Procedures on Prevention and Surveillance of Contagious Diseases at I-Shou University Adopted in 1994 Amended on April 30, 2009 Amended on January 4, 2011 I. Legal Basis: 1. Communicable Disease Control Act 2. School Hygiene Act II. Purpose: 1. To prevent any contagious diseases on campus and achieve effective self health management. 2. To strengthen cooperation among all the units of the University and bring the functions of prevention of contagious diseases into full play. 3. To eliminate any potential sources of infection, control means of infection and protect compromised hosts. III. Responsibilities: 1. Individuals: a. Self Health Management: (1) having a healthy diet, making exercise a habit and keeping physical fitness; (2) developing a habit of hand washing before eating or after using the bathroom; (3) staying away from places where you could easily get sick (e.g. medical institutes) as possible as you can; (4) avoiding traveling to an area known to have a contagious disease; before you or relatives visit such an area for official necessities, it is highly recommended to get vaccinated and keep in close contact with the health authorities; (5) proactively reporting to the Health Section in case of symptoms, such as acute respiratory infection, a fever of 38 degrees Celsius or higher, vomiting, diarrhea for more than three times with the presence of mucous membrane or blood in the stool, headache, severe fatigue, muscle soreness, blisters all over the body, small blisters or rash inside the mouth/in the palm or sole/on the knee or the hips, acute unilateral/bilateral mumps, self-limited swelling for two days, and the like; (6) wearing a mask in public places in case of respiratory symptoms, such as 1 coughing, running nose and sore throat; (7) avoiding touching blood, seminal fluid, or other fluids coming from another person; (8) avoiding multiple sex partners; using condoms if you have intercourse with more than one person; (9) seeking help from teachers or the Health Section if you or any family members have contagious diseases. b. Faculty: (1) knowing well about students’ attendance and health conditions; (2) teaching students good hygiene habits by using incidental teaching; (3) keeping an eye on students’ health conditions, and reporting to the Health Section when any students feel unwell; (4) understanding the reason why students have applied for sick leave, and reporting to the Health Section for follow-ups if it is suspected that they have contagious diseases; (5) knowing whether there are students whose family members have contagious diseases or take care of patients with contagious diseases to prevent household infection. c. Nurses of the University: (1) understanding the reason why teachers, staff or students have applied for sick leave to discover suspected cases of contagious diseases as early as possible; (2) offering the faculty, staff and students correct information on prevention of contagious diseases; (3) helping the faculty, staff or students infected with contagious diseases or suspected of having contagious diseases to seek medical advice; (4) keeping detailed records of how the Health Section has discovered cases of contagious diseases, taken care of patients with contagious diseases, and helped with patient referral, and reporting to superiors; (5) collaborating with health authorities on preventive measures for contagious diseases; (6) collaborating with health authorities on prophylactic administration to contacts; (7) conducting follow-ups on suspected cases and making investigations on the development of an epidemic; (8) showing consideration to the faculty, staff or students who have contagious diseases, are suspected of having contagious diseases or are subject to home quarantine; 2 (9) purchasing the equipment, drugs and supplies required for prevention of contagious diseases. 2. Grouping and Division of Labor: The President serves as the chairperson, the Dean of Student Affairs the vice chairperson, and the section chief of the Health Section the executive secretary. The members to each task force and respective responsibilities are as follows: Unit President Responsibilities 1. supervise preventive measures for contagious diseases and corresponding responses 2. preside at emergency meetings 3. decide on announcements to the public and appoint a spokesperson 4. decide on suspension and resumption of classes 1. draw up and implement projects for prevention of contagious diseases 2. have a full understanding of the development of an epidemic and call Dean of Student Affairs emergency management meetings 3. report to the competent authority 4. have a full understanding of the whole situation and explain to students and their families Office of Secretariat Make sure that the Communicable Disease Control Act of the Republic of China is applicable to international students, overseas compatriot students and mainland Chinese students Office of Accounting Raise fund and make reimbursement for the equipment, drugs and supplies required for prevention of contagious diseases Office of Personnel 1. understand the reason why the faculty or staff have applied for personal