Health Matters

Medical information and exclusion periods

Incubation and exclusion period Comments
Diarrhoea and vomiting illnesses
Diarrhoea and vomiting 48 hours from last episode of diarrhoea Exclusion from swimming should be 2 weeks following last episode of diarrhoea
E. coli 0157
VTEC
Exclusion is important for some children.  Always consult with HPU Exclusion applies to young children and those who may find hygiene practices difficult to adhere to.  Local HPU will advise. Exclusion from swimming should be 2 weeks following last episode of diarrhoea
Typhoid (and paratyphoid) Exclusion is important for some children.  Always consult with HPU Exclusion applies to young children and those who may find hygiene practices difficult to adhere to.  Local HPU will advise. Exclusion from swimming should be 2 weeks following last episode of diarrhoea
Shigella (Dysentery) Exclusion may be necessary Exclusion (if required) applies to young children and those who may find hygiene practices difficult to adhere to.  Local HPU will advise. Exclusion from swimming should be 2 weeks following last episode of diarrhoea
Respiratory Infections
Flu (influenza) Until recovered
Tuberculosis Always consult with HPU Not usually spread in children.  Requires quite prolonged, close contact for spread
Whooping cough (Pertussis) 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.
Rashes/Skin
Athletes foot None Athletes foot is not a serious condition.  Treatment is recommended
Chicken pox Advice from GPAll spots to be dried up/scabbed over
Cold sores (herpes simplex) None Avoid kissing and contact with cold sores.  Cold sores are generally a mild self-limiting disease
German Measles (rubella) 5 days from onset of rash Preventable by immunisation (MMR x 2 doses)
Hand, foot and mouth Seek Medical Advice Contact HPU if a large number of children are affected.  Exclusion may be considered in some circumstances
Impetigo Until lesions are crusted or healed Antibiotic treatment by mouth may speed healing and reduce infectious period
Measles 5 days from onset of rash Preventable by vaccination (MMR x 2 doses)
children aged between 6-13 months should see a GP to determine if the MMR vaccination should be given.  All women pregnant or planning a pregnancy should seek medical advice.
Molluscum contagiosum None A self-limiting condition
Ringworm Until treatment commenced Treatment Is important and is available from pharmacist.  N.B for ringworm of scalp, treatment by GP is required.  Also check and treat for symptomatic pets
Roseola (infantum) None None
Scabies Child can return after first treatment Two treatments 1 week apart for cases.  Contacts should have one treatment; include the entire household and any other very close contacts.  If further information is required contact your local HPU
Scarlet fever 5 days after commencing antibiotics Antibiotic treatment recommended for the affected child
Slapped cheek/fifth disease
Parvovirus B19
None
Shingles Exclude only if rash is weeping and cannot be covered Can cause chicken pox in those who are not immune i.e have not had chicken pox.  It is spread by very close contact and touch.  If further information is required contact your local HPU
Warts and verrucae None Verrucae should be covered in swimming pools and changing rooms
Other infections
Conjunctivitis 24 hours from onset of prescribed course of treatment If an outbreak/cluster occurs consult with your GP
Diphtheria Exclusion is important.  Always consult with HPU Preventable by vaccination.  HPU will organises any contact tracing necessary
Glandular fever None About 50% of children get the disease before they are five and many adults also acquire the disease without being aware of it
Head lice Exclusion until lice and eggs are no longer present. Treat the whole family with medicated shampoo and regular combing.
Hepatitis A Exclusion may be necessary.  Always consult with HPU Good personal and environmental hygiene will minimise any possible danger of spread of Hepatitis A
Hepatitis B and C None 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
HIV/AIDS None HIV is not infectious through casual contact.  There have been no recorded cases of spread within a nursery or school.  Good hygiene will minimise any possible danger of spread of HIV
Meningococcal meningitis / septicaemia Until recovered 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
Meningitis due to other bacteria Until recovered 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 local HPU who will give advice on any action needed  and identify contacts requiring antibiotics
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 HPU
Mumps Five days from onset of swollen glands Preventable by vaccination (MMR x2 doses)
threadworms None Treatment is recommended for the child and household contacts
Tonsillitis After diagnosis of Tonsillitis from GP exclusion of 48 hours Some cases are due to viruses and do not need an antibiotic

For further advice and information:
NHS directwww.nhsdirect.nhs.uk
Tel: 0845 4647

Health Protection Unit (HPU):
Essex Health Protection Unit
8 Collingwood Road
Witham
Essex
CM8 2TT
Tel: 0845 1550069            Fax: 01376 302278
Email: EHPTInfo@essexhpa.nhs.uk