed with a communicable or reportable infectious disease, please notify your school's Health Office as soon as possible. Early communication helps ensure appropriate support, guidance, and prevention measures can be implemented when needed

Working Together to Keep Schools Healthy

The Health Services Department is committed to supporting student wellness while maintaining safe learning environments. Through prevention, early identification, timely communication, and collaboration with public health partners, we help protect the health of students, staff, and our school communities.

Healthy Students. Bright Futures.

Healthy students are better prepared to learn, participate, and thrive every day.

Pertussis (Whooping Cough)

Pertussis, also known as whooping cough, is a highly contagious respiratory illness caused by the bacterium Bordetella pertussis. It spreads easily through coughing and sneezing and can lead to prolonged coughing episodes lasting weeks. It is most serious for infants, young children, and individuals with underlying health conditions. (CDC)

The Fairbanks North Star Borough School District works in collaboration with families and public health partners, including the Alaska Department of Health, to reduce the spread of communicable diseases in school settings. (Alaska Department of Health)

Common Symptoms

Early symptoms of pertussis often resemble a common cold and may include:

Runny or stuffy nose
Mild cough
Low-grade fever
Sneezing

As the illness progresses, symptoms may include:

Severe coughing fits
“Whooping” sound when inhaling after coughing (not always present)
Vomiting after coughing
Exhaustion after coughing episodes

Infants may not develop a typical cough and may instead experience difficulty breathing or pauses in breathing. (CDC)

Caring for Your Child at Home

If your child is diagnosed or suspected to have pertussis, follow healthcare provider instructions closely. Home care may include:

Completing prescribed antibiotic treatment exactly as directed
Ensuring adequate rest
Encouraging frequent fluid intake
Using a cool-mist humidifier for comfort
Monitoring for worsening symptoms or breathing concerns

Antibiotics are most effective in reducing spread when started early in the illness. (CDC)

When to Stay Home

Students should stay home if they:

Have a persistent or worsening cough
Have been diagnosed with pertussis or are under evaluation
Are within the contagious period as determined by a healthcare provider or public health guidance
Are unable to participate in the school day due to illness

Pertussis spreads easily in school settings through respiratory droplets, making exclusion an important prevention strategy. (Alaska Department of Health)

Returning to School

A student with pertussis may return when:

They have completed at least 5 full days of appropriate antibiotic treatment, or have been cleared by a healthcare provider if antibiotics are not prescribed
Symptoms have improved enough to allow participation in school activities
They are no longer considered contagious based on healthcare provider or public health guidance

School re-entry decisions follow local and state public health recommendations. (Alaska Department of Health)

Prevention

The best protection against pertussis is vaccination. The DTaP and Tdap vaccines are recommended across the lifespan according to public health guidelines.

Additional prevention strategies include:

Staying up to date on immunizations
Covering coughs and sneezes with a tissue or elbow
Frequent handwashing
Staying home when sick
Avoiding close contact with individuals who are ill

Vaccination and early identification remain the most effective tools for preventing spread. (CDC)

Reportable to Public Health

Pertussis (whooping cough) is a reportable communicable disease in Alaska. Schools are required to report suspected and confirmed cases to the appropriate public health authorities.

When a case is identified or suspected, the school health office works in collaboration with:

Alaska Section of Epidemiology
Local public health partners
Healthcare providers, as appropriate

This reporting helps:

Monitor disease spread in the community
Identify outbreaks early
Provide guidance on prevention and control measures
Protect students, staff, and families

Families may be contacted by the school or public health officials if follow-up is needed.

District Notice

Additional Resources

Website Resources

State of Alaska, Dept of Health - LINK
CDC - LINK

Handouts

Pertussis (Whooping Cough) Questions and Answers PDF
PARENTS: Protect yourself and your children from whooping cough! PDF
Pertussis (Whooping Cough) PDF
Pertussis (Whooping Cough) Fact Sheet PDF
Whooping Cough: What it is and how it’s treated PDF

Videos

Video - Whooping Cough - Mayo Clinic
Video - Whooping Cough (Pertussis): Symptoms & Treatments - Ask A Nurse
Video - Whooping cough: causes, symptoms, treatment and when to seek help

Hand, Foot and Mouth Disease

Hand, Foot and Mouth Disease (HFMD)

Hand, Foot, and Mouth Disease (HFMD) is a common, highly contagious viral illness that most often affects infants and young children, but can also occur in older children and adults. It is caused by enteroviruses, most commonly Coxsackievirus. HFMD spreads easily through respiratory droplets, saliva, fluid from blisters, and contact with contaminated surfaces.

Common Symptoms

Symptoms of HFMD typically appear 3–6 days after exposure and may include:

Fever
Sore throat
Painful mouth sores or ulcers
Rash on hands, feet and sometimes buttocks, legs or arms
Small blisters on hands, feet or in the mouth
Decreased appetite
Fatigue or irritability (more common in younger children)

Symptoms may range from mild to uncomfortable, and not all individuals will experience every symptom.

