Good hygiene practice is as crucial as ever. The spread of infections can be prevented through good hygiene standards, routine immunisation and by maintaining a clean environment. Ensure children wash their hands (we recommend liquid soap, water and paper towels) after using the toilet, before eating or handling food and after handling animals.
The chart below details the Health Protection Agencies guidelines on diarrhoea and vomiting illnesses, respiratory infections, other infections, vulnerable children, female staff and pregnancy and immunisation.
NB Illnesses marked with an asterisk (*) denote a notifiable disease. It is a statutory requirement that Doctors report a notifiable disease to the proper officer of the Local Authority. An outbreak of an infectious disease should be reported to your local Health Protection Unit .To find your HPU visit www.hpa.org.uk
Diarrhoea and Vomiting illnesses |
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Illness |
Recommended exclusion |
Notes |
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Diarrhoea and/or vomiting |
48 hours from last episode of diarrhoea or vomiting
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2 week exclusion from swimming following last episode of diarrhoea.
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E.coli 0157 VTEC
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Exclusion is important for some children. Always consult HPU.
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Exclusion applies to young children and those who may find hygiene practices difficult to adhere to. Local HPU will advise. 2 week exclusion from swimming following last episode of diarrhoea. |
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Typhoid* [and paratyphoid*] (enteric fever) |
Exclusion is important for some children. Always consult HPU.
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Exclusion applies to young children and those who may find hygiene practices difficult to adhere to. Local HPU will advise. 2 week exclusion from swimming following last episode of diarrhoea |
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Shigella (Dysentery) |
Exclusion may be necessary.
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Exclusion (if required) applies to young children and those who may find hygiene practices difficult to adhere to. Local HPU will advise. 2 week exclusion from swimming following last episode of diarrhoea. |
Respiratory Infections |
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Illness |
Recommended exclusion |
Notes |
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Influenza (flu) |
Until recovered. |
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Tuberculosis*
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Always consult HPU.
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Not usually spread from children. Requires quite prolonged, close contact for spread. |
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Whooping cough* (Pertussis)
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Five days from commencing antibiotic treatment or 21 days from onset of illness if no antibiotic treatment. |
Preventable by vaccination. After treatment non-infectious coughing may continue for many weeks. HPU will organise any contact tracing necessary |
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Athletes foot |
None.
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Athletes foot is not a serious condition. Treatment is recommended. |
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Chicken pox |
5 days from onset of rash.
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Cold sores |
None.
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Avoid kissing and contact with the sores. Cold sores are generally a mild self-limiting disease. |
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German measles (Rubella)* |
5 days from onset of rash.
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Preventable by immunisation (MMR x 2 doses). See female staff – pregnancy. |
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Hand, foot & mouth
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None.
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Contact HPU if a large number of children are affected. Exclusion may be considered in some circumstances. |
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Impetigo
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Until lesions are crusted or healed. |
Antibiotic treatment by mouth may speed healing and reduce infectious period. |
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Measles*
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5 days from onset of rash.
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Preventable by vaccination (MMR x 2). |
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Molluscum contagiosum |
None. |
A self limiting condition. |
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Ringworm
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Until treatment commenced.
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Treatment is important and is available from pharmacist. N.B. GP treatment required for ringworm of scalp. Also check and treat symptomatic pets. |
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Roseola (infantum) |
None. |
None. |
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Scabies
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Child can return after first treatment.
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Two treatments 1 week apart for cases. Contacts should have one treatment; include the entire household and any other very close contacts. Contact HPU if further information required. |
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Scarlet fever*
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5 days after commencing antibiotics. |
Antibiotic treatment recommended for the affected child. |
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Slapped cheek / fifth disease. Parvovirus B19 |
None.
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See vulnerable children and female staff – pregnancy.
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Shingles
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Exclude only if rash is weeping and cannot be covered.
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Can cause chickenpox in those who are not immune i.e. have not had chicken pox. It is spread by very close contact andtouch. Contact HPU if further information required. See vulnerable children and female staff – pregnancy.
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Warts and Verrucae
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None.
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Verrucae should be covered in swimming pools, gymnasiums and changing rooms. |
Other infections |
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|
Illness |
Recommended exclusion |
Notes |
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Conjunctivitis |
None. |
If an outbreak/cluster occurs consult HPU. |
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Diphtheria*
|
Exclusion is important. Always consult HPU. |
Preventable by vaccination. HPU will organise any contact tracing necessary. |
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Glandular fever
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None.
