Health Concerns

To help provide a safe and healthy learning environment, please keep your child home when exhibiting any of the following symptoms.

• Fever of 100.4 or greater

• Significant respiratory symptoms (heavy cough, green nasal discharge, chest congestion). DPS recommends that families seek advice from their medical provider when experiencing symptoms of respiratory illness

• Sore Throat with fever and/or behavioral changes (until medical provider determines that the illness is not a communicable disease)

• Diarrhea or vomiting in the last 24 hours unless it is determined to be caused by a non-communicable condition and the child is not in danger of dehydration

• Abdominal pain that continues for more than 2 hours or intermittent pain associated with fever or other signs or symptoms

• Mouth sores with drooling in that child, unless the child’s physician determines the child is not infectious

• Rash with fever or behavioral changes until the child’s physician determines illness is not a communicable disease

• Skin sore with weeping fluid on the exposed surface, unable to be covered with a waterproof dressing

• Discolored eye drainage (profuse and or thick)

Your child may return to school when symptoms have significantly resolved, they feel well enough to learn, AND they are:

• Fever free for 24 hours without the use of fever-reducing medication and feeling well enough to return to school

• Diarrhea and or vomiting has stopped for a minimum of 24 hours

• Rash has been assessed by a medical provider (must provide a note to the school nurse that includes clearance for when the child may return)

• 12-24 hours after an antibiotic has been started

DPS Nurses reserve the right to send home any student who displays signs of ill health or injury.  Please be sure your contact and emergency contact information in Aspen is current and accurate, and that you have arrangements in place for your child to be picked up within 30 minutes of notification should they become sick during the school day and need to be picked up. Contact your school nurse with any questions. 

Guidelines are based on the Center of Disease Control and Prevention, the American Academy of Pediatrics, and the local and state departments of public health, and are subject to change.

Helpful Links:

DPS Sick Day Guidelines For Families

DPS Exclusion Requirements Guidelines

CSDE-When is Sick too Sick for School

Asthma

Asthma is a long-term condition in children that affects the lungs and breathing. It causes the airways to become inflamed and sometimes tighten, making it harder for a child to breathe. Asthma can be triggered by allergies, including pollen, dust, or pets, and can also be worsened by irritants such as smoke, pollution, or strong odors. In addition, colds and other respiratory viruses, like RSV (Respiratory Syncytial Virus) or the common cold, can make asthma symptoms worse.

Asthma is fairly common, affecting about 8% of school-aged children in the U.S. In a typical classroom, two or three students are likely to have asthma. The condition can lead to missed school days for students and missed workdays for caregivers. Asthma remains one of the top reasons children are admitted to the hospital.

The goal of asthma management is to keep the condition under control using safe medications and strategies that minimize side effects. Proper management helps reduce missed school days, allows students to participate in activities and sports, and prevents severe asthma attacks that require emergency care or oral steroids. When asthma is well-managed, children can enjoy a better quality of life and fully participate in school and daily activities.  At Darien Public Schools (DPS), the health and safety of students is our top priority. We are committed to helping students with asthma manage their condition safely at school. We work closely with families, healthcare providers, school nurses, and staff to create a supportive learning environment.

My Child Has Asthma. What Do I Need to Do?

Step 1. Notify the School Nurse. Please inform the school nurse at your child’s school if your child has asthma. For returning students, notification is only required if there are changes in diagnosis, medications, or management plan.

Step 2. Submit Required Forms and Medications. At the start of each school year, or sooner if needed, families must provide an Asthma Action Plan (AAP), Medication Authorization Form(s), and all prescribed rescue medications as listed on the AAP.  Students may self-carry and self-administer their rescue inhalers with written authorization from both a parent/guardian and their healthcare provider. DPS nurses strongly recommend keeping an additional inhaler, with orders, in the nurse’s office to best ensure immediate access to rescue medication in case of an asthma flare-up while at school.  All medications should be in the original pharmacy box with the pharmacy label.

Tip: Double-check forms for accuracy, signatures, and medication dates. All medications must be picked up at the end of the school year.

