Illness and Exclusion Periods

Exclusion Periods

We adhere to HPA guidelines for minimum exclusion periods, with additional precautionary measures in place to maintain good health of children and staff in the setting, due to the large number of very young children at Kozy Cottage who are cared for in close proximity to one another. You can access the HPA website via our ‘Links’ page.

All measures are in place for the welfare of the sick child and to contain the infection as much as possible from spreading to other children & staff (with particular regard to any female staff who may be pregnant).

The following criteria apply:

  • A child who is unwell and very fretful should not attend, regardless of being infected or not infected.
  • Children or staff with diarrhoea and/or vomiting should be excluded. They must be symptom free for 48 hours after an episode of sickness/diarrhoea before returning to nursery.
  • Simple coughs and runny noses need not be a reason for exclusion, unless point (1) applies.
  • Skin rashes should be professionally diagnosed and the child excluded following our setting guidelines as a minimum, point (1) also applies.
  • Children running extreme high temperatures will be cared for and parents contacted.
  • Please refer to our setting guidelines for other infections/conditions

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Diarrhoea and Vomiting Illnesses

Condition Recommended period to be kept away from Nursery Comments

Diarrhoea and/or vomiting

48 hours from the last episode of diarrhoea and/or vomiting Good handwashing practices help prevent and contain all of these types of infections

E coli O157 VTEC

48 hours from the last episode of diarrhoea Further exclusion may be required for young children under five and those who have difficulty in adhering to hygiene practices. This guidance may also apply to those who require microbiological clearance. Please contact your local HPA/HPU for further advice.

Typhoid *and Paratyphoid*  (enteric Fever)

As above plus further exclusion required for some children/staff. As above

Shigella (Dysentery)

As above As above

Cryptosporidiosis

48 hours from the last episode of diarrhoea Exclusion from swimming/water play is advisable for two weeks after the diarrhoea has settled.

Food poisoning

48 hours from the last episode of diarrhoea with further exclusion required for some children/staff. Further exclusion may be required for young children under five and those who have difficulty in adhering to hygiene practices. This guidance may also apply to those who require microbiological clearance. Please contact your local HPA/HPU for further advice.

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Rashes and Skin Infections

Condition Recommended period to be kept away from Nursery Comments

Athlete’s foot

None Not a serious condition but can spread-treatment is recommended

Chickenpox

Six days from the onset of the rash & until spots are dried/crusted over. Child should be well and not fretful upon return.SEE-vulnerable children/staff pregnancy.

Cold sores (herpes simplex virus)

None Avoid kissing & contact with the sores. Care not to share feeder cups/dummies. Generally mild and self-limiting but treatment is available.

German Measles * (Rubella)

Six days from onset of rash Preventable by immunisation (MMR x 2 doses).  SEE-vulnerable children/staff pregnancy.

Hand foot & mouth

Until spots heal/crust over. Child should be well have no spluttery cough and not be fretful upon return. Infection can remain in faeces for up to 4 weeks so good hygiene practices must be in place. Exclusion may be considered in some circumstances.Exclusion may be considered in some circumstances.

Impetigo

Until lesions are crusted and healed or 48 hours after commencing antibiotic treatment. We will need to see evidence of any antibiotic treatment.

Measles *

Four days from the onset of rash Preventable by immunisation (MMR x 2 doses). SEE-vulnerable children/staff pregnancy.

Molluscum contagiosum

None Cover any open sores (if child has scratched them) to prevent spread on the child’s own skin. Self-limiting.

Ringworm

Exclusion not usually required once child has been treated. Treatment required

Roseola (infantum)

None None

Scabies

May return after first treatment Household and close contacts require treatment

Scarlet Fever *

May return 24 hours after commencing antibiotic treatment Antibiotic treatment required.

Slapped cheek/fifth disease. Parvovirus B19

None SEE-vulnerable children/staff pregnancy.

Shingles

Exclude if rash is weeping and cannot be kept covered. Can cause chickenpox in those who are not immune. It is spread by very close contact/touch.SEE-vulnerable children/staff pregnancy.

Thrush

Once diagnosed by a GP child may return after first dose of treatment. Parents will be advised to seek medical treatment for their child. Nursery staff to monitor and taking measures to prevent spread

Warts and verrucae

None Verrucae should be covered during wet/messy/water play.

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Respiratory Infections

Condition Recommended period to be kept away from Nursery Comments

Flu (Influenza)

Until recovered SEE: Vulnerable Children

Tuberculosis *

Always contact your local HPA/HPU Requires prolonged close contact for spread

Whooping Cough * (Perticussis)

Five days from commencing antibiotic treatment or 21 days from onset of illness if no treatment Preventable by vaccination. After treatment non-infectious coughing may continue for many weeks. Your HPU will organize any contact tracing if necessary.

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Other Infections

Condition Recommended period to be kept away from Nursery Comments

Conjunctivitis

Exclusion until the infection has cleared and the eyes are pus free or after 1st administration of prescribed drops/cream OR if seen by a doctor and no medication is deemed necessary. If an outbreak/cluster occurs consult your local HPU

Diphtheria *

Exclusion is always essential. Always consult your local HPU Preventable by vaccination. Family contacts must be excluded until cleared to return by your local HPU

Glandular Fever

None recommended- but it is advised to keep children at home until they feel better and rested. Very contagious through saliva so rigorous hygiene practice are vital to reduce spread.

Head Lice

None once treatment has commenced Treatment is necessary where live lice and/or eggs (nits) have been seen. Treatment needs to continue regularly over time until all nits and lice have been removed

Hepatitis A*

Exclude until seven days after onset of jaundice (or seven days after onset of symptoms if no jaundice) In an outbreak of hepatitis A your local HPU will advise on control measures

Hepatitis B* Hepatitis C* & HIV/AIDS

None Hepatitis B and C and HIV are blood borne viruses that are not infectious through casual contact. For cleaning of body spills follow good hygiene practices.

Meningococcal meningitis*/ Septicaemia*

Until recovered Meningitis C is preventable by vaccination. There is no reason to exclude siblings or other close contacts of a case.

Meningitis *due to other bacteria

Until recovered HIB and pneumococcal meningitis are preventable by vaccination. There is no reason to exclude siblings or other close contacts of a case.

Meningitis* Viral

None Milder illness. There is no reason to exclude siblings or other close contacts of a case. Contact tracing is not required.

MRSA

None Good hygiene in particular handwashing and environmental cleaning are important to minimize any danger of spread. Consult your local HPU

Mumps

Exclude for five days after onset of swelling Preventable by vaccination (MMR x 2 doses)

Threadworms

None Treatment is recommended for child and household contacts.

Tonsillitis

None There are many causes but most cases are due to viruses and do not need an antibiotic

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*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).

Regulating bodies such as Ofsted may wish to be informed-Kozy Cottage will refer to local policy in the case of any confirmed notifiable diseases.

Outbreaks: If there are suspected outbreaks within the nursery of infectious disease, we will consult Local HPU.

Vulnerable children: On entry, parents let us know if their child has a medical condition which makes them more vulnerable to infections. If your child’s medical condition changes while at Kozy Cottage, please make us aware of this so that we are best informed how to care for your child.

Female Staff/Students-Pregnancy & Infections: Some infectious diseases can affect the development of the baby, cause early delivery or even loss of the baby.

Please see our links page for the most up-to-date immunisation advice

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