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. It is also to help minimise the spread of infections.

Because infectious diseases are spread by contact with others, 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.

Preventing the spread of germs

The 3 most important ways to prevent the spread of infectious diseases among children are:

  • excluding sick children (and staff) from school and early childhood education and care services - this means that parents/carers are asked to keep their children at home for a certain amount of time when they are ill;
  • effective hand washing; and
  • immunisation (getting vaccinated).

Staying home from school, preschool or child care

Keeping your child at home until they have recovered or received appropriate treatment is the best way to help them get better faster. It’s also the best way to protect others from infection.

Recommended exclusion periods based on guidelines published by the Australian Government and the National Health and Medical Research Council (NHMRC) 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 whether your child should stay home, or for how long, see your doctor.

 

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

 

Recommended minimum exclusion periods for infectious diseases
ConditionDoes 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?
Campylobacter infectionYes, 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 infectionYes, until there has not been a loose bowel motion for 24 hours.No
Cytomegalovirus (CMV) infectionNoNo
Diarrhoea (No organism identified as the cause)Yes, until there has not been a loose bowel motion for 24 hours.No
GiardiasisYes, until there has not been a loose bowel motion for 24 hoursNo
Glandular feverNoNo
Haemophilus influenzae type b (Hib)Yes, until child has received antibiotic treatment for at least 4 days.No
Hand, foot and mouth diseaseYes, until all blisters have dried.No
Head liceNo, if effective treatment is started before the next day at the facility. The child does not need to be sent home immediately if head lice are found.No
Hepatitis AYes, until your doctor signs a medical certificate of recovery. Children should stay away until at least 7 days after jaundice begins.No. It may be recommended that children from the same room or group are vaccinated or treated for hepatitis A.
Hepatitis BNoNo
Hepatitis CNoNo
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)NoNo
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 illnessesStay away until wellNo
Listeria infectionNoNo
MeaslesYes, until at least 4 days after the rash begins.Not if immunised. If not immunised, seek specific advice. 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 infectionYes, until antibiotic treatment has finished.No. It may be recommended that children from the same room or group be immunised or given antibiotics.
Molluscum contagiosum (skin infection)NoNo
MumpsYes, for 9 days or until swelling gets better - whichever is sooner.No
NorovirusYes, until there has not been a loose bowel motion or vomiting for 48 hours.No
Parvovirus B19 (erythema infectiosum - 'fifth disease', 'slapped cheek disease')NoNo
Pneumococcal diseaseYes, until fully recovered.No
Ringworm, tineaCan return the day after antifungal treatment has begun.No
RoseolaNoNo
Ross River virusNoNo
Rotavirus infectionYes, 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 5 days after rash started.No (women of childbearing age working at the school/centre should ensure they are immune to the disease or vaccinated against it).
Salmonella or shigella infectionYes, until there has not been a loose bowel motion for 24 hours.No
ScabiesYes, 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)NoNo
ToxoplasmosisNoNo
Tuberculosis (TB)Yes, until your doctor or other appropriate health authority issues a medical certificate.No
Viral gastroenteritis (viral diarrhoea)Yes, until there has not been a loose bowel motion for 24 hours.No
Whooping cough (pertussis)Yes, until 5 days after antibiotic treatment has begun, or for 21 days from the start of coughing.Contacts who have received fewer than 3 doses of pertussis vaccine may need to stay away and/or take antibiotics - seek further advice.
Worms (intestinal)Yes, if there are loose bowel movements. Exclusion isn't necessary if treatment has occurred.No
Source: Australian Government; National Health and Medical Research Council. Staying healthy: Preventing infectious diseases in early childhood education and care services (5th edition; updated June 2013).

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.

Handwashing

Washing your hands properly and encouraging your children to do the same is a very effective way of stopping the spread of germs. Wash hands with soap and running water, making sure you lather the soap all over your hands. Drying your hands afterwards is also important.

Hand sanitisers are a handy option for when you are out and about and there is nowhere to wash your hands. Make sure you use hand sanitisers as directed and supervise children when using them.

Immunisation

Doctors recommend that all children be immunised against certain infectious diseases, including:

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

These vaccines are available free of charge through the routine childhood vaccination programme in Australia.

Parents and carers are usually asked to provide immunisation records when enrolling their children in child care and preschool. In some states, children who are not fully immunised cannot be enrolled in certain child care services unless they have a medical reason for not being able to be immunised. This policy is sometimes referred to as ‘No jab no play’. Children who are on a catch-up schedule for vaccinations can be enrolled.

In other states and territories, unimmunised children can still be enrolled in child care or preschool but may be asked to stay at home if there is an outbreak of an infectious illness that they have not been vaccinated against. This is to prevent them catching and spreading the disease.

Immunisation records may also be requested when enrolling in primary and secondary schools, and those who are not vaccinated may be excluded from school (even during examination times) if there is an outbreak of an infectious illness.

References

1.Australian Government; National Health and Medical Research Council (NHMRC). Staying healthy: preventing infectious diseases in early childhood education and care services, 5th Edition 2012 (updated June 2013). https://www.nhmrc.gov.au/guidelines-publications/ch55 (accessed Apr 2018).
2. Australian Government Department of Health. National Immunisation Program Schedule (updated 8 Dec 2017). http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/national-immunisation-program-schedule (accessed Apr 2018).
3. NHMRC. Recommended minimum exclusion periods. Adapted from Staying Healthy, 5th Edition, 2013. https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/ch55e_exclusion_period_poster_130701.pdf (accessed Apr 2018).
4. National Centre for Immunisation Research and Surveillance. No jab no play, no jab no pay policies (updated Aug 2017). http://www.ncirs.edu.au/consumer-resources/no-jab-no-play-no-jab-no-pay-policies/ (accessed Apr 2018).
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