Step 3. Review and sign your child’s AAP and IHP (if indicated).  The school nurse will review the AAP with you and create an IHCP if indicated. An IHCP outlines the steps taken to manage your child’s asthma at school. Families review, sign, and return the IHCP.

Helpful Links

• American Lung Association

• CDC: How to Use An Asthma Inhaler

• CDC: Inhaler with Spacer fact sheet and illustrations

Concussion

A concussion is a type of traumatic brain injury (TBI) caused by a bump, blow, or jolt to the head that affects how the brain works. Concussions can occur during sports, play, or everyday activities. While some concussions result from a direct hit to the head, many are caused by sudden movement, such as a rapid stop or change in direction, which causes the brain to move quickly within the skull.

Concussions are common among children and adolescents. Each year, emergency departments across the United States treat thousands of young people for sports and recreation-related brain injuries, including concussions. Because every brain is different, each concussion is unique, and recovery can vary widely from one student to another.

A concussion may affect a student’s ability to learn, concentrate, and fully participate in school activities. Some students may continue attending school with minimal support, while others may experience symptoms that persist for weeks or longer and require more significant academic adjustments. In accordance with Connecticut State Department of Education guidelines and Darien Public Schools practices, students recovering from a concussion are supported through an individualized plan that guides their gradual return to academics and physical activity.

Rest is a critical part of concussion recovery. Both cognitive (mental) and physical rest help the brain heal. Returning to schoolwork, sports, or other activities too quickly can prolong recovery, increase the risk of further injury, and interfere with academic progress. For this reason, school staff work closely with families and healthcare providers to monitor symptoms and adjust supports as needed throughout the recovery process.

For more information about concussion management and return-to-school guidelines, please visit the Connecticut State Department of Education website or contact your school nurse. 

Helpful Links

• DPS Concussion Return to Play protocol

• CSDE Concussion Education Plan and Guidelines for Connecticut-Schools

• CDC Heads Up

Hand Foot and Mouth Disease (HFMD)
Hand, Foot, and Mouth Disease (HFMD) is a contagious viral illness, most often caused by the coxsackievirus.  While it can be uncomfortable, HFMD is generally mild and common, especially among younger children. It spreads through direct contact with nose and throat secretions, saliva, blister fluid, or stool from an infected person.

Treatment 
HFMD is usually managed with supportive care. Encourage your child to drink plenty of fluids to stay hydrated and use pain relievers (as advised by your healthcare provider) for fever or discomfort. Soft, cool foods can help soothe mouth sores, and plenty of rest will support recovery. 

If your child’s symptoms worsen, if they are unable to stay hydrated, or if you have concerns about healing, please get in touch with your healthcare provider

Prevention
To help prevent the spread of HFMD, encourage your child to wash their hands often, cover coughs and sneezes with a tissue or elbow, and avoid sharing utensils or drinks with anyone who is sick. Avoid touching other children’s blisters or their own, as the fluid can spread the virus. Regularly cleaning high-touch surfaces, such as desks and doorknobs, can also help prevent the spread of germs.

School Exclusion
Children with HFMD should stay home if they have a fever, mouth sores that make it hard to swallow, or are simply not feeling well enough to participate comfortably in school. They can return once they have been fever-free for 24 hours without medication, feel well enough to participate in class, and have no uncontrolled drooling with mouth sores. Blisters do not need to be fully healed before returning, as long as they are dry, covered (as well as possible), and the child feels well.

Excluding children from the group setting does not reduce disease transmission, as some children may shed the virus even when they are not visibly ill, and the virus may be shed for weeks. Good cough and sneeze etiquette as well as good hand hygiene, is the best way to reduce transmission.

Helpful Links

• Hand, Foot and Mouth Disease DPS letter to Parents
• CDC: Coxsackie Virus
• KidsHealth Coxsackie Virus and KidsHealth Hand, Foot & Mouth Disease

Type 1 Diabetes

Type 1 Diabetes (T1D) is a condition where the body can’t make enough insulin, a hormone that helps turn the food your child eats into energy. Without enough insulin, sugar from food builds up in the blood instead of being used for energy. Children with T1D need insulin every day to help their bodies use sugar properly and stay healthy.  It is one of the most common chronic diseases in school-aged children, affecting approximately 1 in 300 children by the age of 18. 