leave or sick leave, and report to the Health Section for surveillance and follow-ups if it is suspected that they or their families have contagious diseases 2. help the faculty or staff infected with contagious diseases or subject to home quarantine to apply for leave 3. help the faculty or staff who have collaborated on prevention of contagious diseases with stress adjustment 4. handle applications for consolation payment to the faculty or staff who died of contagious diseases 5. handle applications for staff rewards or punishments in association with prevention of contagious diseases Office of International Affairs 1. act as the bridge between international students’ families and the University 2. proactively investigate whether there are any international students coming from an area known to have an outbreak of a contagious disease, have a 3 complete understanding of such international students’ health conditions, if any, and report to the Health Section if any international student feels unwell 3. offer any possible assistance to international students who do not manage to go to class because of illness Computer Center 1. assist in promoting information on prevention of contagious diseases 2. posting real-time announcements and relevant information in case of an outbreak of contagious diseases Registration Section help students who need convalescence for a long time to apply for suspension or resumption of schooling 1. draw up regulations and rules for suspension and resumption of schooling as per Article 35 of the Communicable Disease Control Act Curriculum Section 2. help students infected with contagious diseases or subject to home quarantine with remedial teaching 3. help teachers infected with contagious diseases to look for substitutes 4. help classes which need sampling or a clinical examination to reschedule classes General Affairs Section (Office of General Affairs) 1. collaborate with health and environmental protection authorities on campus disinfection 2. purchase the equipment, drugs and supplies required for prevention of contagious diseases 3. control animals that can transmit contagious diseases (e.g. dogs, cats or rats) Student Campus Life Guidance Section 1. understand the reason why students have applied for sick leave, and report to the Health Section for follow-ups if it is suspected that they have contagious diseases 2. report to the Health Section without delay when any students have been diagnosed as having contagious diseases 3. help dormitory residents infected with contagious diseases to seek medical advice and disinfect the dormitory area 4. prepare private rooms for those infected with contagious diseases 5. take measures to prevent a contagious disease from spreading within the dormitory 6. take care of students infected with contagious diseases and help such students to apply for student insurance coverage Counseling and Guidance Section 1. offer counseling to the faculty or students infected with contagious diseases, considered as contacts or subject to home quarantine 2. offer counseling to all the faculty and students for fear of students infected with contagious diseases, considered as contacts or subject to home quarantine being rejected 4 3. show consideration and offer any possible assistance to students infected with contagious diseases through advisors Health Section 1. 2. 3. 4. 5. implement projects for prevention of contagious diseases set up a schedule for all prevention projects to achieve the goals collaborate health authorities on preventive measures collect and promote information on prevention of contagious diseases conduct follow-ups on suspected cases and make investigations on the development of an epidemic 6. coordinate patient referral with hospitals 7. help health authorities collecting samples 8. purchase the equipment, drugs and supplies required for prevention of contagious diseases IV. Flowcharts 1. Flowchart on Prevention and Control of Contagious Diseases at I-Shou University (Appendix 1) 2. Flowchart on Management and Follow-ups of Tuberculosis Contacts (Appendix 2) 3. Flowchart on Sending People with a Fever to Hospitals During the Epidemic of a Contagious Disease (Appendix 3) 4. Flowchart on Handling Cases of Novel Influenza on Campus (Appendix 4) 5. Flowchart on Handling Cases of Novel Influenza at Dormitories (Appendix 5) 6. Flowchart on Management of Cholera Cases on Campus (Appendix 6) Note: In the event of any disputes or misunderstanding as to the interpretation of the language or terms of these Procedures, the Chinese language version shall prevail. 