Medical Exclusion Table

 Health Protection for schools, nurseries and other childcare facilities

 

Exclusion table Infection

Exclusion period

Comments

Athlete’s foot

None

Athlete’s foot is not a serious condition. Treatment is recommended.

Chicken pox

Five days from onset of rash and all the lesions have crusted over

 

Cold sores (herpes simplex)

None

Avoid kissing and contact with the sores. Cold sores are generally mild and heal without treatment

Conjunctivitis

None

If an outbreak/cluster occurs, consult your local HPT

Diarrhoea and vomiting

Whilst symptomatic and 48 hours after the last symptoms.

 

Diphtheria *

Exclusion is essential. Always consult with your local HPT

Preventable by vaccination. Family contacts must be excluded until cleared to return by your local HPT

Flu (influenza)

Until recovered

Report outbreaks to your local HPT.

Glandular fever

None

 

Hand foot and mouth

None

Contact your local HPT if a large numbers of children are affected. Exclusion may be considered in some circumstances

Head lice

None

Treatment recommended only when live lice seen

Hepatitis A*

Exclude until seven days after onset of jaundice (or 7 days after symptom onset if no jaundice)

In an outbreak of hepatitis A, your local HPT will advise on control measures

Hepatitis B*, C*, HIV

None

Hepatitis B and C and HIV are blood borne viruses that are not infectious through casual contact. Contact your local HPT for more advice

Impetigo

Until lesions are crusted /healed or 48 hours after starting antibiotic treatment

Antibiotic treatment speeds healing and reduces the infectious period.

Measles*

Four days from onset of rash and recovered

Preventable by vaccination (2 doses of MMR). Promote MMR for all pupils and staff. Pregnant staff contacts should seek prompt advice from their GP or midwife

Meningococcal meningitis*/ septicaemia*

Until recovered

Meningitis ACWY and B are preventable by vaccination (see national schedule @ www.nhs.uk). Your local HPT will advise on any action needed

Meningitis* due to other bacteria

Until recovered

Hib and pneumococcal meningitis are preventable by vaccination (see national schedule @ www.nhs.uk) Your local HPT will advise on any action needed

Meningitis viral*

None

Milder illness than bacterial meningitis. Siblings and other close contacts of a case need not be excluded.

MRSA

None

Good hygiene, in particular handwashing and environmental cleaning, are important to minimise spread. Contact your local HPT for more information

Mumps*

Five days after onset of swelling

Preventable by vaccination with 2 doses of MMR (see national schedule @ www.nhs.uk). Promote MMR for all pupils and staff.

Ringworm

Not usually required.

Treatment is needed.

Rubella (German measles)

Four days from onset of rash

Preventable by vaccination with 2 doses of MMR (see national schedule @ www.nhs.uk). Promote MMR for all pupils and staff. Pregnant staff contacts should seek prompt advice from their GP or midwife

Scarlet fever

Exclude until 24hrs of appropriate antibiotic treatment completed

A person is infectious for 2-3 weeks if antibiotics are not administered. In the event of two or more suspected cases, please contact local health protection team.

Scabies

Can return after first treatment

Household and close contacts require treatment at the same time.

Slapped cheek /Fifth disease/Parvo virus B19

None (once rash has developed)

Pregnant contacts of case should consult with their GP or midwife.

Threadworms

None

Treatment recommended for child & household contacts

Tonsillitis

None

There are many causes, but most cases are due to viruses and do not need an antibiotic treatment

Tuberculosis (TB)

Always consult your local HPT BEFORE disseminating information to staff/parents/carers

Only pulmonary (lung) TB is infectious to others. Needs close, prolonged contact to spread

Warts and verrucae

None

Verrucae should be covered in swimming pools, gyms and changing rooms

Whooping cough (pertussis)*

Two days from starting antibiotic treatment, or 21 days from onset of symptoms if no antibiotics

Preventable by vaccination. After treatment, non-infectious coughing may continue for many weeks. Your local HPT will organise any contact tracing

 

*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).

 

Health Protection Agency (2010) Guidance on Infection Control in Schools and other Child

Care Settings. HPA: London.

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