DPS school nurses are trained and authorized to meet the healthcare needs of students with diabetes. Every student’s diabetes care is unique, and our approach follows national and state guidelines based on the latest evidence and best nursing practices. We understand that managing diabetes doesn’t stop when your child is at school.

At DPS, the goal of diabetes care is to keep your child’s blood sugar within the target range set by their healthcare provider while maximizing time in the classroom. Staying within this range supports healthy growth, development, and learning. Effective management involves balancing food, activity, and insulin or medication to prevent blood sugar from going too high or too low, which can be dangerous.

Our school nurses work closely with families and healthcare providers to support students with diabetes, ensuring they remain safe, healthy, and confident at school. Care is tailored to each student’s individual needs, abilities, and developmental stage, while fostering independence at every level.

My Child Has Type 1 Diabetes. What Do I Need to Do?

Step 1. Notify the School Nurse.  Please inform the school nurse at your child’s school of your child's Type 1 Diabetes (T1D) diagnosis. 

Step 2. Submit Required Forms, Medications, and Supplies. At the start of each school year, or sooner if indicated, families must submit a current Diabetes Management Plan and School Treatment Authorizations (DMP) prepared and signed by your child's Diabetes Provider, along with all prescribed rescue medications (as listed on DMP) and supplies (including rescue snacks, glucometer, and strips).

Step 3. Review and sign your child’s Individualized Health Care Plan (IHCP). Upon receipt of required forms, medications and supplies, the school nurse will review the DMP with the parent and prepare an Individualized Health Care Plan (IHCP) for your child. An IHCP outlines the steps the school will take to manage your child’s T1D and support a safe learning environment. Families are asked to review, sign, and return the IHCP. The IHCP is reviewed and updated annually, or more often as needed.

Step 4. Attend your child’s annual Section 504 Meeting. T1D is considered a significant health condition and is protected under Section 504 of the Rehabilitation Act of 1973, a federal civil rights law that prevents discrimination for students with disabilities. Families will receive written notice each school year regarding the annual review of the 504 plan, and will be requested to participate in the meeting. Following the annual review, the updated 504, along with the IHCP, is uploaded to CT‑SEDS for family review.

Student Expectations. To support growing independence and ensure safe diabetes management at school, the following section outlines general expectations for students by grade level.

Elementary School Student with T1D
* Participate in diabetes care with guidance, supervision, and direct assistance (indicated) from the nurse.
* Carry a “go-to” bag with a CGM transmitter (usually an iphone), glucometer, testing strips, glucose tabs, and snacks.
* Keep extra supplies and snacks in the Health Office for classroom and activity use.
* Coordinate meals and snacks with carbohydrate (CHO) counts. The nurse assists with covering the carbohydrates at snack and lunch.
* Learn to recognize and respond to high or low blood sugar.

MMS Student with T1DMMS Student with T1D
*Build on elementary school skills while gradually shifting more diabetes self-care responsibilities to require less supervision and more indepencance. 
*Learn school schedules and coordinate with the school nurse to plan for care, activities, and meal timing.
*Set goals that promote independence, confidence, and skill development.
*Continue collaboration with parents/guardians, the school nurse, and staff to meet each student’s individual needs.

DHS Student with T1D
*Independent self-management is the ultimate goal
*Students visit the DHS health office as needed
*Role of the school nurse shifts toward guidance, problem-solving, and emergency support.
*Care plans evolve throughout the high school years as students mature and prepare for independent diabetes management after graduation.
*The focus remains on keeping students healthy, engaged in learning, and confident in their self-care skills.

Across all grade levels, our goal is safe, effective diabetes management while fostering independence, confidence, and success.

Helpful Links:

• Managing Diabetes at School | Diabetes
• Helping the Student with Diabetes Succeed: A Guide for School Personnel
• Joslin Diabetes Center – World Leader in Diabetes Care & Research 

Fifth Disease (Parvovirus B19) is a common, usually mild illness caused by parvovirus B19. It is also known as erythema infectiosum and was historically identified as the fifth most common childhood rash illness. It occurs more often in children than in adults, and symptoms typically develop about 4 to 14 days after exposure.

