What is Required for My Student Health Program?

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Posted: Aug 29th, 2016 at 12:00AM - by e7 Health

You may have been prepared for uniforms and textbooks once you were accepted into your health care program, but are you prepared for the vaccines, physical, drug test, and other health services that will be required before you can start your program or clinical work? Most students are not fully prepared and are only made aware of the series of health services required soon before starting their already stressful first semester of classes. You have worked hard to get into your health program, don't let your health services be an added stress!

The list of medical services required before your start classes or clinical work is designed to keep you safe while in a medical setting. Your school may require some or all of the following services

Physical exam

A physical exam is required by some schools and some programs. The school may provide you with a physical exam form, or they may just want a standard physical provided by a specific clinic. Either way, most school physicals are a simple head-to-toe exam including a check of your vital signs, cardiovascular system, respiratory system, ect. Sometimes a vision test is also required, so make sure that you bring your corrective lenses as well as any paperwork that your school has provided you regarding your physical exam requirements.

Vaccines

Practicing proper use of personal protective equipment (PPE) and hand hygiene will provide much needed protection from harmful bacteria and viruses in the healthcare setting. Even so, many diseases can be prevented by receiving a full series of vaccines. Check with your school for which vaccines are required. The most common vaccines will be discussed here.

Hepatitis B is a disease of the liver caused by a virus that is spread through blood and other bodily fluids. The disease can cause mild illness that lasts a few weeks, or can cause a more serious lifelong (chronic) infection. The Centers for Disease Control and Prevention (CDC) estimates that anywhere from 850,000 – 2.2 million people in the United States are infected with chronic Hepatitis B infection and that each year approximately 19,200 new Hepatitis B infections occur. People with chronic infections may not show signs or symptoms for 20-30 years and may not be aware that they have the disease but can still infect others.

Symptoms of acute infection include fever, nausea, loss of appetite, vomiting, joint and abdominal pain, clay-colored stools, dark urine, and jaundice. Chronic Hepatitis B can lead to other serious liver conditions like cirrhosis and liver cancer.

Coming in contact with blood and other bodily fluids in the health care setting can also expose you to other diseases like HIV and Hepatitis C which do not have vaccines, so it is still important to use your PPE, hand hygiene, and other precautions, and always remember that a vaccine will not offer 100% protection from any disease.

Tdap vaccine provides protection against three diseases: tetanus, diphtheria, and pertussis (Whooping Cough) and is needed every ten years. Tetanus is a disease that causes painful tightening (tetany) of the muscles, sometimes making it very difficult to eat and drink when the muscles of the jaw are affected (lockjaw). About 1 in 10 people who are infected with tetanus will die.

Diphtheria is spread through the air, or by touching open sores of an infected person. Severe cases can cause neck swelling and a thick coating in the throat and nose that leads to difficulty breathing, This disease is very rare in the United States, thanks largely to vaccination, although it still occurs in other areas of the world. Healthcare workers could potentially be exposed through travelers.

Pertussis (whooping cough) is a highly contagious respiratory disease caused by bacteria. The bacteria attach to the cilia in the respiratory tract and releases toxins that damage the cilia and cause swelling. The name whooping cough comes from the uncontrollable coughing fits accompanied by a long "whoop" sound when the individual tries to catch their breath after an episode.

Pertussis in adults often times shows few or no symptoms but can still be passed on from person to person through the air. This spread is especially dangerous for newborns where the disease is often times passed on from a family member or caregiver and is especially fatal in this age group.

Varicella (Chickenpox) is a highly contagious disease caused by the varicella-zoster virus (VZV). Once an individual is infected with VZV they develop chickenpox, The telltale fluid-filled blister rash usually starts in the face, back, and chest before spreading to the rest of the body. Before the rash develops, the individual typically has a fever with tiredness, loss of appetite, and headache. During this period, the individual is still contagious. A person who receives the VZV vaccine will most likely not get the chickenpox. However, some individuals may still get the disease, although the rash is typically milder with little to no fever.

