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Guidance on infection control

Guidance on infection control in schools and other childcare settings

 

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 sores. Cold sores are generally mild and self-limiting.

German measles (rubella)*

Four days from onset of rash(as per “Green Book”)

Preventable by immunisation (MMRx2 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 antibiotic treatment.

Antibiotic treatment speeds healing and reduces the infectious period

Measles*

Four days from onset of rash

Preventable by vaccination (MMRx2) 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 antibiotic treatment

Antibiotic treatment is recommended for the affected child.

Slapped cheek/fifth disease. Parvovirus B19

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 chicken pox in those who are not immune, ie have not had chicken pox. It is spread by very close contact and touch. If further information is required, contact your local PHE centre. See: Vulnerable Children and Female Staff-Pregnancy

Warts and verrucae

None

Verrucae should be covered in swimming pools, gymnasiums and changing rooms.

 

Diarrhoea and vomiting illness

Infection or Complaint

Recommended period to be kept away from school, nursery or childminders

Comments

Diarrhoea and/or vomiting

48 hours from last episode of diarrhoea or vomiting

 

E. coli 0157 VTEC Typhoid* [paratyphoid*] (enteric fever) Shigella (dynsentery)

Should be excluded for 48 hours from the last episode of diarrhoea. Further exclusion may be required for some children 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 catergories 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 further advice.

Cryptosporidiosis

Exclude for 48 hours from the last episode of diarrhoea

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 or childminders

Comments

Flu (influenza)

Until recovered

See:  Vulnerable children

Tuberculosis*

Always consult your PHE centre

Requires prolonged close contact for spread

Whooping cough* (pertussis)

Five days from starting 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. Your local PHE centre will organise any contact tracing necessary.

 

Other infections 

Infection or Complaint

Recommended period to be kept away from school, nursery or childminders

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 tracing necessary

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 no jaundice)

In an outbreak of hepatitis A, your local PHE centre 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 needed

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 will give 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 hand- washing and environmental cleaning are important to minimise any danger of spread. If further information is required, contact your local PHE centre

Mumps*

Exclude child for five days after onset of swelling

Preventable by vaccination (MMRx2)

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

 

* denotes a notifiable disease. It is a statutory requirement that doctors report a notifiable disease to the proper officer of the local authority (usually a consultant in communicable disease control). In addition, organisations may be required via locally agreed arrangements to inform their local PHE centre. Regulating bodies (for example, Office for Standards in Education(OFSTED)/Commission for Social Care Inspection(CSCI) may wish to be informed)

 

The above information was published in September 2014 this version in May 2016. Further information can be found at:https://www.gov.uk/government/publications/infection-control-in-schools

 


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