5 Appendix 1 Flowchart on Prevention and Control of Contagious Diseases at I-Shou University A suspected case of contagious diseases on campus Report to Health Section (6577711 ext.2241-5) to activate preventive measures Help the suspected case to Report to health authorities Notify the University as per Communicable Unit: Disease Control Section Unit: Health Section, Office of Disease Control Act of Public Health Bureau International Affairs and Unit: medical institutes seek medical advice Yes medical institutes Report to Campus Security Report Center of Ministry No 1. A name list of teachers, staff and Stop preventive measures Unit: Health Section students having contact with the patient of Education (02) 23343-7855 Unit: Office of Military 2. Have suspected cases Education hospitalized or undergo home quarantine 3. Local Contact the family of the public conduct health daily centers follow-ups on suspected cases and contacts and follows doctor’s advice, and returns to the University after the course Unit: Office of Military Education and Health Section 4. The patient signs an affidavit completing confirmed case (International students: Office of International Affairs contacts the family or school) of treatment 5. The patient suspends schooling for convalescence Unit: Health Section, Office of Academic Affairs, Office of International Affairs, medical institutes and health authorities 1. Investigate development on of the an epidemic, and clean and disinfect the campus 2. Conduct daily interviews with teachers and students Units: Office of Military Education and Health Section 6 Reviewed by Centers for Disease Control Unit: health authorities and Health Section Eliminate the possibility of Suspected or probable infection cases Unit: health authorities and Health Unit: Health Section Section Delisting by Public Health Bureau (Center) Unit: health authorities and Health Section 7 Appendix 2 Flowchart on Management and Follow-ups of Tuberculosis Contacts at I-Shou University Notified by health authorities of a tuberculosis case Health Section immediately contacts his/her family to investigate on the contact history, and compiles data into a file Open Tuberculosis Active Non-open Tuberculosis Have contacts undergo a chest X-ray Have roommates undergo a chest immediately (those who have lived with X-ray immediately (those who the case in the same household for a long live with the case) time) Normal Abnormal Chest X-ray or Symptoms Normal of Tuberculosis Undergo another chest X-ray within one The chest X-ray shows cases of Health Section year; in case of any TB symptoms (e.g. non-old-tuberculosis; have more offers health chronic cough, night sweat or weight persons undergo a chest X-ray education on tuberculosis loss), please undergo a chest X-ray without delay Normal Chest X-ray and No TB Symptoms End Contacts with tuberculosis shall undergo a chest X-ray as instructed by the University. Alternatively, they can submit a report on chest X-ray issued by a public hospital or regional hospital (or above) to the University. Contacts with tuberculosis shall undergo a chest X-ray within three months of occurrence of the incident, and another chest X-ray within one year of occurrence of the incident. If the patient with tuberculosis is an international student, the Office of International Affairs is responsible for contacting his/her family or school. 8 Appendix 3 Flowchart on Sending People with a Fever to Hospitals During the Epidemic of a Contagious Disease A person with a fever (ear/oral temperature of > 37.5℃ or armpit temperature of > 37℃) 1. take a day off from work or school 2. wear a mask at all times and rest at home 3. contact Health Section (Main Campus:2241-5; Yanchao Campus: 3224), Office of Personnel (2045), the military training instructor on duty (2885), or the dormitory management office (male residents: 2401; female residents: 2403) Fever of Unknown Origin or Suspected of Being Infected with a Contagious Disease Influenza or Upper Respiratory Phone Counseling Infection 1. wash hands and wear a mask 2. seek medical advice from Health Section, Syuecheng Clinic or clinics/hospitals nearby 3. rest at home for at least three days, and return to the University only after having no fever without taking antipyretics 1. wash hands and wear a mask 2. Health Section sends a suspected case to a hospital for emergency care 3. Heath Section follows up the diagnosis results and treatment outcomes ※ Please do not use public transportation to see a doctor. or or Those not infected with a contagious disease or no longer being contagious shall follow doctor’s advice without being quarantined, and they can return to the University. They must visit Health Section every day for health education. Those infected with a mild contagious disease (no need for hospitalization; possibilities of infection) shall be subject to home quarantine or isolation in a private dorm room, and return to the University only after they are no longer contagious. 