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Ringworm (Tinea)

Clinical Description
Ringworm is an infection caused by a fungus which can affect the skin on the body (Tinea corporis), scalp (Tinea capitis), groin area (Tinea cruris “jock itch”), or feet (Tinea pedis “athlete’s foot”). Ringworm usually begins as a small red bump or papule that spreads outward, so that each affected area takes on the appearance of a red, scaly outer ring with a clear central area. The lesions are frequently itchy, and can become infected if scratched.

Incubation Period
The incubation period varies depending on the type of ringworm. The incubation period for Tinea capitis is 10 to 14 days, Tinea corporis and Tinea cruris is 4 to 10 days, and the incubation for Tinea pedis is unknown.

Mode of Transmission
Transmission is usually by direct contact with a human or animal source. Tinea capitis can also be transmitted by inanimate infected objects such as the back of seats, combs, brushes, or hats.  Tinea cruris, corporis and pedis can be contracted from places such as shower stalls, benches, contaminated floors, and articles used by an infected person.

Period of Communicability
A person can spread ringworm as long as lesions are present and viable fungus persists on contaminated materials and surfaces.

Exclusion/Attendance
The 2009 American Academy of Pediatrics Red Book provides basic guidance on school attendance as follows:
• Students with a fungal infection of the skin should be referred to a medical provider for treatment; however, students who fail to receive treatment do not need to be excluded unless the nature of their contact with other students could potentiate spread.

Prevention/Care
• Students infected with tinea pedis should be excluded from swimming pools, and from walking barefoot on locker room and shower floors until treatment has been initiated.
• Students with tinea capitis should be instructed not share of combs, hats, hair ribbons, or brushes
• Cleaning and draining the school shower areas should be done frequently.

Other Resources
Indiana State Department of Health Quick Fact Link:
http://www.in.gov/isdh/24266.htm

National Institutes of Health Link:
http://www.nlm.nih.gov/medlineplus/ency/article/001439.htm