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Guidance on Illness in School

 

Rashes and skin infections

Children with rashes should be considered infectious and assessed by their doctor.

Infection or complaint Recommended period to be kept away from school, nursery or childminders Comments
Athlete’s foot None Athlete’s foot is not a serious condition. Treatment is recommended
Chickenpox Until all vesicles have crusted over See: Vulnerable Children and Female Staff –Pregnancy
Cold sores, (Herpes simplex) None Avoid kissing and contact with the sores. Cold sores are generally mild and self-limiting
German measles(rubella)* Four days from onset of rash (as per “GreenBook”) Preventable by immunisation (MMR x2 doses). See: Female Staff – Pregnancy
Hand, foot and mouth None Contact your local HPT if a large number of children are affected. Exclusion may be considered in some circumstances
Impetigo Until lesions are crusted and healed, or 48 hours after starting antibiotictreatment Antibiotic treatment speeds healing and reduces the infectious period
Measles* Four days from onset of rash Preventable by vaccination (MMR x2). See: Vulnerable Children and Female Staff –Pregnancy
Molluscum contagiosum None A self-limiting condition
Ringworm Exclusion not usually required Treatment is required
Roseola (infantum) None None
Scabies Child can return after first treatment Household and close contacts require treatment
Scarlet fever* Child can return 24 hours after starting appropriate antibiotictreatment Antibiotic treatment is recommended for the affected child
Slapped cheek/fifth disease. ParvovirusB19 None (once rash has developed) See: Vulnerable Children and Female Staff –Pregnancy
Shingles Exclude only if rash is weeping and cannot be covered Can cause chickenpox in those who are not immune, ie have not had chickenpox. It is spread by very close contact and touch. If further information is required, contact your local PHE centre. See: Vulnerable Childrenand Female Staff – Pregnancy
Warts and verrucae None Verrucae should be covered in swimming pools, gymnasiums and changing rooms

 

Diarhoea and vomiting illness

Infection or complaint Recommended period to be kept away from school, nursery orchildminders Comments
Diarrhoea and/or vomiting 48 hours from last episode of diarrhoea orvomiting
E. coli O157 VTEC Typhoid* [and paratyphoid*] (enteric fever) Shigella(dysentery) Should be excluded for48 hours from the last episode of diarrhoea. Further exclusion may be required for somechildren until they are no longer excreting Further exclusion is required for children aged five years or younger and those who have difficulty in adhering to hygiene practices. Children in these categories should be excluded until there is evidence of microbiological clearance. This guidance may also apply to some contacts who may also require microbiological clearance. Please consult your local PHE centre for furtheradvice
Cryptosporidiosis Exclude for 48 hours from the last episode ofdiarrhoea Exclusion from swimming is advisable for two weeks after the diarrhoea has settled

 

Respiratory infections

Infection or complaint Recommended period to be kept away from school, nursery orchildminders Comments
Flu (influenza) Until recovered See: Vulnerable Children
Tuberculosis* Always consult your local PHE centre Requires prolonged close contact for spread
Whooping cough* (pertussis) Five days from starting antibiotic treatment, or21 days from onset ofillness if no antibiotic treatment Preventable by vaccination. After treatment, non-infectious coughing may continue for many weeks. Your local PHE centre will organise any contact tracing necessary

 

Other infections

Infection or complaint Recommended period to be kept away from school, nursery orchild minders Comments
Conjunctivitis None If an outbreak/cluster occurs, consult your local PHE centre
Diphtheria * Exclusion is essential. Always consult with your local HPT Family contacts must be excluded until cleared to return by your local PHE centre. Preventable by vaccination. Your local PHE centre will organise any contact tracingnecessary
Glandular fever None
Head lice None Treatment is recommended only in cases where live lice have been seen
Hepatitis A* Exclude until seven days after onset of jaundice(or seven days after symptom onset if nojaundice) In an outbreak of hepatitis A, your local PHEcentre will advise on control measures
Hepatitis B*, C*, HIV/AIDS None Hepatitis B and C and HIV are bloodborne viruses that are not infectious through casual contact. For cleaning of body fluid spills see:Good Hygiene Practice
Meningococcal meningitis*/ septicaemia* Until recovered Meningitis C is preventable by vaccination There is no reason to exclude siblings or other close contacts of a case. In case of an outbreak, it may be necessary to provide antibiotics with or without meningococcal vaccination to close school contacts. Your local PHE centre will advise on any action isneeded
Meningitis* due to other bacteria Until recovered Hib and pneumococcal meningitis are preventable by vaccination. There is no reason to exclude siblings or other close contacts of a case. Your local PHE centre willgive advice on any action needed
Meningitis viral None Milder illness. There is no reason to exclude siblings and other close contacts of a case. Contact tracing is not required
MRSA None Good hygiene, in particular handwashing and environmental cleaning, are important to minimise any danger of spread. If further information is required, contact your localPHE centre
Mumps Exclude child for five days after onset of swelling Preventable by vaccination (MMR x2 doses)
Threadworms None Treatment is recommended for the child and household contacts
Tonsillitis None There are many causes, but most cases are due to viruses and do not need an antibiotic

This Table was taken from Public Health England’s Website.

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