(CDC: https://www.cdc.gov/hand-foot-mouth/signs-symptoms/index.html)

Caring for Your Child at Home

HFMD is a viral illness. There is no specific antiviral treatment, and care is focused on symptom relief and hydration:

Encourage frequent fluid intake to prevent dehydration
Offer soft, bland foods if mouth sores are painful
Use fever or pain reducers as directed by a healthcare provider
Avoid acidic, spicy, or salty foods
Ensure plenty of rest
Monitor for signs of dehydration (decreased urination, dry mouth, lethargy)

Most children recover within 7–10 days.

(CDC: https://www.cdc.gov/hand-foot-mouth/index.html)

When to Stay Home

Students should stay home if they:

Have a fever
Are unable to participate in the school day due to illness or discomfort
Have excessive drooling or are unable to manage oral secretions
Have open blisters that are actively draining or cannot be covered
Require care beyond what can be safely managed in the school setting

Students are most contagious during the first week of illness. Virus shedding may continue after symptoms improve; therefore, good hygiene is essential.

Families should contact a healthcare provider if the child has:

Signs of dehydration (dry mouth, decreased urination, lethargy)
Inability to drink fluids due to mouth pain
Fever lasting more than 3 days
Worsening symptoms or concern for secondary infection
Uncertainty about diagnosis or symptom severity

Returning to School

A student may return when all of the following are met:

Fever-free for at least 24 hours without fever-reducing medication
Able to participate in school activities
Symptoms are improving
Oral secretions are controlled (no excessive drooling)
Open lesions are healing and can be appropriately covered if needed

A healthcare provider note may be required depending on clinical severity or school guidance.

Prevention

Reportable to Public Health

District Notice

Additional Resources

Website Resources

CDC, About Hand, Foot, and Mouth Disease - LINK
Mayo Clinic, Hand-foot-and-mouth disease - LINK

Handouts

WHAT IS HAND-FOOT-AND-MOUTH DISEASE? - PDF
Preventing Hand, Foot & Mouth Disease - PDF
Hand, Foot and Mouth Disease (PedsCases) - PDF
Typical Symptom Timeline - PDF
Best and Worst Foods for Kids with Mouth Sores - PDF

Videos

Gastrointestinal Illnesses

Gastrointestinal Illness (Norovirus and Viral Gastroenteritis)

Gastrointestinal (GI) illnesses such as norovirus are highly contagious viral infections that cause inflammation of the stomach and intestines. Norovirus is the most common cause of viral gastroenteritis outbreaks in schools. It spreads easily through contaminated hands, surfaces, food, and close contact with infected individuals.

These illnesses are not caused by bacteria and do not respond to antibiotics.

Common Symptoms

Caring for Your Child at Home

There is no specific treatment for norovirus or most viral gastrointestinal (GI) illnesses. Care is supportive and focused on preventing dehydration:

Encourage frequent small sips of fluids
Use oral rehydration solutions if needed
Avoid sugary, greasy, or dairy-heavy foods until symptoms improve
Rest as needed
Monitor hydration closely (urination, dry mouth, lethargy)

Most children recover within 1–3 days, although weakness may last longer.

When to Stay Home

Students should stay home if they have:

Vomiting
Diarrhea
Fever with GI symptoms
Inability to maintain hydration
Symptoms that interfere with participation in school activities

Students should remain home while actively symptomatic to reduce classroom spread.

Families should contact a healthcare provider if the child has:

Signs of dehydration (dry mouth, decreased urination, dizziness, lethargy)
Persistent vomiting preventing fluid intake
Blood in stool or vomit
Symptoms lasting more than 3 days
Severe abdominal pain

Returning to School

A student may return when all of the following are met:

At least 24 hours have passed since last episode of vomiting or diarrhea
They are able to eat and drink normally
They are fever-free for 24 hours without fever-reducing medication
They are well enough to participate in school activities

Strict hand hygiene is strongly recommended upon return.

Prevention

GI illness spread can be reduced through strict hygiene practices:

Frequent handwashing with soap and water (especially after bathroom use)
Cleaning and disinfecting contaminated surfaces immediately
Proper disposal of vomit and stool contamination
Not sharing food, drinks, or utensils
Staying home when ill and for 24 hours after symptoms resolve

Alcohol-based hand sanitizers are less effective against norovirus than soap and water.

Reportable to Public Health

District Notice

Additional Resources

Website Resources

CDC - Norovirus - LINK

Handouts

Norovirus: Everything You Need to Know - PDF
How You Get Norovirus from People and Surfaces - PDF
Norovirus Fact Sheet - PDF
Norovirus: the 'Winter Vomiting bug" - PDF
The Parent Survival Guide to Stomach Bugs - PDF
Protect Yourself Against Norovirus - PDF

Videos

Video - Have You Ever Heard of Norovirus?

