NHS Health Advice
The Table below shows which one has an Exclusion Period from School, Nurseries and other Childcare Facilities e.g Childminders. It also gives comments about each one what to look for or if treatment is recommended. If you want to know about the systems of each one there are in more depth underneath these tables.
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Chicken Pox and Shingles
What is it?
Chickenpox and shingles are caused by the same virus which causes an itchy rash starting with flat red spots that become raised and filled with fluid. Chickenpox is usually a mild childhood illness but there is a risk of complications in people who have a weakened immune system, including young babies and pregnant women.
Chickenpox and shingles are caused by the same virus which causes an itchy rash starting with flat red spots that become raised and filled with fluid. Chickenpox is usually a mild childhood illness but there is a risk of complications in people who have a weakened immune system, including young babies and pregnant women.
What are the symptoms?
- Chickenpox usually begins with the onset of a slight fever, feeling generally unwell for a couple of days before the spots appear.
- The spots can appear everywhere, they usually begin on the scalp/face and back, but they can be seen inside the mouth and genitalia. It is rarely seen on the palms of the hands and soles of the feet. The rash is very itchy.
- The spots leave scarring if they are scratched and become infected. The spots look flat and red; these later become raised and filled with fluid. Most children become free from chickenpox in less than two weeks.
Is it infectious?
Chickenpox is spread from person to person; the virus is shed from the nose or throat as droplets or by direct contact. The fluid inside the spot is infectious. Chickenpox is highly infectious during its early stages from one - two days before until five days after spots first appear.
Chickenpox is spread from person to person; the virus is shed from the nose or throat as droplets or by direct contact. The fluid inside the spot is infectious. Chickenpox is highly infectious during its early stages from one - two days before until five days after spots first appear.
What is the incubation period?
The incubation period of chickenpox is between 13 and 17 days after contact with the infected person. The following groups of people should see advice from their GP if they are exposed to chickenpox and do not remember if they have been previously infected with the virus.
The incubation period of chickenpox is between 13 and 17 days after contact with the infected person. The following groups of people should see advice from their GP if they are exposed to chickenpox and do not remember if they have been previously infected with the virus.
- Pregnant women
- Babies whose mothers developed chickenpox in the first 28 days of their life.
- People who are immunosuppressed (e.g. people having large doses of oral steroids or receiving chemotherapy for cancer/ leukaemia/ HIV related illness.)
What is the treatment?
The most common treatment for chickenpox is aimed at relieving the symptoms:
The most common treatment for chickenpox is aimed at relieving the symptoms:
- A pharmacist can recommend effective itch-relieving products
- Ice lollies may help to reduce a fever
- Paracetamol can be given according to the age of the child. Aspirin must not be given to children under 16 yrs old. Ibuprofen should not be given to children with chickenpox.
- Nails should be kept short to prevent damaging the skin from scratching
- Wear loose, cool clothes and keep the room temperature cool as this may help to reduce itching
Are there any complications?
The majority of people affected by chickenpox suffer no long-term effects however there is an increased risk that individuals could develop shingles later in life due to the virus remaining dormant in the body following chickenpox then reactivating later.
Bacterial infections can arise if the blistered areas become contaminated with bacteria. If chickenpox is circulating in the school at the same time as infections like scarlet fever, contact the health protection team for further advice.
Very occasionally chickenpox infection causes pneumonia, which presents as a persistent high fever and severe dry cough. Very rarely it can lead to condition called encephalitis. This is an inflammation of the brain which can occur between seven days and tens days after the onset of the rash Encephalitis is very rare, and would present with symptoms of drowsiness, headache, neck stiffness, dislike of bright lights and possibly convulsions.
The majority of people affected by chickenpox suffer no long-term effects however there is an increased risk that individuals could develop shingles later in life due to the virus remaining dormant in the body following chickenpox then reactivating later.
Bacterial infections can arise if the blistered areas become contaminated with bacteria. If chickenpox is circulating in the school at the same time as infections like scarlet fever, contact the health protection team for further advice.