Signs and Symptoms. Early symptoms are often mild and may include a low-grade fever, runny nose, and headache. Several days later, a bright red rash may appear on the cheeks, often described as a “slapped cheek” appearance. This is the most recognizable sign of fifth disease and is more commonly seen in children. A second rash may develop a few days later on the chest, back, buttocks, arms, and legs. This rash may be itchy, especially on the soles of the feet, and often has a lacy or net-like appearance as it fades. While the rash usually resolves within 7 to 10 days, it may come and go for several weeks. Older children and adults may also experience joint pain or swelling.

Transmission. Parvovirus B19 spreads through respiratory secretions, such as saliva and mucus, when an infected person coughs or sneezes. A person is most contagious before the rash appears, when symptoms may resemble a mild cold. Once the rash develops, the individual is typically no longer contagious and may return to school. People with weakened immune systems may remain contagious for a longer period. The virus can also spread through blood or blood products. In some cases, a pregnant individual who becomes infected can pass the virus to their baby. Adults of childbearing age who are exposed and have concerns are encouraged to contact their healthcare provider. After recovery, most people develop lasting immunity.

Complications. Fifth disease is generally mild in otherwise healthy children and adults. However, complications can occur in individuals with weakened immune systems, those who are pregnant, or those with certain blood disorders. Anyone in these groups who has been exposed or is experiencing symptoms should seek medical advice.

Treatment. Fifth disease typically resolves on its own, and treatment focuses on relieving symptoms such as fever, itching, and joint discomfort. Anyone who develops complications or experiences prolonged symptoms should contact their healthcare provider.

Diagnosis. Healthcare providers can often diagnose fifth disease based on the characteristic rash. In some cases, a blood test may be used to determine whether a person is immune, susceptible, or recently infected. This can be particularly helpful for individuals who are pregnant and may have been exposed.

Prevention. There is no vaccine to prevent parvovirus B19 infection. Preventive measures focus on good hygiene practices, including frequent handwashing, covering coughs and sneezes, avoiding touching the face, limiting close contact with individuals who are ill, and staying home when sick. By the time the rash appears, a person is usually no longer contagious and can safely return to school.

Helpful Links

• Information for Parents about Fifth Disease
• CDC- About Fifth Disease

Life‑Threatening Food Allergies: Information for Families
At Darien Public Schools (DPS), the health and safety of our students is our highest priority. We are committed to the prevention and careful management of life‑threatening food allergies (LTFA) and work in close partnership with families, health care providers, school nurses, DPS staff, and Dining Services to ensure every student learns in a safe, inclusive, and supportive environment. Below, please find all the information you might need to help us support your child.

My Child Has a Life‑Threatening Food Allergy. What Do I Need to Do?
DPS follows a clear, step‑by‑step process to ensure students with life‑threatening food allergies are safely supported at school.

Step 1. Notify the School Nurse. Please inform the school nurse at your child’s school of your child’s food allergy. For returning students, notification is only required if there has been a change in allergy status.

Step 2. Submit Required Forms and Medications. At the start of each school year, or sooner if indicated, families must submit: Emergency Care Plan for Food Allergy, Medication Authorization Form(s) and all prescribed rescue medications (as listed on the emergency care plan)
NOTE: Before leaving your medical provider’s office, please carefully review forms to ensure that allergens are listed correctly, rescue medications and dosages are accurate and match pharmacy labels, required signatures are completed (healthcare provider and parent/guardian), AND medication orders are dated and cover the school year. All medication must be picked up at the end of the school year.

Step 3. Review and sign your child’s Individualized Health Care Plan (IHCP). Once the required documentation and medications are received, the school nurse will provide parents/guardians with an Individualized Health Care Plan (IHCP) to review and sign. The IHCP outlines the steps the school will take to manage your child’s allergy and support a safe learning environment. Families are asked to review, sign, and return the IHCP.

