APPENDIX

Harrow Bangkok Health and Safety Policy

APPENDIX 1. ILLNESS EXCLUSION

To ensure the health, safety and welfare of all persons using the School facilities:• When a child becomes ill at the School, every effort will be made to contact the parents or carers, who will be requested to collect their child as soon as possible. • In most cases when a child is sent home we feel it would be beneficial for them to see a doctor. • Parents must notify the School if they are aware that their child has a contagious illness or if a doctor has confirmed the cause of illness. • We expect parents to co-operate with us by not bringing children to the School if they have any infectious or contagious illness. Staff will also be asked not to attend work under the same circumstances. • If your child has been kept at home due to illness for 3 days or longer we require a doctor’s certificate on their return stating what the problem was and that they will be well enough to be back at school. • Any child showing symptoms of conjunctivitis will be required to be collected and checked by a doctor.

DISEASE/ILLNESS MINIMAL EXCLUSION PERIODS

Antibiotics prescribed

Bad cough, heavy cold with green Mucus Bronchitis

Temperature

Vomiting

Sickness/Diarrhoea

Infective (Bacterial) Conjunctivitis (Pinkeye)

Nonbacterial (allergic) conjunctivitis Chickenpox and shingles Should stay at home for the first 2 days of the course and until fever has subsided Should stay at home till Mucus has cleared up and the coughing has subsided Should be excluded until the child has been given appropriate treatment and feels well If sent home ill, child must be off for 24 hours. They may return after this time if their temperature has returned to normal (without the need for medication to control the temperature) If sent home ill, child must be off for at least 24 hours after the last bout of vomiting Should stay off until at least 48 hours have elapsed from the last bout and they are eating normally Should be treated with antibiotics, oral, drops or ointment, and the child should be kept at home for at least 48 hours. Can return when eyes are no longer weeping A child with red eyes and clear watery discharge doesn’t need antibiotics or to be excluded Should be excluded until all lesions have crusted, there are no moist sores and the person feels well

DISEASE/ILLNESS

Gastroenteritis, food poisoning, salmonellosis and dysentery Infective hepatitis

Measles

Meningococcal infection

Mumps Hand, foot and mouth disease

Pertussis (whooping cough) Poliomyelitis (infantile paralysis)

Rubella (German measles)

Tuberculosis Typhoid fever Impetigo Pediculosis (head lice)

Plantar warts Ringworm of scalp Ringworm of body

Scabies

Diphtheria

Scarlet fever and streptococcal infection of the throat MINIMAL EXCLUSION PERIODS

Until authorised by your doctor that it is alright for your child to return Child should be excluded for 7 days after the onset of jaundice or illness (doctor’s certificate needed) Should be excluded for 7 days after the onset of the rash (doctor’s certificate needed) Until recovered from the illness (doctor’s certificate needed) Until the swelling has subsided The child should be excluded until all blisters have dried up (doctor’s certificate needed) and at least 7 days from the onset of symptoms 21 days from the onset of paroxysmal cough Should be excluded for at least 2 weeks after onset or until declared free from infection by a doctor Should be excluded for 4 days after appearance of the rash or until a medical certificate of recovery is produced Until declared free from infection by a Doctor Until declared free from infection by a Doctor Until the sores are fully healed Until appropriate treatment has been given and no eggs are present on scalp No exclusion. Should be treated and covered Until cured Seldom necessary to exclude provided effective treatment is being given Need not be excluded once appropriate treatment has been given Should be excluded until after at least two negative nose and throat swabs and with medical certificate of recovery Until appropriate medical treatment has been given and declared free from infection by a doctor, and at least 7 days from the onset of symptoms

Harrow Bangkok Health and Safety Policy

APPENDIX 2. HAND, FOOT AND MOUTH DISEASE

Background Information. Hand, Foot and Mouth Disease (HFMD) is a viral infection. It is not linked to the foot and mouth disease that affects animals. HFMD is mainly seen in children under the age of 10 or in young adults. It is easily spread from one person to another. Most people have had HFMD by the time they are adults. It rarely causes further complications. Very rare complications of hand, foot and mouth disease include meningitis, encephalitis or paralysis. If your child has symptoms of a headache, stiff neck or back pain, immediately seek medical advice. With these points in mind, our actions (outlined below) are focused on potential outbreaks in the Lower School. Mode of Transmission. The main manner HFMD is spread is by touching the fluid from inside the HFMD blisters and/or fluids from the nose, mouth and chest (spread from sneezing and coughing). It can also be present via faeces for some weeks after infection.