Very occasionally chickenpox infection causes pneumonia, which presents as a persistent high fever and severe dry cough. Very rarely it can lead to condition called encephalitis. This is an inflammation of the brain which can occur between seven days and tens days after the onset of the rash Encephalitis is very rare, and would present with symptoms of drowsiness, headache, neck stiffness, dislike of bright lights and possibly convulsions.
What is the exclusion period for chickenpox?
Individuals should be kept away from school for at least 5 days from onset of rash (and not developing new lesions). It is not necessary for all the spots to have healed or crusted over before return to school as the risk of transmission to other children after five days is minimal.
Individuals should be kept away from school for at least 5 days from onset of rash (and not developing new lesions). It is not necessary for all the spots to have healed or crusted over before return to school as the risk of transmission to other children after five days is minimal.
Is it necessary for individuals with chickenpox to see their Doctor?
There is no requirement to routinely visit a general practitioner if the affected individual has uncomplicated chickenpox. Chickenpox is a self-limiting illness for most children who will usually be completely better within two weeks. Taking the child to a busy doctor’s surgery increases the risk of further spread of the virus and there is no specific treatment other than that available from a local pharmacy to relieve symptoms. It is worth recording that a child has had chickenpox on their immunisation record sheet.
There is no requirement to routinely visit a general practitioner if the affected individual has uncomplicated chickenpox. Chickenpox is a self-limiting illness for most children who will usually be completely better within two weeks. Taking the child to a busy doctor’s surgery increases the risk of further spread of the virus and there is no specific treatment other than that available from a local pharmacy to relieve symptoms. It is worth recording that a child has had chickenpox on their immunisation record sheet.
What is shingles and how it is different from chickenpox?
Singles, as known as zoster or herpes zoster, is a painful skin rash caused by the same virus responsible for chickenpox: the varicella zoster virus. An individual with only develop shingles if they have previously been in contact with the virus and had chickenpox. This is because the chickenpox virus remains in the body lying dormant in the roots of nerves and can reactive many year later.
Singles, as known as zoster or herpes zoster, is a painful skin rash caused by the same virus responsible for chickenpox: the varicella zoster virus. An individual with only develop shingles if they have previously been in contact with the virus and had chickenpox. This is because the chickenpox virus remains in the body lying dormant in the roots of nerves and can reactive many year later.
Conjunctivitis
What is it?
Conjunctivitis (also known as “pink eye”) is inflammation of the thin layer of tissue that covers the front of the eye (the conjunctiva). It is a very common self-limiting condition that can be caused by a bacterial or a viral infection (invective conjunctivitis).
Conjunctivitis can also be caused by allergic reaction to substances such as pollen and dust or when the eye is exposed to irritants including chlorinated water and shampoo.
Conjunctivitis (also known as “pink eye”) is inflammation of the thin layer of tissue that covers the front of the eye (the conjunctiva). It is a very common self-limiting condition that can be caused by a bacterial or a viral infection (invective conjunctivitis).
Conjunctivitis can also be caused by allergic reaction to substances such as pollen and dust or when the eye is exposed to irritants including chlorinated water and shampoo.
What are the symptoms?
Symptoms of conjunctivitis are:
• Swelling and watering of the eyes
• Burning sensation
• Feeling of grit in the eye
• Itchy eyes (more common in allergic conjunctivitis).
The white of the eye may appear red or pink and there may be a discharge which
causes the eyelids to stick together, making them difficult to open Light might cause pain in the eye and increase the watery discharge
Symptoms of conjunctivitis are:
• Swelling and watering of the eyes
• Burning sensation
• Feeling of grit in the eye
• Itchy eyes (more common in allergic conjunctivitis).
The white of the eye may appear red or pink and there may be a discharge which
causes the eyelids to stick together, making them difficult to open Light might cause pain in the eye and increase the watery discharge
Is it infectious?
Yes, bacterial or viral conjunctivitis is usually spread from person to person by direct or indirect contact with the discharge from the eye.
Yes, bacterial or viral conjunctivitis is usually spread from person to person by direct or indirect contact with the discharge from the eye.
Does an affected child or staff member need to be excluded from school of Childcare Facilities?