9 Those infected with a contagious disease and hospitalized shall be subject to home quarantine or isolation in a private dorm room after leaving the hospital, and return to the University only after they are no longer contagious. Appendix 4 Flowchart on Handling Cases of Novel Influenza on Campus A suspected case of novel influenza on campus (having such symptoms as a fever, coughing, running nose, sneezing, muscle soreness, headache or severe fatigue) Immediate Reporting Health Section Main Campus: 6577711 ext. 2241-5 Yanchao Campus: 6151100 ext. 3224 Campus Security Report Center: 6577711 ext. 2885 Help the suspected case to seek medical advice (E-Da Hospital or Jiannren Hospital), and contact his/her family (taking him/her back home if he/she is diagnosed as having novel influenza); if he/she is diagnosed as having novel influenza but cannot go home, the University will send him/her to a private dorm room for convalescence. No Meeting the laboratory criteria or guidelines for evaluating suspected or confirmed cases (decided by health authorities) Yes Eliminate the possibility of getting infected of novel influenza 1. fill in relevant forms according to the Influenza Pandemic Level Chart 2. make investigations on the development of a flu epidemic every day and require contacts of novel influenza to conduct self health management 3. clean and disinfect the campus The confirmed case recovers and is delisted by the local Public Health Bureau (Center) Return to the University to resume studies Offer remedial teaching and counseling services to the student 10 Appendix 5 Flowchart on Handling Cases of Novel Influenza at Dormitories A suspected case of novel influenza at the dormitory Dormitory Resident Environment Dormitory Area 1. seek medical advice from Syuecheng Clinic 2. Health Section sends the suspected case to a hospital 3. The military training instructor on duty sends the suspected case to a hospital Negative Positive Self Health Management for 7 Days (including his/her roommates) Report to Campus Security Report Center and the local Public Health Center Unable to return home for convalescence Notify his/her family to take him/her back home for convalescence Stay at a private dorm room After all the symptoms are relieved Return to the University 24 hours after all the symptoms are relieved Take good care of the confirmed case (Health Section provides masks, alcohol for disinfection, a clinical thermometer and bleach) 1. Contact General Affairs Section of Office of General Affairs to clean and disinfect the dorm floor with bleach (500ppm) 2. Check whether residents of the same floor have a fever or feel unwell 11 Appendix 6 Flowchart on Management of Cholera Cases on Campus A suspected case of cholera on campus Report to Health Section (6577711 ext.2241-5) to activate preventive measures Help the suspected case to Report to health authorities Notify the University seek medical advice as per Communicable Unit: Disease Control Section Unit: Health Section Disease Control Act of Public Health Bureau No Yes Unit: medical institutes Report to Campus Security Stop preventive measures Unit: Health Section Report Center of Ministry Confirmed Case: place the confirmed case under isolation in a designated isolation care institution collect samples: stool, vomit or environmental/food samples have the confirmed case recall what he/she has eaten and where he/she has gone over the past week the local Public Health Center conducts follow-ups on the confirmed case every day the stool test result is negative one month after the treatment the confirmed case undergoes treatment for three days; after suspended from taking medicine for 48 hours, collect stool samples or use the Anal tape for three consecutive days (three time a day); the confirmed case can be delisted or released from isolation when all the results are negative 12 of Education (02) 23343-7855 Unit: Office of Military Education Contact the family of the confirmed case Unit: Office of Military Education, Health Section and Office of International Affairs Environment: collect samples: stool, vomit or environmental/food samples make investigations on the development of an epidemic university-wide, and clean and disinfect the campus (bleach: 0.5%) Contacts: When there is a suspected case from an area known to have cholera entering Taiwan, people who take the same airplane/ship or join the same travel group shall be subject to examination supervise contacts for seven days (including those from an area known to have cholera) make an investigation on the faculty, staff or students who have had meals with the confirmed case or who are highly suspected of being infected of cholera source of infection: looking for water or food that may be contaminated; using stool culture to look for confirmed cases the local Public Health Center conducts follow-ups on contacts every day offer relevant health education to all faculty and students conduct daily interviews with teachers and students Reviewed by Centers for Unit: Health Section, Office of Disease Control Unit: health authorities and Academic Affairs, medical institutes and health authorities Health Section Eliminate the possibility of Suspected or Probable infection Cases Unit: medical institutions, Health Unit: Health Section Section and health authorities Delisting by Public Health Bureau (Center) Unit: Health Section and health authorities 13 take emergency measures to ensure water safety, add chlorine to water, and prevent water from being contaminated; add chlorine to water or boil drinking water supervise the preparation process of food and drinking water: preventing boiled water or food from being contaminated by flies or improper methods If the test results of environment samples are positive, it is necessary to collect samples and disinfect every day until the results become negative Units: Office of Military Education and Health Section