Infectious Period. The incubation period of HFMD is 3 to 5 days. Symptoms usually show within 3 to 7 days after infection and can last between 7 to 10 days.

Key points to remember: • HFMD is easily spread from one person to another. • There is no specific treatment, vaccine or cure. • There is no known risk to pregnant women or their unborn babies. • Usually the rash disappears with recovery within a week

1. Prevention/Monitoring Local Situation • The school is in regular contact with the local Health Authority throughout the school year, so is informed of any outbreaks of HFMD in schools in the area. For climatic reasons and historically, end of Term One and Three are potential risk times for HFMD. • The school will hold routine parent/carer information workshops to educate about common communicable illnesses, preventative measures and symptoms.

2. Preventative Measures Taken In Case of HFMD confirmation in local Don Muang area • The school will screen all children entering Pre Prep for a period of 7 days. If no cases are confirmed during this time, the screening will stop at the end of that 7 day period. • The school will conduct weekend steaming of the Pre Prep and a deep clean of areas and equipment/toys as a preventative measure. The swimming pool will also be monitored. • The school will raise awareness with parents by communicating about avoiding public areas, the importance of hand washing and awareness for symptoms.

3. Action Taken In Case of a confirmed case of HFMD in School • Information will be sent to all parents informing them of the confirmed case and the year group, but not the name of the affected child. • An update will be sent to parents from the Head of the school section, as necessary,

with details of any further confirmed cases. • All children will be screened before entering the affected section of the school. • The period of screening will last until 7 days have passed since the last confirmed case. • Intense daily deep clean of that year group and all communal equipment • will be carried out, as well as deep clean of all the areas and equipment in the affected section. • Weekend steaming and deep cleaning of all Pre Prep areas inside and out will happen

4. Additional Actions Taken if more than one confirmed case of HFMD in School • The school will continue with the measures and procedures above (Section 3). • Year groups may not mix at outside playtimes or in communal areas (Multi-purpose room, Assembly room etc). • Affected year groups will have no swimming for 7 days, and then reviewed. • Outside groups or children from other sections of the school will not be allowed in the affected section for 7 days after the last confirmed case. • The school will monitor developments on a daily basis and liaise with the health authorities. • If any year group reaches a level of 10% active cases within a 7 day period, the School Leadership Group will consider the closure of that year group or section of the school.

5. Details regarding any School section or Year Group Closure in Response to HFMD • Parents will be informed of the closure which will last 7 continuous days. • Curriculum planning will be adjusted to make up for lost lessons as a result of the closure. • Complimentary places on School Holiday Programmes will be offered to compensate missed days.

6. Working in Partnership with Parents • Parents should cooperate with the screening procedures during an outbreak. • Parents should communicate with the school immediately if their child is confirmed with HFMD. • A parent may choose to communicate with the health authorities about an outbreak. This should be done in cooperation with the school to ensure the best outcomes. • Parents should understand that the school is not to blame for outbreaks of illness any more than parents are. Illnesses such as HFMD are naturally occurring and are part of life. • Parents are asked to respect that siblings of infected children may be asked to not attend school for 7 days after the first child’s infection was confirmed. • Parents must provide a doctor’s certificate of recovery for their child before returning to school. This cannot happen before the end of a 7 day period after confirmation of infection. • Parents can refer to the Pre Prep Illness Exclusion Policy in all cases of illness. • Parents are asked to follow health authority guidelines to avoid mixing with other children in public places during an outbreak.

Harrow Bangkok Health and Safety Policy

APPENDIX 3. INFLUENZA VIRUS. TYPES A AND B.