Exclusion from school if an individual has conjunctivitis is not required unless they are feeling particularly unwell.
Parents should be encouraged to notify the school if their child has conjunctivitis to ensure that staff can take preventative action to reduce the risk of transmission to others. This includes;
If there are a number of cases of conjunctivitis at one school or nursery, staff should contact the health protection team to discuss further actions as it may be necessary to consider exclusion in these instances.
Generally adults who work in close contact with others or share equipment such as phones and computers should not return to work until the discharge has cleared up.
Exclusion from school if an individual has conjunctivitis is not required unless they are feeling particularly unwell.
Parents should be encouraged to notify the school if their child has conjunctivitis to ensure that staff can take preventative action to reduce the risk of transmission to others. This includes;
- Ensuring that the affected child uses paper towels after hand-washing (or has a dedicated hand towel which must be washed / changed daily )
- Ensuring the child does not share flannels while in school
- Discouraging close facial contact between infected and non-infected children.
If there are a number of cases of conjunctivitis at one school or nursery, staff should contact the health protection team to discuss further actions as it may be necessary to consider exclusion in these instances.
Generally adults who work in close contact with others or share equipment such as phones and computers should not return to work until the discharge has cleared up.
What is the incubation period?
This is variable depending on the cause, usually:
This is variable depending on the cause, usually:
- One - three days for bacteria
- One -12 days for viruses (but this may be longer for certain eye infections in small babies).
Glandular Fever
What is Glandular Fever?
Glandular fever is an illness caused by a virus.
It is a worldwide disease which can affect both sexes. It mostly affects young adults aged 15 - 26 years in the UK.
Glandular fever is an illness caused by a virus.
It is a worldwide disease which can affect both sexes. It mostly affects young adults aged 15 - 26 years in the UK.
What is the incubation period?
Incubation is thought to be usually around four - eight weeks.
Incubation is thought to be usually around four - eight weeks.
How long does the illness last?
The illness lasts two - three weeks but can be up to six weeks and is characterised by:
The illness lasts two - three weeks but can be up to six weeks and is characterised by:
- Swollen glands
- Fever and sometimes a rash.
- Occasionally patients become jaundiced (turn yellow).
Hand, Foot and Mouth Disease
What is Hand, Foot and Mouth Disease?
Hand, Foot and Mouth Disease is a common childhood viral illness that can affect adults. This is quite different from Foot and Mouth disease (which is a disease of animals).
Hand, Foot and Mouth Disease is a common childhood viral illness that can affect adults. This is quite different from Foot and Mouth disease (which is a disease of animals).
What is the incubation period?
The incubation period is three – five days. The person will remain infectious during the acute illness and while the virus remains in the faeces. Infection generally leads to immunity.
It is communicable immediately before and during the acute stage of the illness, and perhaps longer as the virus may be present in the faeces for weeks.
The incubation period is three – five days. The person will remain infectious during the acute illness and while the virus remains in the faeces. Infection generally leads to immunity.
It is communicable immediately before and during the acute stage of the illness, and perhaps longer as the virus may be present in the faeces for weeks.
What are the symptoms?
The onset of the disease generally presents as:
The onset of the disease generally presents as:
- Fever
- Malaise
- Sore mouth
- Development of a rash.
- Mouth lesions appear on the inside surfaces of the cheeks, gums and on the sides of the tongue.
- Raised pink spots that develop into blisters, which may persist for seven to ten days, can also occur as a rash, especially on the palms, fingers, soles and occasionally on the buttocks.
Is it infectious?
The disease is self-limiting and more common in summer and early autumn, mainly in children under ten years of age, but adult cases are not unusual. The disease frequently occurs in outbreaks in groups of children, in a nursery school for example.
The virus is spread by direct contact with nasal and throat secretions or faeces of the infected person. The virus can also be transmitted by aerosol spread such as:
The disease is self-limiting and more common in summer and early autumn, mainly in children under ten years of age, but adult cases are not unusual. The disease frequently occurs in outbreaks in groups of children, in a nursery school for example.