Step 4. Attend or opt out of your child’s annual Section 504 Meeting. Families receive written notice each school year regarding the annual review. Parents/guardians are invited to participate in the meeting; attendance is encouraged but not required. Following the annual review, the updated 504, along with the IHCP, is uploaded to CT‑SEDS for family review.

Helpful Links

• Parent Letter Food Allergies 2025-2026
• Life Threatening Food Allergy Flyer for Families
• LTFA FAQs from DPS Nursing Services
• Elementary Letter from Nursing and Dining Services
• MMS Letter from Nursing and Dining Services
• DHS Letter from Nursing and Dining Services

• Use a quality lice comb (e.g., LiceMeister®¹) LINK
• Perform checks on wet hair, leaving a small amount of shampoo or conditioner in to make spotting lice easier—especially on darker hair.
• Begin at the nape of the neck, then check behind the ears, which are common sites for lice.
• Use a bright light (like a phone flashlight) and/or magnifying glass, if available.
• Place the comb at a downward angle close to the scalp and comb through to the end of the hair.
• Wipe the comb on a paper towel after each stroke and check for any lice or nits (eggs).
• Continue until you’ve checked the entire scalp.

• Begin with an over-the-counter treatment (e.g., a product containing pyrethrins), and repeat on Day 7.
• If lice persist, consult your healthcare provider about a prescription treatment (e.g., Ovide).
• If lice still remain, switch to mechanical removal only, as repeated use of pesticide treatments is not recommended and may be harmful.

Lyme Disease

• KidsHealth – Information for parents about Lyme disease
• CDC Fact Sheet and Graphic for Parents "Children & Lyme Disease"
• CDC Informational Page on Lyme Disease

Pink Eye (Conjunctivitis)
Pink eye, also known as conjunctivitis, is a common eye condition in children. It happens when the thin, clear layer that covers the white part of the eye and lines the eyelid becomes irritated or infected. This can make the eye look red or pink and may cause watering, discharge, itching, or discomfort.

Pink eye is frequently seen in school settings and can sometimes lead to missed school days, although not all cases require children to stay home. Some types of pink eye are contagious, while others are not.

Causes. Pink eye can be caused by viruses or bacteria, which can spread easily from person to person. It can also be caused by allergies, such as pollen, or by irritants like smoke, dust, or chemicals. These non-infectious causes are not contagious.

Signs and symptoms. Children with pink eye may have redness or swelling of the eye, increased tearing, or a feeling like something is in the eye. Itching, irritation, or a mild burning sensation is also common. Some children develop discharge that can cause crusting on the eyelashes, especially after sleep. Symptoms may affect one or both eyes.

When to a Healthcare Provider.  In some situations, it is important to contact your healthcare provider. This includes if your child has eye pain, sensitivity to light, blurred vision, or significant redness. You should also seek medical advice if symptoms are not improving, are getting worse, or if your child has a weakened immune system, a known eye condition, or is a newborn. A healthcare provider can usually determine the cause and recommend appropriate care.

Transmission. Viral and bacterial pink eye can spread through contact with eye discharge or by touching contaminated hands, surfaces, or objects and then touching the eyes. Children are most contagious while there is active tearing and discharge. Good handwashing is one of the most effective ways to prevent the spread.

Treatment. Treatment for pink eye depends on the cause. Viral pink eye usually improves on its own, and care focuses on relieving discomfort, such as using cool compresses or artificial tears. Bacterial pink eye may require antibiotic eye drops or ointments prescribed by a healthcare provider. Pink eye caused by allergies or irritants can be managed by avoiding triggers and using soothing eye drops recommended by a healthcare provider. Regardless of the cause, good hygiene and handwashing help prevent the infection from spreading.  
If your child wears contact lenses, they should stop wearing them until advised by their eye care provider that it is safe to resume. Proper cleaning and replacement of lenses and storage cases is important to prevent reinfection.

Prevention. Helping children practice healthy habits can reduce the spread of pink eye. Encourage frequent handwashing and remind children to avoid touching or rubbing their eyes. Personal items such as towels, washcloths, bedding, eye drops, makeup, eyeglasses, and contact lenses should not be shared. Using clean towels each day, washing pillowcases regularly, and keeping eyeglasses clean are also helpful.