Background Information. Influenza is caused by various strains of the influenza virus. The usual symptoms are fever, headache, aching muscles, sore throat and cough. Nausea, vomiting and diarrhoea can occur especially in children. It is sometimes accompanied or followed by chest infections that can be severe. Influenza is generally a milder illness in children. Mode of Transmission. The main way that influenza is spread from person to person is by coughs and sneezes or direct contact. Potential for airbourne transmission is controversial. The virus concentration in respiratory secretions is usually highest up to 7 days before a person develops symptoms of illness. Viruses continue to be present in respiratory secretions for 2 to 3 days after symptoms begin. As a result, infected individuals have already spread viruses before they begin to feel ill. Infectious Period/Exclusion period. The infectious period of influenza is 3 to 5 days (not more than 7 days) from clinical onset. Children should be excluded from school a minimum of 5 days or until fully recovered without a fever or any of the symptoms mentioned above. Key points to remember: • Immunisation is recommended for the weak or elderly. • Good hand hygiene, and cough/sneeze etiquette will reduce the spread. • Aspirin (or products containing salicylate) should NEVER be used if influenza is suspected • Children who show symptoms of influenza fever whilst in school, should be kept in isolation and collected, as soon as possible by parents, to limit the spread of illness to other children.

1. Prevention/Monitoring Local Situation • The school is in regular contact with the local health authority throughout the school year, so is informed of any outbreaks of influenza types in schools in the area and/or nationwide. Influenza in Thailand can be transmitted throughout every season. However the rainy season is a high transmission time. • The school will hold parent/carer information workshops to educate about common communicable illnesses, preventative measures and symptoms as appropriate.

2. Action taken in case of influenza at school • Information will be sent to all parents informing them of the confirmed case and the year group, but not the name of the affected child. • An update will be sent to parents from the Head of the School section, as necessary, with details of any further confirmed cases. • Students will be screened on entering school. The period of screening will last until 7 days have passed since the last confirmed case. • Intense daily deep clean of that year group and all communal equipment will be carried out, as well as deep clean of all the areas and equipment in the affected

section. Weekend steaming and deep cleaning of all relevant areas inside and out will happen as needed. • Siblings of infected children will be screened daily by our nurses and will be sent home if they show symptoms of influenza.

3. Action taken to avoid further spread of influenza across sections of the school • Year groups may be required to avoid mixing at outside playtimes or in communal areas. • Affected year groups may have swimming or splash play cancelled. • Outside groups or children from other sections of the school may not be allowed in the affected section for 7 days after the last confirmed case as appropriate. • The school will monitor developments on a daily basis and liaise with the health authorities. • If any year group reaches a level of 10% active cases within a 7 day period, the School Leadership Group will consider the closure of that year group or section of the school.

4. Details regarding any school section or year groupcClosure in response to influenza outbreak • Parents will be informed of the closure which will last 7 continuous days. • Curriculum planning will be adjusted to make up for lost lessons as a result of the closure. • Complimentary places on School Holiday Programmes will be offered to compensate missed days.

5. Working in partnership with parents • Parents should be vigilant for symptoms during an outbreak. • Parents should cooperate with the screening procedures during an outbreak. • Parents should communicate with the school immediately if their child is diagnosed with influenza. • A parent may choose to communicate with the health authorities about an outbreak. This should be done in cooperation with the school to ensure the best outcomes. • Parents should understand that the school is not to blame for outbreaks of illness any more than parents are. Illnesses such as Influenza are naturally occurring and are part of life. • Parents are asked to respect that siblings of infected children may be asked to not attend school for 7 days after the first child’s infection was confirmed. • Parents must provide a doctor’s certificate of recovery for their child before returning to school. This cannot happen before the end of a 7 day period after confirmation of infection. • Parents can refer to the Illness Exclusion Policy in all cases of illness. • Parents are asked to follow health authority guidelines to avoid mixing with other children in public places during an outbreak.

Routes to School

Harrow International School Bangkok 45 Soi Kosumruamchai 14, Kosumruamchai Road Don Mueang Subdistrict, Don Mueang District Bangkok 10210 Thailand Telephone: +66 (0) 2 503 7222 www.harrowschool.ac.th