Spread of the disease is through contact with an infected person and is also airborne. A person who has had a VZV infection may develop Shingles later in life. A person with an active shingles outbreak cannot spread shingles to others, but can spread chickenpox.

MMR vaccine provides protection against three diseases: measles, mumps, and rubella. Measles is a highly contagious virus that is spread through the air. Outbreaks do occur periodically in the United States and are worse among those who are unvaccinated or who have not received the full series of vaccine. Symptoms start with a fever, sore throat, and runny nose before the individual develops a body rash. The individual is contagious from 4 days before that rash appears until 4 days after the rash has cleared.

Mumps is also highly contagious viral infection that is spread through the air. It can also be spread through sharing of utensils and touching infected surfaces. Symptoms include fever, head and muscle ache, loss of appetite, and swollen salivary glands (puffy cheeks). Men who have a severe infection can develop swelling in the testicles and woman can develop swelling of the ovaries which can lead to fertility issues.

Rubella (German Measles) was eliminated in the United States in 2004, but can be brought into the countries through travelers to endemic areas. It is spread through the air. Symptoms of rubella start out as a low-grade fever, headache, pink eye, swollen lymph nodes, cough, and runny nose before the individual develops a body rash. Up to half of all infected individuals may not show any symptoms.

Blood titers

If you believe you have already had a full series of a vaccine but do not have the vaccination record, or if you have been exposed to a vaccine preventable disease, your school may require that you have a blood draw to prove your immunity. This blood draw, called a blood titer, checks your immune status to vaccinations or diseases you may have received in the past. If your titers results are positive, it means that you have adequate immunity to a particular infectious disease. Therefore, you do not need to get that particular vaccine. However, if you results are negative, that means that you do not have enough of the particular antibody in your system to provide adequate immunity against the disease and should restart the vaccine series.

TB testing

There are a few different ways to test for tuberculosis so it is important to know exactly what type of TB testing your school requires. The simplest form of TB testing is a 1-step TB or PPD test. This test will require you to come into a clinic and have a small amount of fluid injected under the skin on your forearm. This will form a small bump called a wheel. You will need to return to the clinic between 48-72 hours to have the medical staff check your results. If the area where the wheel was injected is not raised, or only raised a certain amount, the test result is negative. If the measurement is over a certain diameter, a chest x-ray is needed to complete the test.

A 2-step TB or PPD test is the same process as above, done twice, at least a week apart. This will require you to return to the clinic a total of four times for two administrations and two "reads" or "checks." Both of these test results needs to be negative, otherwise a chest x-ray is needed.

A quantiferon test is a blood test for tuberculosis and may be used in place of a TB skin test for certain schools. Some schools will also require that a quantiferon blood test be done in place of a TB skin test, so check your school's requirements. The quantiferon is typically more expensive than a TB skin test, but you will not need to return to the clinic for the results. You are also less likely to have false positive results.

If either a 1-step or 2-step TB skin test or a quantiferon result is positive, you will be required to receive a chest x-ray to rule out active tuberculosis. Most schools and clinical sites will require that your TB test, quantiferon blood test, and chest x-ray results be current within the past year, and will require you to have a new test done annually.

Drug Test

Finally, your school or clinical sight may want you to have a drug test before entrance. The drug test is typically a simple urine test, and depending on the school it may look for illicit drugs and prescription drugs. If you are currently taking any prescription drugs, make sure to have the names and dosages available as you may get a call after the drug test to confirm these.

You may or may not get the results of your drug test, depending on your school. If you school provides you with a drug test carbon-copy form or a drug test e-mail with a barcode number to bring into the clinic o0r collection site, the results will most likely be submitted directly to the school for you. Other schools will tell you directly which type of drug test to take, and will have you receive the results and submit them back to them. If you are receiving the results, you may or may not receive them the same day as your test was performed.

At e7 Health, we can perform the entire above mentioned student health services in our offices. We have some of the fastest lab turn-around times available and can take care of most of your needs same or next day with short wait times so that your long list of health services won't be a hassle. Our knowledgeable staff can also help you schedule all follow up appointments including complicated vaccine and TB test schedules. Give us a call or book your appointment online to get these important student services checked off your list.

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