When to Keep Your Child Home. Children should stay home from school if they have significant eye discharge that cannot be managed, are unable to avoid close contact with others, or are not feeling well enough to participate in normal school activities. Many children with mild symptoms who can follow good hygiene practices may remain in school. If you are unsure, or if your child’s symptoms are not improving or are getting worse, please contact your healthcare provider or DPS  school nurse for guidance.

Most cases of pink eye are mild and resolve on their own. Good hygiene is the most effective way to prevent spreading the infection at home and at school.

Helpful Links

CDC: Help Protect Yourself from Getting and Spreading Pink Eye graphic

American Academy of Pediatrics: Conjunctivitis

Respiratory Illnesses

Below, please find important information on common respiratory illnesses, including Influenza (Flu), community-acquired pneumonia (CAP), Respiratory Syncytial Virus (RSV), and COVID-19, to help you make the best health decisions for your family. 
 
Community-acquired or "Walking" Pneumonia (CAP) is a respiratory infection that causes the air sacs (alveoli) in the lungs to fill with fluid. CAP is typically caused by a bacterium called Mycoplasma pneumoniae. Infections are generally mild. Symptoms include a productive cough, fever, trouble breathing, and fatigue.  In general, bacterial pneumonia is less contagious than the viruses that cause respiratory illness, including Flu, RSV, and COVID-19. If your child experiences CAP symptoms, it is advised that you consult your pediatrician for an evaluation. Treatment often includes antibiotics and rest.  For more information on CAP, visit the American Family Physician Website

Influenza (Flu) virus usually presents with the following symptoms: a sudden fever, chills, headache, fatigue, sore throat, dry cough, and/or nasal congestion. While symptoms are similar to a common cold, children with the flu usually have a higher fever and more severe symptoms. If your child experiences flu symptoms, it is advised that you consult their pediatrician. Testing is recommended as antiviral therapies are effective and readily available.

Respiratory Syncytial Virus (RSV) is a common respiratory virus that usually causes mild, cold-like symptoms such as fever, congestion, cough, and sneezing.  Symptoms may be more severe in young children and the elderly. With RSV, children can become sick very quickly. If you notice a rapid increase in the severity of symptoms and/or changes in breathing, call your child’s pediatrician immediately or go directly to the emergency room. Routine testing is often not recommended, as symptoms are generally mild and effective antiviral therapy is not readily available in the community setting. 

COVID-19 symptoms include sudden loss of taste or smell, cough, headache, shortness of breath, loss of appetite, and sore throat.  Routine home testing is important so infected individuals can have access to effective antiviral therapy, and isolate from persons at high risk of complications 

Management and Prevention of Respiratory Illnesses
In order to promote the health and safety of our school community, we continue to recommend consulting your health care providers regarding the Flu vaccine and COVID-19 boosters, and keeping your child home if they are sick, returning when they are fever-free for 24 hours without the use of fever-reducing medication and feel well enough to return.  Follow this LINK to learn more about respiratory illness, including signs/symptoms, treatment options, and case rates in Connecticut. Always seek the advice of your health care provider when you are concerned about your child's health. 

Helpful Links

• Staying Healthy Over the Holidays Letter to DPS Families 
• Update on Respiratory Viruses 
• Flu Shot Locations: For a link to where you can get a flu shot in the community
• CDC Respiratory Virus Guidance 2024

• Two or more unprovoked seizures occurring more than 24 hours apart, or
• One unprovoked seizure and additional evidence that they are at high risk for future seizures

• Fatigue or drowsiness
• Irritability or anxiety
• Dizziness
• Stomach upset
• Difficulty concentrating (“brain fog”)

Seizure Action Plans at School
At Darien Public Schools (DPS), every student with a known seizure disorder or diagnosis of epilepsy has a Seizure Action Plan (SAP), also called an Emergency Care Plan for Seizures. This plan helps ensure that school staff can respond quickly and appropriately to support the student’s safety. SAPs are provided by your child's medical provider and usually include:

• Emergency contact information
• A description of the student’s seizure type(s)
• Daily and rescue medications
• Clear, step-by-step instructions for responding to a seizure

• Epilepsy Foundation: Schools and seizure preparedness.  
• CDC Guidance for schools | Epilepsy.
• Seizures in Children. Merck Manual Consumer Version.