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About 50% of children get the disease before they are five and many adults also acquire the disease without being aware of it. |
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Head lice
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None.
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Treatment is recommended only in cases where live lice have definitely been seen. Close contacts should be checked and treated if live lice are found. Regular detection (combing) should be carried out by parents. |
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Hepatitis A*
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Exclusion may be necessary. Always consult HPU.
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Good personal and environmental hygiene will minimise any possible danger of spread of hepatitis A. |
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Hepatitis B* and C*
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None.
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Hepatitis B and C are not infectious through casual contact. Good hygiene will minimise any possible danger of spread of both hepatitis B and C. |
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HIV / AIDS
|
None.
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HIV is not infectious through casual contact. There have been no recorded cases of spread in a child care setting. Good hygiene will minimise any possible danger of spread of HIV. |
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Meningococcal meningitis* / septicaemia*
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Until recovered.
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Meningitis C is preventable by vaccination. There is no reason to exclude siblings and other close contacts of a case. The HPU will give advice on any action needed and identify contacts requiring antibiotics. |
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Meningitis* due to other bacteria
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Until recovered.
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Hib Meningitis and Pneumococcal Meningitis are preventable by vaccination. There is no reason to exclude siblings and other close contacts of a case. Always contact the HPU who will give advice on any action needed and identify contacts requiring antibiotics. |
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Meningitis viral*
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None.
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Milder illness. There is no reason to exclude siblings and other close contacts of a case. Contact tracing is not required. |
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MRSA
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None.
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Good hygiene, in particular hand washing and environmental cleaning, are important to minimise any danger of spread. Contact HPU if further information required. |
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Mumps*
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Five days from onset of swollen glands. |
Preventable by vaccination. (MMR x 2 doses).
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Threadworms
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None.
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Treatment is recommended for the child and household contacts. |
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Tonsillitis
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None.
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There are many causes, but most cases are due to viruses and do not need an antibiotic. |
Certain medical conditions can make some children vulnerable to infections that would rarely be serious in most children, these include: children being treated for leukaemia or other cancers; on high doses of steroids by mouth, and children with conditions which seriously reduce immunity. Childcare professionals will normally have been made aware of such children who are particularly vulnerable to chicken-pox or measles. If exposed to either of these, the parent/carer should be informed promptly and further medical advice sought. It may be advisable for these children to have additional immunisations e.g. pneumococcal and influenza.
NB. Shingles is caused by the same virus as chickenpox virus therefore anyone who has not had chickenpox is potentially vulnerable to the infection if they have close contact with a case of shingles.
In general, if a pregnant woman develops a rash or is in direct contact with someone with a potentially infectious rash this should be investigated by a doctor. The greatest risk to pregnant women from such infections comes from their own child/children rather than the workplace.
Chickenpox
Chickenpox can affect the pregnancy if a woman has not already had the infection. If exposed early in pregnancy (first 20 weeks) or very late (last three weeks), the GP and ante-natal carer should be informed promptly and a blood test should be done to check immunity. NB. shingles is caused by the same virus as chickenpox virus therefore anyone who has not had chickenpox is potentially vulnerable to the infection if they have close contact with a case of shingles.
German measles (Rubella)
If a pregnant woman comes into contact with German Measles she should inform her GP and ante-natal carer immediately to ensure investigation. The infection may affect the developing baby if the woman is not immune and is exposed in early pregnancy. All female staff under the age of 25 years, working with young children should have evidence of two doses of MMR vaccine.
Slapped cheek disease (Parvovirus B19)
Can occasionally affect an unborn child. If exposed early in pregnancy (before 20 weeks) inform the ante-natal carer, as this must be investigated promptly.
Measles
During pregnancy can result in early delivery, or even loss, of the baby. If a pregnant woman is exposed, immediately inform the ante-natal carer to ensure investigation. All female staff under the age of 25 years, working with young children should have evidence of two doses of MMR vaccine.
Immunisation status should always be checked at school entry and at the time of any vaccination. Any immunisations that have been missed should be given and further catch-up doses organised at school or through the child’s GP. For the most up to date immunisation advice check on www.immunisation.nhs.uk or the school health service can advise on the latest national immunisation schedule.
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