The virus is spread by direct contact with nasal and throat secretions or faeces of the infected person. The virus can also be transmitted by aerosol spread such as:
- Coughing and sneezing.
- Hands contaminated from secretions which, if not washed thoroughly may transmit infection.
What is the treatment?
There is no specific treatment for the infection.
The illness is mild and usually clears up by itself in seven to ten days. To help with the symptoms:
There is no specific treatment for the infection.
The illness is mild and usually clears up by itself in seven to ten days. To help with the symptoms:
- Keep the child cool
- Encourage fluids to prevent dehydration (but avoid acidic drinks like fruit juice) Encourage soft foods like ice cream, yogurt may or soup.
Head Lice
What are head lice?
Head lice are parasitic insects that only live on human heads. There are three forms of head lice:
Head lice are parasitic insects that only live on human heads. There are three forms of head lice:
- Nits are head lice eggs. The oval, yellowy white eggs are hard to see and may be confused with dandruff. They attach themselves to the hair shaft and take about a week to hatch. The eggs remain after hatching and many nits are empty egg cases.
- Nymphs hatch from the nits. The baby lice look like the adults, but are smaller.
- Adults are about the size of a sesame seed. They have six legs and are tan to greyish-white. The legs have hook-like claws to hold onto the hair with. Adults can live up to 30 days and feed on blood.
Who catches head lice?
Anyone can catch head lice but preschool children, primary school children and their families are most at risk.
Anyone can catch head lice but preschool children, primary school children and their families are most at risk.
What is the treatment?
A diagnosis of head lice can only be made if live lice are seen.
Wet combing method:
Using lotions:
A diagnosis of head lice can only be made if live lice are seen.
Wet combing method:
- Wash the hair in the normal way, with an ordinary shampoo
- Using lots of conditioner, and while the hair is very wet, comb through the hair from the roots to the ends with a fine-toothed detector comb. Make sure the teeth of the comb slot into the hair at the roots of every stroke
- Clear the comb of lice between each stroke
- Repeat this routine every 3 days for 2 weeks so that any lice emerging from eggs are removed before they mature and spread
- Household contacts of individuals with head lice should also be checked and treated if they are found to have head lice too.
Using lotions:
- Only those with live lice should be treated.
- Dimeticone (a silicone oil), Malathion or Permethrin (insecticides) are recommended treatments which can be bought from the chemist or obtained on prescription.
- It is important that the instructions on the bottle are followed very carefully and that all the family and close contacts are checked and treated if necessary.
- Asthmatics, those with skin problems such as eczema, pregnant women, breast feeding mothers and children under 6 months should be treated under medical supervision.
Influenza (Common Flu)
What is influenza?
Influenza (commonly known as flu) is a viral respiratory illness caused by infection with a virus (usually influenza A or B). Influenza is usually more severe than a simple cold (although the illness can be mild in some cases). More severe illness is associated with the elderly, very young and those with other chronic medical conditions like chest or heart disease and diabetes but can occur in people who are fit and well of any age group. Influenza (flu) and the common cold are both types of upper respiratory infections (URIs). Both are caused by viruses. But the flu is not the same as the common cold.
Influenza (commonly known as flu) is a viral respiratory illness caused by infection with a virus (usually influenza A or B). Influenza is usually more severe than a simple cold (although the illness can be mild in some cases). More severe illness is associated with the elderly, very young and those with other chronic medical conditions like chest or heart disease and diabetes but can occur in people who are fit and well of any age group. Influenza (flu) and the common cold are both types of upper respiratory infections (URIs). Both are caused by viruses. But the flu is not the same as the common cold.
What are the symptoms of influenza?
Flu symptoms are usually much worse than a cold. The flu usually comes on suddenly and lasts longer. The most common symptoms of influenza are an abrupt onset of:
Flu symptoms are usually much worse than a cold. The flu usually comes on suddenly and lasts longer. The most common symptoms of influenza are an abrupt onset of:
- Fever
- Cough
- shaking chills
- Body Aches
- Shivering
- Headache
- Sore throat
- Muscle ache
- Dry cough
- Lethargy
- Feeling very tired
What is the incubation period?