Fifth Disease (Parvovirus B19)

Fifth Disease (Parvovirus B-19)

Fifth disease (erythema infectiosum) is a common childhood illness caused by parvovirus B19, a virus that spreads from person to person through respiratory droplets when an infected person coughs, sneezes, or talks.

The illness often begins with mild, cold-like symptoms. Several days later, some children develop a characteristic facial rash that appears as bright red cheeks, sometimes called a “slapped cheek” rash. A lighter, lace-like rash may also appear on other parts of the body.

One of the unique features of fifth disease is that children are usually most contagious before the rash appears. Once the typical rash develops, children are generally much less likely to spread the virus. Because of this, identifying fifth disease after the rash appears does not always prevent exposure that may have already occurred.

Most children recover without complications. However, fifth disease may require additional guidance from a healthcare provider for individuals with certain health conditions, including some blood disorders, weakened immune systems, or during pregnancy.

Common Symptoms

Symptoms may vary from child to child. Some children may have mild symptoms or no symptoms at all.

Common symptoms may include:

Mild fever
Tiredness or fatigue
Headache
Runny nose
Sore throat
Muscle aches
Joint pain (more common in older children and adults)
Bright red cheeks (“slapped cheek” appearance)
A lace-like or blotchy rash on the arms, legs, trunk, or buttocks

The rash may come and go and can become more noticeable with:

Heat
Sun exposure
Exercise
Stress

Caring for Your Child at Home

Most children with fifth disease can be cared for at home with supportive care.

Helpful care includes:

Encourage plenty of fluids
Allow your child to rest as needed
Support comfort with age-appropriate fever or pain relief as recommended by your healthcare provider
Use gentle skin care measures if the rash is itchy or uncomfortable

Contact your healthcare provider if:

Symptoms worsen
Fever persists
Your child has significant joint pain
Your child has a medical condition that may increase risk from parvovirus B19
You have concerns about your child’s health

When to Stay Home

Students should stay home when they are not well enough to participate in normal school activities.

Keep your child home if they have:

Fever
Significant fatigue or discomfort
Symptoms that interfere with learning or participation
Any symptoms that require additional care or monitoring

A child with fifth disease does not usually need to stay home solely because of the rash once they feel well enough to participate in school activities

Returning to School

Prevention

Families and schools can help reduce the spread of illness by practicing everyday prevention strategies:

Wash hands often with soap and water
Cover coughs and sneezes
Avoid sharing drinks, food, or personal items
Clean commonly touched surfaces
Stay home when sick

Because fifth disease can spread before symptoms are recognized, everyday prevention practices are important.

Reportable to Public Health

District Notice

Additional Resources

Measles (Rubeola)

Measles is a highly contagious viral illness caused by the measles virus. It spreads through the air when an infected person coughs or sneezes, and the virus can remain in the air for a period of time after the person has left the area.

Measles is not a routine childhood illness. It can lead to serious complications, particularly in young children, pregnant individuals, and people with weakened immune systems. These complications can include pneumonia, brain inflammation, hospitalization, and, in rare cases, death.

Measles is preventable through vaccination, and immunization is the most effective way to reduce the risk of infection and spread in school communities.

Because of how easily measles spreads, suspected or confirmed cases require immediate public health coordination and strict exclusion guidance. Rapid identification and exclusion are critical to preventing school-based spread.

Common Symptoms

Symptoms typically appear 7–14 days after exposure and may include:

High fever
Cough
Runny nose
Red, watery eyes
Sensitivity to light
Fatigue or decreased energy
A red rash that typically starts on the face and spreads downward across the body

Small white spots inside the mouth (Koplik spots) may appear before the rash develops.

If measles is suspected, families should contact a healthcare provider promptly for evaluation and care guidance. Providers are responsible for diagnosing measles and recommending appropriate medical management.

Incubation Period and Contagious Period

After exposure to measles, symptoms typically develop within 7 to 14 days, though it may take up to 21 days in some cases.

A person with measles is contagious:

Approximately 4 days before the rash appears, and
Up to 4 days after the rash begins

This means individuals can spread measles before they know they are sick.

Because contagiousness occurs before the rash is visible, exposure management and exclusion of non-immune individuals may be necessary even before symptoms develop.

How This Affects School Exposures

Because measles can spread before symptoms develop, public health guidance focuses on identifying individuals who may have been exposed and reducing the risk of further spread.

If a measles exposure is identified in a school setting:

Public health officials determine appropriate follow-up based on the specific circumstances of the exposure
Students who may have been exposed may be monitored for symptoms for up to 21 days after exposure
Students who are not immune to measles may be subject to exclusion from school, depending on public health guidance
Students who develop symptoms should stay home and be evaluated by a healthcare provider before returning to school

Public health officials provide guidance for each situation, including monitoring timelines, exclusion requirements, testing recommendations, and return-to-school decisions.

