Maryland officials released guidelines yesterday recommending that public school students with the deadly acquired immune deficiency syndrome or infected with the virus should be allowed to remain in the classroom, with some exceptions.
The guidelines, drafted by the state's Department of Health and Mental Hygiene, say only children with AIDS who are preschoolers, lack control of their body secretions, are prone to biting or have open lesions should be barred from attending school.
The guidelines leave it to local school boards to determine whether students with AIDS who don't fit into those categories should remain in school, after consulting with the child's doctor and parents and with education and local health officials.
Decisions to allow a school employe with AIDS to remain in school also should be made on a case-by-case basis, the guidelines say.
"The policy says we are not going to automatically exclude children or employes because they have AIDS, but each case will evaluated individually," said Thomas Krajewski, assistant secretary for health.
The state guidelines, however, are only recommendations and local school boards are not bound to follow them, state officials said.
They could be made binding only if the state Board of Education adopted them as bylaws, said Gus Crenson, a spokesman for the state Department of Education. He said the state board has not taken a position on the guidelines.
In the meantime, Crenson said, the state's 24 local school boards are "so eager for direction that they will take the guidelines seriously and adopt them pretty quickly."
Krajewski agreed. "We think they are conservative guidelines and balance the safety of the larger school setting with the safety of the patient who may be exposed to other infections," he said.
Maryland's guidelines are patterned after those issued this summer by the federal Centers for Disease Control in Atlanta. The federal guidelines say children with AIDS should not be barred from the classroom except under special circumstances because the condition cannot be spread through casual contact.
AIDS is a virus that destroys the body's immune system leaving it open to infection. It is spread through sexual contact and by sharing blood or blood products.
Some persons have a milder form of AIDS, called AIDS-Related Complex (ARC), and still others may be infected by the virus but show no symptoms.
In Maryland, Virginia and the District of Columbia, there have been 463 reported cases of AIDS so far, including 248 deaths, according to the state health department.
Ten school employes in Maryland have been found to have AIDS. Eight of them have died and the other two are no longer employed in public schools, said Polly Roberts, assistant director of infant, child and adolescent health for the state. Two of those employes were teachers in Montgomery County who died in the last 14 months.
The only known case of a student with AIDS in Maryland is an adolescent girl currently attending school in Baltimore who has tested positive for the virus but is not sick, Roberts said.
Several other states, including California and New York, have adopted guidelines on AIDS in the public schools, but Maryland is the first in this region to do so.
The District is in the process of devising a policy on AIDS, expected to be finished by the end of December, said schools spokeswoman Janis Cromer.
Virginia has decided to let local school boards set their own policies on AIDS, said Robert Stroube, assistant state commissioner of health.
In Maryland, several school systems, including Prince George's County, have adopted formal policies on AIDS, and others are drafting guidelines.
Baltimore City probably will adopt the state's guidelines with only minor modifications, according to Leonard Wheeler, executive director of elementary education.
Robert Shoenberg, president of the Montgomery County board, called the state's guidelines "prudent." Montgomery has adopted an interim policy that would exclude students and employes with AIDS from school until the board comes up with a formal policy.