Usually about two to three days (but can be from one to seven days).
Usually about two to three days (but can be from one to seven days).
Common Cold
What are colds?
Everyone gets a cold from time to time. Children get more colds than adults. Colds usually last 1 to 2 weeks. You can catch a cold any time of the year, but they are more common in late winter and early spring. There is no cure for a cold. Antibiotics will not cure a cold. If you catch a cold, treat the symptoms.
Everyone gets a cold from time to time. Children get more colds than adults. Colds usually last 1 to 2 weeks. You can catch a cold any time of the year, but they are more common in late winter and early spring. There is no cure for a cold. Antibiotics will not cure a cold. If you catch a cold, treat the symptoms.
What are the symptoms?
Lots of different viruses cause colds, but the symptoms are usually the same:
You will probably feel a cold come on over the course of a couple days. As the colds gets worse, your nose may get stuffy with thicker mucus. A cold is not the same as Influenza (flu). Flu symptoms are worse and come on faster. If you have the flu, you may feel very fired. You may also have a fever and shaking chills, lots of aches and pains, a headache, and a cough. If you feel like you have a cold all the time, or if cold symptoms last more than 2 weeks, you may have allergies or sinusitis. Call your doctor.
Lots of different viruses cause colds, but the symptoms are usually the same:
- Runny nose and sneezing
- Red Eyes
- Sore throat
- Cough
- Headaches
- Body Aches
You will probably feel a cold come on over the course of a couple days. As the colds gets worse, your nose may get stuffy with thicker mucus. A cold is not the same as Influenza (flu). Flu symptoms are worse and come on faster. If you have the flu, you may feel very fired. You may also have a fever and shaking chills, lots of aches and pains, a headache, and a cough. If you feel like you have a cold all the time, or if cold symptoms last more than 2 weeks, you may have allergies or sinusitis. Call your doctor.
What can you do for a cold?
Good home treatment of a cold can help you feel better. When you get a cold:
Good home treatment of a cold can help you feel better. When you get a cold:
- Get extra rest. Slow down just a little from your usual routine. You don't need to stay home in bed, but try not to expose others to your cold.
- Drink plenty of fluids.
- Use a humidifier in your bedroom and take hot showers to relieve a stuffy nose and head. Saline drops may also help thick or dried mucus to drain.
- If you feel mucus in the back of your throat (post-nasal drip), gargle with warm water. This will help make your throat feel better.
- Use paper tissues, not handkerchiefs. This will help keep your cold from spreading.
- If your nose gets red and raw, put a dab of petroleum jelly on the sore area.
How can you prevent colds?
There are several things you can do to help prevent colds:
There are several things you can do to help prevent colds:
- Wash your hands often.
- Be extra careful in winter and when you are around people with colds.
- Keep your hands away from your face. Your nose, eyes, and mouth are the most likely places for germs to enter your body.
- Eat well, and get plenty of sleep and exercise. This keeps your body strong so it can fight colds.
- Do not smoke. Smoking makes it easier to get a cold and harder to get rid of one.
Measles
What is Measles?
Measles is a highly infectious viral illness that can be very unpleasant and can sometimes lead to serious complications. The success of the MMR vaccine means that cases of measles are uncommon in the UK. However, the number of cases has risen in recent years and there have been some high-profile outbreaks (e.g. between November 2012 and July 2013 a measles outbreak in the Swansea area led to over 1,200 reported cases).
Measles is a highly infectious viral illness that can be very unpleasant and can sometimes lead to serious complications. The success of the MMR vaccine means that cases of measles are uncommon in the UK. However, the number of cases has risen in recent years and there have been some high-profile outbreaks (e.g. between November 2012 and July 2013 a measles outbreak in the Swansea area led to over 1,200 reported cases).
What are the symptoms?
The initial symptoms of measles usually appear around ten days after infection and disappear about seven -ten days later.
The initial symptoms can include:
The initial symptoms of measles usually appear around ten days after infection and disappear about seven -ten days later.