These measures are used to help prevent measles transmission in school settings and protect students who may be at higher risk for serious illness.

Caring for Your Child at Home

If measles is suspected or diagnosed, families should contact a healthcare provider immediately. Providers guide testing, treatment recommendations, and isolation instructions during the infectious period.

Supportive care may include:

Encouraging fluids to prevent dehydration
Rest
Fever-reducing medication as directed by a healthcare provider
Monitoring for worsening symptoms or complications

Because measles can lead to serious illness, medical follow-up is important.

When to Stay Home

Students should stay home if they have symptoms consistent with measles or have been diagnosed with measles.

Do not send your child to school if they have:

Fever and cough with red eyes
Rash with fever
Known or suspected exposure to measles
A healthcare provider evaluation pending for suspected measles

Immediate exclusion helps reduce the risk of transmission in school settings.

Returning to School

Students diagnosed with measles may return to school only when all of the following are met:

At least 4 days have passed after rash onset, and
The student is fever-free without the use of fever-reducing medication, and
The student is well enough to participate in school activities, and
Clearance has been provided in accordance with public health guidance

Health Services follows both public health direction and healthcare provider guidance for exclusion and return-to-school decisions due to the highly contagious nature of measles.

Unimmunized or Non-Immune Students

In the event of a confirmed measles exposure in a school setting, students who are not immune to measles (based on immunization status or documented history of disease) may be subject to exclusion from school in accordance with public health guidance.

Exclusion of non-immune individuals is a preventive measure used to reduce transmission and protect students who are at higher risk for serious illness.

Return to school for excluded students will be determined by public health guidance and may depend on timing since exposure and development of symptoms.

Prevention

Reportable to Public Health

Measles is a reportable disease.

Suspected or confirmed cases of measles are reported to public health authorities in accordance with public health requirements. Health Services follows district procedures and works with public health partners to support appropriate response measures, including guidance related to exclusion, exposure, communication, and return-to-school decisions.

District Notice

Additional Resources

Website Resources

Clinical Overview of Measles (CDC) - LINK
American Academy of Pediatrics (AAP) - LINK
Pediatric Pandemic Network - LINK
Seattle Children's - LINK

Handouts

MEASLES (Rubeola) - PDF
Measles: Important Considerations - PDF
Measles and Transmission - PDF
Measles: It Isn't Just a Little Rash - PDF

Videos

Video - Measles - causes, symptoms, diagnosis, treatment, pathology
Video - Measles Is Back in the U.S.: What Parents Need to Know
Video - Measles cases surged in 2025 as vaccination rates dropped
Video - How Measles Made a Comeback

Epstein-Barr Virus (EBV) / Infectious Mononucleosis (Mono)

Epstein - Barr Virus (EBS)/Infectious Mononucleosis (Mono)

Epstein-Barr virus (EBV) is one of the most common viruses people are exposed to during their lifetime. Many people are infected with EBV at some point and never know it because they have no symptoms or only a mild illness.

In some children and teenagers, EBV can cause infectious mononucleosis, often called “mono.” Mono is best known for causing extreme tiredness, sore throat, fever, and swollen lymph nodes. Unlike many short-term illnesses, the fatigue from EBV can sometimes last longer than the initial symptoms.

EBV spreads through saliva and respiratory secretions, which is why it is sometimes called the “kissing disease.” It can also spread through everyday activities such as sharing drinks, utensils, or items that come into contact with the mouth.

Because EBV is so common and can spread before someone knows they are sick, the focus in schools is on supporting students who are ill, preventing the spread of germs, and helping students return when they are well enough to safely participate.

Common Symptoms

Incubation Period and Contagious Period

After exposure to EBV, symptoms may not appear for several weeks.

The incubation period for infectious mononucleosis is typically about 4–6 weeks.

EBV can spread before symptoms begin and may remain in saliva for an extended period after illness. Because of this, it is not possible to completely prevent spread by excluding a student after symptoms appear.

Students with EBV should continue practicing good hygiene and avoid sharing items that come into contact with saliva.

How This Affects School Exposures

EBV is common, and exposure does not usually require school-wide notifications or exclusion of contacts.

If a student has EBV or mono:

Close contacts are generally not required to stay home
Students who are feeling well enough may attend school
Prevention focuses on hygiene practices and avoiding sharing personal items

Families should follow healthcare provider recommendations, especially regarding activity restrictions or return to sports.

Caring for Your Child at Home

Care for EBV is focused on rest and symptom management.

Helpful measures include:

Encourage plenty of fluids
Allow extra rest as needed
Support nutrition as tolerated
Use medications for fever or discomfort only as directed by a healthcare provider

Families should follow healthcare provider guidance, especially if a student has significant symptoms or concerns.