Shingles (Herpes Zoster)
According to the CDC, nearly 1 in 3 people in the United States will develop shingles in their lifetime. There are an estimated 1 million cases each year.  Shingles is caused by the varicella zoster virus (VZV), the same virus that causes chickenpox. Anyone who has had chickenpox can develop shingles later in life, including children. However, the risk increases with age, and about half of all cases occur in adults age 60 and older.
Some individuals are at greater risk for shingles, including people who:

• Have medical conditions that weaken the immune system (such as leukemia, lymphoma, or HIV)
• Take immunosuppressive medications (such as steroids, chemotherapy, or medications after organ transplantation)
• Most people experience shingles only once, but it is possible to have it more than once.

Cause
After a person recovers from chickenpox, the virus remains inactive in the body. Years later, the virus can reactivate and cause shingles. The reason for this reactivation is not fully understood.  Shingles is NOT caused by the virus that causes genital herpes.

Signs and Symptoms
Shingles usually appears as a painful rash on one side of the face or body. The rash forms blisters that typically scab over in 7–10 days and clear within 2–4 weeks.
Before the rash appears, a person may feel:

• Burning
• Tingling
• Itching

These early symptoms may occur 1–5 days before the rash develops. The rash most often appears as a single stripe on either the left or right side of the body or face. In rare cases, especially in people with weakened immune systems, the rash may be more widespread and resemble chickenpox. Shingles can also affect the eye and may cause vision loss.
Other symptoms may include:

• Fever
• Headache
• Chills
• Upset stomach

Transmission
Shingles cannot be passed from one person to another. However, the varicella zoster virus can spread from a person with active shingles to someone who has never had chickenpox or the chickenpox vaccine through direct contact with the rash blisters. If this occurs, the exposed person would develop chickenpox, not shingles.  The virus is not spread through coughing, sneezing, or casual contact.

A person with shingles is contagious only while the rash is in the blister phase. Once the rash has crusted over, the person is no longer contagious. A person is not contagious before blisters appear or after the rash has healed.  Shingles is much less contagious than chickenpox, and the risk of spread is low if the rash is covered.

If You Have Shingles
To prevent spreading the virus:

• Keep the rash covered
• Avoid touching or scratching the rash
• Wash your hands frequently

Until the rash has crusted over, avoid contact with:

• Pregnant women who have never had chickenpox or the chickenpox vaccine
• Premature or low birth weight infants
• People with weakened immune systems (including those receiving chemotherapy, transplant recipients, or individuals with HIV)

Prevention (Vaccination)
Vaccination is the best way to reduce the risk of developing shingles and the long-term nerve pain known as post-herpetic neuralgia (PHN).
The CDC recommends the Shingrix vaccine for:

• All adults 50 years and older
• Adults 19 years and older** who have weakened immune systems

Shingrix is given as a **two-dose series**, 2–6 months apart, and is available at pharmacies and healthcare providers’ offices.  Talk with your healthcare provider if you have questions about whether the shingles vaccine is right for you.

Treatment
Several antiviral medications are available to treat shingles, including Acyclovir, Valacyclovir. Famciclovir.  These medications can shorten the length and severity of the illness, but they are most effective when started as soon as possible after the rash appears. Anyone who thinks they may have shingles should contact their healthcare provider promptly.
To help manage symptoms:

• Pain relievers may reduce discomfortInformation
• Wet compresses, calamine lotion, and colloidal oatmeal baths may help relieve itching

Helpful Links

CDC Information on the Shingles Vaccine

State of Connecticut Department of Public Health Information Sheet on Shingles

• Link to CDC information on Zika Virus

• Link to Darien Public Health Department Informational Video about Zika virus

• Link: What parents should know about Zika (CDC)

• Link: American Academy of Pediatrics information about Zika Virus

• Link: Healthy Children.org info on What Parents need to know about Zika Virus