Infectious diseases: when can my child go back to school or child care?

Children who have caught certain infectious diseases need to stay away from school or child care until they have completely recovered. This is not only because they need time and lots of rest in order to fully recuperate from their illness. Because infectious diseases are spread by contact with others who are affected, there are regulations about when children can go back to school or child care after contracting these diseases. This is to prevent epidemics of these illnesses happening. Exclusion of sick children (and staff) from child care centres is one of the 3 most important ways to prevent the spread of infectious disease. The others are effective handwashing and immunisation.

Guidelines published by the National Health and Medical Research Council (NHMRC) for exclusion from school or child care are listed below. Of course, even if your child doesn't have one of the conditions on the list, he or she should still always stay away from school if he or she is unwell.

If your child's condition isn't listed, or if you aren't sure how long your child should stay at home, see your doctor.

If children have immunity to these diseases then the NHMRC suggests they don't need to be kept out of school if an outbreak occurs.

STOP, don't go to school
OK to go to school
Depends - see criteria

Recommended minimum exclusion periods for infectious diseases
Condition Does my child need to stay away if he or she has this condition? Does my child need to stay away if they have been in contact with a person who has this condition?

Do other people need to stay away if they've been in contact with my child who has the condition?
Amoebiasis (Entamoeba histolytica infection) Yes, until there has not been a loose bowel motion for 24 hours. No
Campylobacter infection Yes, until there has not been a loose bowel motion for 24 hours. No
Chickenpox (varicella) Keep your child away until all blisters have dried. This is usually at least 5 days after the spots first appeared in unimmunised children and less in immunised children. No, unless he or she has immune system problems, such as leukaemia, or is receiving chemotherapy.
Conjunctivitis (acute infectious) Yes, until the discharge from the eyes has stopped. No
Cryptosporidium infection Yes, until there has not been a loose bowel motion for 24 hours. No
Cytomegalovirus (CMV) infection No No
Diarrhoea (No organism identified as the cause) Yes, until there has not been a loose bowel motion for 24 hours. No
Diphtheria Keep your child away until your doctor signs a medical certificate of recovery. Your child must have at least 2 negative throat swabs after antibiotic treatment is finished, to ensure they are fully recovered. Yes. All contacts living in same house should stay away from the school until your doctor or another appropriate health authority clears them to return.
Giardiasis Yes, until there has not been a loose bowel motion for 24 hours No
Glandular fever No No
Haemophilus influenzae type b (Hib) Yes, until child has received antibiotic treatment for at least 4 days. No
Hand, foot and mouth disease Yes, until all blisters have dried. No
Head lice No, if effective treatment is started before the next day at the facility - that means child does not need to be sent home immediately. No
Hepatitis A Yes, until your doctor signs a medical certificate of recovery. Children should stay away until at least 7 days after jaundice begins. No
Hepatitis B No No
Hepatitis C No No
Herpes simplex
(‘cold sores’, fever, blisters)
If your young child isn't able to follow hygiene practices while the cold sore is weeping, then he or she should stay away until it is dry. Cover cold sores with dressings if possible. No
Human immunodeficiency virus (HIV/AIDS) No. However, if the child is severely immunocompromised they will be vulnerable to catching infections from other people. No
Hydatid disease (type of tapeworm) No No
Impetigo (school sores) Yes, until antibiotic treatment has begun. Sores on exposed surfaces must be covered with a watertight dressing. No
Influenza and influenza-like illnesses Stay away until well No
Legionnaires' disease No No
Leprosy Yes, until your doctor or other health authority gives approval to return. No
Measles Yes, until at least 4 days after the rash begins. Not if immunised. Not if he or she gets immunised within 72 hours of contact with an infected person. If not immunised, he or she should stay away until 14 days after the appearance of a rash in the last person to be infected. All immunocompromised children should be excluded until 14 days after the first day of appearance of rash in the last case.
Meningitis (bacterial) Yes, until well and has received antibiotics. No
Meningitis (viral) Yes, until well. No
Meningococcal infection Yes, until antibiotic treatment has finished. No
Molluscum contagiosum (skin infection) No No
Mumps Yes, for 9 days after onset of swelling. No
Norovirus Yes, until there has not been a loose bowel motion or vomiting for 48 hours. No
Parvovirus (erythema infectiosum - ‘fifth disease’, ‘slapped face disease’) No No
Respiratory syncitial virus (RSV) No No
Ringworm, tinea Can return the day after treatment has begun. No
Roseola No No
Ross River virus No No
Rotavirus infection Yes, until there has not been a loose bowel motion or vomiting for 24 hours No
Rubella (German measles) Yes, until fully recovered or can go back 4 days after rash started. No (women of childbearing age working at the school should ensure they are immune to the disease or vaccinated against it).
Salmonella, shigella infection Yes, until there has not been a loose bowel motion for 24 hours. No
Scabies Yes, until day after treatment has been started. No
Streptococcal sore throat (including scarlet fever) Yes, until your child has had antibiotics for at least 24 hours, and feels well. No
Thrush (candidiasis) No No
Toxoplasmosis No No
Tuberculosis (TB) Yes, until your doctor or other appropriate health authority issues a medical certificate. No
Typhoid fever (including paratyphoid fever) Yes, until your doctor or other appropriate health authority issues a medical certificate. Not excluded unless a public health authority says so.
Viral gastroenteritis (viral diarrhoea) Yes, until there has not been a loose bowel motion or vomiting for 24 hours. No
Warts No No
Whooping cough (pertussis) Yes, until 5 days after antibiotic treatment has begun, or for 21 days from the start of coughing. Contacts living in the same house who have received fewer than 3 doses of pertussis vaccine must stay away until they have had 5 days of antibiotics. If antibiotics have not been taken, these contacts must be excluded for 21 days after their last exposure to the case while the case was infectious.
Worms (intestinal) Yes, until treatment has occurred. No
Source: National Health and Medical Research Council. Staying Healthy in Child Care. Preventing Infectious Diseases in Child Care, 4th edition. Endorsed December 2005.

The NHMRC recommends that children who are physically unwell should be excluded from attending school, pre-school and childcare centres.

These guidelines may be reviewed from time to time. Always check with your doctor or healthcare worker if you are not sure whether your child should go back to school.

Immunisation

In some states and territories, some schools and child care centres ask to see children's immunisation records at enrolment time. This is because if an outbreak of an infectious disease occurs, the school will know who isn't immunised and therefore must be sent home to prevent them catching and spreading the disease.

In any case, doctors recommend that all children be immunised against certain infectious diseases. These are:

  • measles;
  • mumps;
  • rubella;
  • poliomyelitis (polio);
  • diphtheria;
  • tetanus;
  • pertussis (whooping cough);
  • haemophilus influenzae type B (Hib);
  • rotavirus;
  • pneumococcal disease;
  • meningococcal C;
  • chickenpox; and
  • hepatitis B.

 
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