When to Stay Home

Students should stay home when they are not well enough to participate in normal school activities.

Keep your child home if they have:

Fever
Significant fatigue that prevents participation
Severe sore throat or difficulty swallowing
Symptoms that interfere with learning or classroom activities
Any symptoms requiring care beyond what can safely be provided at school

A diagnosis of EBV or mono alone does not automatically require exclusion if the student is well enough to participate.

Returning to School

Students with EBV or infectious mononucleosis may return to school when:

They are fever-free without fever-reducing medication
They feel well enough to participate in school activities
Symptoms can be safely managed during the school day

Because fatigue can last after other symptoms improve, students may need a gradual return to normal activities.

Healthcare providers may provide additional guidance related to physical activity, sports, or strenuous exercise.

Prevention

Reportable to Public Health

District Notice

Additional Resources

Website Resources

CDC - LINK
Infectious Disease Advisor - LINK
Cleveland Clinic - LINK

Handouts

MONO Glandular Fever Signs & Management - PDF
EBV/Mononucleosis Fact Sheet - PDF
Mononucleosis Symptom and Management - PDF

Videos

Impetigo

Impetigo is a common and contagious bacterial skin infection caused by bacteria that enter the skin through small breaks, cuts, scrapes, insect bites, eczema patches, or other areas of irritated or broken skin. The most common bacteria that cause impetigo are Staphylococcus aureus (staph) and Streptococcus pyogenes (strep).

These bacteria are commonly found on the skin and in the environment. When they enter damaged skin, they can cause an infection that results in sores, blisters, and crusting.

Impetigo most often affects areas of skin that are exposed or easily irritated, including the face (especially around the nose and mouth), hands, arms, and legs. It can occur anywhere bacteria enter broken or irritated skin.

In Alaska, impetigo may be seen more often during late spring through early fall, when children have increased outdoor activity, insect exposure, and minor skin injuries such as scrapes. It can also increase during the winter months, when dry air, frequent nose wiping, and respiratory illnesses can cause irritation and breakdown of the skin around the nose and face.

Impetigo can spread easily through direct contact with infected skin, drainage from sores, or contaminated items such as towels, clothing, or personal items.

Impetigo often begins as small sores or blisters that may break open and develop a characteristic yellowish or honey-colored crust. While impetigo is usually treatable, early identification and treatment help reduce discomfort and prevent spread to others.

Because impetigo can spread through close contact, students with suspected or confirmed impetigo should be evaluated and follow treatment guidance before returning to school.

Common Symptoms

How Impetigo Spreads

Caring for Your Child at Home

If impetigo is suspected, families should contact a healthcare provider for evaluation and treatment guidance.

Care may include:

Keeping affected areas clean and covered as directed
Washing hands frequently
Avoiding scratching or picking at sores
Washing clothing, towels, and bedding regularly
Following all prescribed treatment instructions

Complete the full course of treatment as prescribed by the healthcare provider.

When to Stay Home

Students should stay home when symptoms cannot be safely managed during the school day or when treatment has not yet been started.

A student with suspected or confirmed impetigo should stay home if:

Sores are uncovered and cannot be appropriately covered
Drainage cannot be contained
The student is not well enough to participate in school activities
Recommended treatment has not been started

Returning to School

Prevention

Reportable to Public Health

District Notice

Additional Resources

Website Resources

CDC - LINK
Mayo Clinic - LINK
American Academy of Pediatrics - LINK

Handouts

Impetigo, A Visual Guide - PDF
How to get rid of impetigo and prevent the spread? - PDF

Videos

Conjunctivitis (Pink Eye)

Conjunctivitis (“pink eye”) is inflammation of the eye that can have different causes. Because the cause determines whether it is contagious and whether a child needs to stay home, not all red or irritated eyes are treated the same way in the school setting.

Some cases are caused by infection (viral or bacterial), while others are caused by allergies or irritation. Only some forms of conjunctivitis are contagious.

Understanding the difference helps determine whether a child needs treatment, exclusion from school, or simply comfort care.

How to Tell the Difference

Possible Contagious Conjunctivitis (Viral or Bacterial)

May include:

Thick or colored eye drainage (yellow/green)
Eyelids stuck together after sleep
Redness in one or both eyes
Watery or mucous discharge
Recent illness or cold symptoms
Eye discomfort or gritty feeling

These types may spread through contact with eye drainage or contaminated hands/surfaces.

Non-Contagious Conjunctivitis (Allergy or Irritation)

May include:

Itchy eyes (very common with allergies)
Watery discharge (clear, not thick)
Redness in one or both eyes
Symptoms that come and go
Other allergy symptoms (sneezing, runny nose)
Exposure to dust, smoke, wind, or irritants

These types are not contagious and do not require exclusion from school.