The initial symptoms can include:
- Cold-like symptoms (such as a runny nose, watery eyes, swollen eyelids and sneezing)
- Conjunctivitis or red eyes and sensitivity to light
- High temperature (fever), which may peak at around 40°C (104°F)
- Tiredness, irritability and a general lack of energy,
- Lack of appetite
- Aches and pains
- Dry harsh cough
- Small white spots (Koplick spots) may be seen inside the mouth. These can persist for several days.
- Diarrhoea and/or vomiting are common.
- A red blotchy rash normally develops about three -four days after the first symptoms. It usually starts on the head and neck, spreading down the body.
- Children are initially usually quite unwell and miserable for three - five days until the fever settles and the rash fades.
Meningitis and Septicaemia
What are meningitis and septicaemia?
There are many different causes of meningitis but the two most common organisms are viruses and bacteria.
There are many different causes of meningitis but the two most common organisms are viruses and bacteria.
- Viral meningitis is usually a mild disease but it can make people very unwell. Many thousands of cases occur each year, mostly affecting babies and children. Although most people will make a full recovery some are left with serious and debilitating after-effects.
- Bacterial meningitis can be life-threatening and needs urgent medical attention. Most people who suffer from bacterial meningitis recover but many can be left with a variety of after-effects. Meningococcal disease is a serious bacterial infection which causes meningitis and septicaemia.
What is the treatment?
- Antibiotics are used to treat bacterial meningococcal disease
- The earlier the treatment, the better the prospect of recovery. Often GPs will give treatment even before the person is admitted to hospital.
- If meningitis or septicaemia is suspected, contact the doctor immediately. If the doctor is unavailable the affected individual should be taken to the nearest Accident and Emergency or Walk-In Department. Prompt action is vital.
Norovirus (Diarrhoea and Vomiting)
What is Norovirus?
Norovirus is highly contagious. It's particularly prevalent in schools and nurseries as the virus can survive for several days on surfaces or objects. But it can affect people of all ages and cause vomiting and diarrhoea.
The symptoms are unpleasant and can initially be quite distressing, but they shouldn't last for more than a couple of days. Adults and children with Norovirus symptoms should avoid visiting GP surgeries or hospitals to prevent the further spread of the virus.
Norovirus is highly contagious. It's particularly prevalent in schools and nurseries as the virus can survive for several days on surfaces or objects. But it can affect people of all ages and cause vomiting and diarrhoea.
The symptoms are unpleasant and can initially be quite distressing, but they shouldn't last for more than a couple of days. Adults and children with Norovirus symptoms should avoid visiting GP surgeries or hospitals to prevent the further spread of the virus.
Because the virus is highly contagious, children who have Norovirus symptoms must remain off school, nursery or childminders for at least 48 hours and upto 72 hours after the last episode of vomiting or diarrhoea to stop the spread of the infection to other children and staff.
Different types of Norovirus?
Norovirus is the most common cause of stomach bugs in the UK, with at least 25 different strains known to affect humans. Each year, it's estimated between 600,000 and 1 million people in the UK catch Norovirus because there are so many strains, we don't develop immunity to it.
The virus is sometimes called "Winter Vomiting Bug" as it's more common in winter. However, you can catch the virus at any time of the year.
Norovirus is the most common cause of stomach bugs in the UK, with at least 25 different strains known to affect humans. Each year, it's estimated between 600,000 and 1 million people in the UK catch Norovirus because there are so many strains, we don't develop immunity to it.
The virus is sometimes called "Winter Vomiting Bug" as it's more common in winter. However, you can catch the virus at any time of the year.
How do you treat Norovirus?
To treat the symptoms of Norovirus, we recommend the following for children and young people:
To treat the symptoms of Norovirus, we recommend the following for children and young people:
- Ensure they drink plenty of water to avoid dehydration.
- Give them liquid paracetamol for any fever or aches and pains.
- If they feel like eating, give them easy to digest foods such as bananas or brown rice.
- Stay at home - there is nothing the GP can prescribe for sickness and diarrhoea, although your local chemist may be able to provide re-hydration solutions.
- Contact your GP or NHS 111 to seek advice if the symptoms last longer than a few days, or visit the website on nhs.uk/norovirus for more information.