Common Symptoms (All Types)

When to Stay Home (Most Important Section)

Whether a student needs to stay home depends on symptoms and ability to safely participate, not just the presence of a red eye.

A student may need to stay home if they have:

Fever or other illness symptoms
Significant eye pain or discomfort
Heavy drainage that cannot be managed in school
Symptoms that interfere with learning or participation
Symptoms that cannot be safely managed in the school environment

A red or irritated eye alone does not automatically require staying home.

Returning to School

Bacterial Conjunctivitis

If a healthcare provider identifies bacterial conjunctivitis, the student may return to school when:

Antibiotic eye drops or ointment have been started
The student is well enough to participate in school activities
Symptoms can be safely managed during the school day

In partnership between the classroom teacher and the Health Office, a determination will be made regarding safe participation in the school setting and the ability to manage symptoms without compromising the health and safety of the student or others.

Viral or Allergic Conjunctivitis

Students generally do not need to stay home if:

They are fever-free
They feel well enough to participate in school activities
Symptoms can be managed during the school day

Key Takeaway for Families

Prevention

Reportable to Public Health

District Notice

Additional Resources

Website Resources

CDC Conjunctivitis (Pink Eye) - LINK
Pink Eye: Quick Home Remedies - LINK
The Ultimate Guide to Pink Eye - LINK

Handouts

Help Protect Yourself from Pink Eye - PDF
Pink Eye Facts for Parents and Teachers - PDF
Pink Eye: What You Need to Know - PDF

Videos

Video - Mayo Clinic Minute - What is Pink Eye?
Video - Pink Eye / Conjunctivitis: Symptoms, Diagnosis & Treatments
Video - Viral or Allergic Conjunctivitis: How to Tell Them Apart?

Concussion Guidance for Parents/Guardians

The Fairbanks North Star Borough School District's concussion guidelines are designed to support students as they safely recover from a concussion and gradually return to their normal activities, including learning, physical activity, and athletics.

Every student's recovery is different. Symptoms, recovery timelines, and readiness to return to activities can vary from one student to another. A student may appear to feel better before their brain has fully recovered, which is why a gradual return process is important.

A concussion may occur during school activities, athletics, recreational activities, or outside of school. If your student has been diagnosed with a concussion, or there is concern they may have sustained a concussion, please notify the school Health Office as soon as possible and provide any medical documentation or recommendations from your healthcare provider.

Concussion symptoms can change throughout the recovery process and may not always be immediately noticeable. Students are encouraged to report symptoms, and families should communicate concerns with the school so appropriate support can be provided.

Health Services works collaboratively with students, families, healthcare providers, school staff, Athletic Trainers, and coaches to support a safe and successful return to activities. The goal of concussion management is to support recovery while gradually increasing activity and reducing the risk of further injury.

Understanding Concussions

A concussion is a type of traumatic brain injury caused by a bump, blow, or jolt to the head or body that causes the brain to move quickly inside the skull. A concussion can happen during sports, physical activities, accidents, falls, or everyday activities. A student does not have to lose consciousness to have a concussion.

A concussion affects each student differently. Some students may have symptoms right away, while others may not notice symptoms until later. Symptoms can change throughout recovery and may become more noticeable as a student returns to normal activities.

Common concussion symptoms may include:

Headache or pressure in the head
Dizziness or balance problems
Nausea or vomiting
Sensitivity to light or noise
Blurred vision
Feeling tired or having changes in sleep patterns
Difficulty concentrating, remembering, or completing tasks
Feeling slowed down, foggy, or confused
Increased irritability, sadness, nervousness, or emotional changes

Students may not always recognize or report their own symptoms. Families, teachers, coaches, and school team members play an important role in noticing changes and communicating concerns.

The risks associated with concussions include temporary changes in thinking, learning, emotions, sleep, balance, and physical activity tolerance. Returning to activities too quickly, especially activities with a risk of head impact, may increase the risk of a longer recovery or another concussion. A second concussion before the brain has fully recovered can increase the risk of serious complications, including rare but life threatening conditions.

Recovery from a concussion requires patience and a gradual return to activities. The goal is not simply to rest until symptoms disappear, but to safely and gradually increase activity while monitoring for symptoms and following guidance from healthcare providers and the student's recovery team.

If you suspect your student may have a concussion, encourage them to report their symptoms and contact their healthcare provider for evaluation and guidance. Notify the school Health Office so we can work together to provide appropriate support during your student’s recovery process.

Health Services Concussion Monitoring Process

For students with a diagnosed or suspected concussion, Health Services follows a structured monitoring process aligned with recommendations from the Alaska Youth Brain Injury Program.

Health Services will complete daily concussion assessments for the first five school days following identification of a concussion or concern for a possible concussion. After the initial monitoring period, assessments will continue weekly for four additional weeks to support the student's Return to School process, monitor changes in symptoms, and identify any concerns that may require follow up or communication with the family and healthcare provider.

Consistent communication between home, the school Health Office, healthcare providers, Athletic Trainers, coaches, and other members of the student's support team is an important part of helping students recover safely and successfully. Families are encouraged to share updates, changes in symptoms, or additional medical recommendations with the school Health Office so appropriate supports can be provided and communication can occur with the appropriate members of the student's recovery team.

Health Services monitoring is intended to support the student's safe return to school and activities and does not replace evaluation, treatment, or medical recommendations provided by a healthcare provider.

Return-to-School and Return-to-Sports Protocols

Returning to learning and returning to sports following a concussion are connected processes that support a student’s safe recovery. A student’s ability to participate in academics does not automatically mean they are ready to return to full physical activity, practice, or competition. Students progress through recovery based on their symptoms, tolerance for increased activity, and guidance from their healthcare provider and school support team.

Return-to-School Protocol

The Return-to-School process focuses on helping students safely return to learning while the brain continues to recover. Following a diagnosed or suspected concussion, Health Services supports the student’s return-to-school process through symptom monitoring, communication with families and school staff, and coordination of recommended accommodations.

Health Services will complete daily concussion assessments for the first five school days following identification of a concussion or concern for a possible concussion. After the initial monitoring period, assessments will continue weekly for four additional weeks to support ongoing recovery, monitor changes in symptoms, and identify any concerns that may require follow-up.

Students may need temporary academic or school-based adjustments, such as reduced workload, breaks, modified screen time, or other supports based on their symptoms and recovery progress. The goal is to support a gradual return to classroom activities while avoiding significant symptom worsening.

View the Return-to-School (RTS) Protocol

Return-to-Sports Protocol

The Return-to-Sports process focuses on safely returning students to physical activity, athletics, and competition following a concussion. The early stages of Return-to-Sports progression occur alongside the student’s overall concussion recovery and Return-to-School process.

Students must first demonstrate that they can tolerate regular school activities and normal cognitive demands without a significant increase in symptoms before progressing to later stages of the Return-to-Sports protocol. Before beginning the final stages of Return-to-Sports progression, the student must receive written medical clearance from their healthcare provider.

Following medical clearance, the Athletic Trainer oversees the Return-to-Sports progression and determines when the student has successfully completed the protocol and is ready to return to full athletic participation. Coaches, families, and school staff support the process by communicating concerns, monitoring for symptom changes, and following established restrictions.

A student may be able to attend school and participate in classroom activities while still requiring restrictions from physical education, sports, or other activities that increase the risk of another head injury.

Families should communicate all healthcare provider recommendations and updates with the school Health Office so appropriate supports, accommodations, and activity restrictions can be coordinated.

View the Return-to-Sports Protocol

Concussion Forms and Documentation

Additional Resources

Web Resources

Concussion Alliance - LINK
Concussion Basics - LINK
American Academy of Pediatrics - LINK
Alaska Youth Brain Injury Program - LINK
Concussions and their Effect on Mental Health - LINK

Handouts

Youth Sports Rates of Concussion - PDF
Concussion in Alaska: What to Know - PDF
Toddler Concussion (2-4) Signs and Symptoms - PDF
Pediatric Concussion (5-12) SIgns and Symptoms - PDF
Concussion Information Sheet - PDF
Concussion Fact Sheet for High School Parents - PDF
Understanding the Nature & Risk of Concussions - PDF

Videos

Video - Concussions 101, A Primer for Kids and Parents
Video - Concussion Facts vs. Fiction: A Guide for Parents
Video - 5 Tips for Concussion Recovery & Treatment at Home

Caffeine and Energy Drinks

What Parents Need to Know

Energy drinks are not the same as sports drinks. Energy drinks are designed to increase alertness and often contain high amounts of caffeine, added sugars, and other stimulant ingredients, such as guarana and taurine. These ingredients can have significant effects on a child's developing brain and body.

Research shows that caffeine use among adolescents is common, with many teens consuming caffeine daily through energy drinks, coffee, soda, tea, and specialty beverages. Because adolescents are still developing physically and neurologically, they are more susceptible to the effects of caffeine than adults.

The American Academy of Pediatrics (AAP) recommends that children and adolescents should not consume energy drinks. The National Association of School Nurses (NASN), Centers for Disease Control and Prevention (CDC), and National Federation of State High School Associations (NFHS) also recognize the health risks associated with excessive caffeine use in youth and encourage education on healthy beverage choices.

Did You Know?

Many energy drinks contain 200–300 mg of caffeine or more in a single container, with some containing substantially higher amounts.
Caffeine may also be listed under ingredients such as guarana, which naturally contains caffeine and can increase the total stimulant content of a beverage.
Large container sizes may contain more than one serving, resulting in students consuming significantly more caffeine than they realize.
Mixing energy drinks with exercise, dehydration, or inadequate sleep can increase the risk of unwanted side effects.

Caffeine by the Numbers

Parents are often surprised by how much caffeine today's teens consume and how concentrated energy drinks have become.

30–50% of adolescents report consuming energy drinks.
Many energy drinks contain 200–300 mg of caffeine in a single container, and some contain even more. This exceeds the 100 mg per day limit recommended for adolescents who consume caffeine.
In 2011, nearly 1,500 adolescents (ages 12–17) were treated in U.S. emergency departments for energy drink-related emergencies.
Some energy drinks contain more than one serving per container, meaning students may consume significantly more caffeine than they realize.
Guarana is a natural source of caffeine. When it is added to energy drinks, it increases the beverage's total stimulant content beyond the listed caffeine alone.

Did You Know? One energy drink may contain as much caffeine as two to three cups of coffee, and many teens consume additional caffeine throughout the day from coffee, soda, tea, pre-workout supplements, or caffeinated snacks.

Potential Health Risks

Excessive caffeine intake can affect nearly every body system and may result in:

Heart and Circulation

Rapid or irregular heartbeat
Heart palpitations
Increased blood pressure
Increased risk of complications in students with underlying heart conditions

Brain and Nervous System

Anxiety, nervousness, or panic attacks
Irritability and mood changes
Difficulty concentrating
Headaches
Tremors or shakiness
Seizures in rare cases or in students with certain medical conditions

Sleep and Learning

Sleep is essential for healthy growth, learning, memory, and emotional well-being. Excess caffeine intake may contribute to:

Difficulty falling asleep or staying asleep
Poor-quality sleep
Daytime fatigue
Difficulty paying attention in class
Reduced memory and learning
Lower academic performance

Students at Greater Risk

FNSBSD Health Services Position

The Fairbanks North Star Borough School District Health Services Department supports the recommendations of the American Academy of Pediatrics (AAP), the National Association of School Nurses (NASN), the Centers for Disease Control and Prevention (CDC), and the National Federation of State High School Associations (NFHS).

Health Services does not recommend the use of energy drinks by children or adolescents because of the potential health risks associated with high caffeine and stimulant intake.

Energy drinks are not permitted for elementary or middle school students on school premises or during school-sponsored activities.

Commercially available energy drinks are permitted for high school students only; however, Health Services strongly discourages their use. Families are encouraged to discuss the potential risks of caffeine and energy drinks with their students and support healthy habits through adequate sleep, balanced nutrition, regular physical activity, and proper hydration.

Health Services does not provide or distribute energy drinks to students.

Questions?

Screens & Student Well‑Being

Today's students have grown up in a digital world where smartphones, tablets, gaming systems, and social media are a regular part of daily life. While technology offers incredible opportunities for learning and connection, excessive recreational screen time can begin to interfere with healthy development, relationships, sleep, and academic success.

At FNSBSD Health Services, we recognize that digital wellness is an important part of overall student health. By helping children develop healthy technology habits, families can support both their child's well-being and their ability to succeed in school

Smartphone Addiction

Negative Effects

Why it Matters

Studies continue to show that children and adolescents are spending unprecedented amounts of time on screens.

Did You Know?

Children ages 8–12 spend an average of 5½ hours each day using recreational screen media.
Teens average more than 8 hours each day using recreational screen media.
These numbers reflect entertainment use only and do not include time spent on school-issued devices, classroom instruction, or homework. When educational screen use is added, a child or teen’s total daily screen exposure may exceed 10 hours.
Nearly 95% of teenagers have access to a smartphone.
Nearly half of teens report being online almost constantly.

While technology itself is not harmful, excessive recreational screen use has been associated with:

Difficulty concentrating
Poor sleep
Increased anxiety and depression
Headaches and eye strain
Reduced physical activity
Lower academic performance
Increased stress
Difficulty regulating emotions

How Screen Time Affects Students at School

Healthy students are better learners.

When recreational screen time begins replacing healthy sleep, physical activity, face-to-face interactions, and downtime, the effects are often seen during the school day.

Students may experience:

Difficulty Focusing

Constant notifications, short-form videos, and rapid digital stimulation can make it harder for students to maintain attention during instruction or complete longer academic tasks.

Poor Sleep

Using electronic devices before bedtime suppresses melatonin production, making it harder to fall asleep and stay asleep.

Students who do not get enough sleep are more likely to experience:

Difficulty concentrating
Memory problems
Mood changes
Reduced classroom participation
Lower academic achievement

Increased Health Office Visits

School health offices frequently see students experiencing:

Headaches
Eye fatigue
Neck and shoulder pain
Fatigue
Anxiety
Difficulty concentrating

While these symptoms can have many causes, excessive screen use is becoming an increasingly common contributing factor.

Mental Health

Social media can be a wonderful way to stay connected, but excessive use has also been associated with increased anxiety, depression, loneliness, and lower self-esteem, particularly