Health Information

As requested we have put some information about some of the common problems/ailments that children may suffer from at one time or another.  There is information about symptoms, causes and treatments for Headlice, Threadworm and Hand, Foot and Mouth from the NHS website in the subpages found at the bottom of this page.

We hope you find this helpful. If you would like to see other health information under here please come and discuss this with Mrs Benson.

The following information was sent to schools from Public Health England:

Rashes and skin infections

Children with rashes should be considered infectious and assessed by their doctor.

Infection or complaint

Recommended period to be kept away from school, nursery or childminders

Comments

Athlete’s foot

None

Athlete’s foot is not a serious condition. Treatment is recommended

Chickenpox

Until all vesicles have crusted over

See: Vulnerable Children and Female Staff – Pregnancy

Cold sores, (Herpes simplex)

None

Avoid kissing and contact with the sores. Cold sores are generally mild and self-limiting

German measles (rubella)*

Four days from onset of rash (as per “Green Book”)

Preventable by immunisation (MMR x2 doses). See: Female Staff – Pregnancy

Hand, foot and mouth

None

Contact your local HPT if a large number of children are affected. Exclusion may be considered in some circumstances

Impetigo

Until lesions are crusted and healed, or 48 hours after starting antibiotic treatment

Antibiotic treatment speeds healing and reduces the infectious period

Measles*

Four days from onset of rash

Preventable by vaccination (MMR x2). See: Vulnerable Children and Female Staff – Pregnancy

Molluscum contagiosum

None

A self-limiting condition

Ringworm

Exclusion not usually required

Treatment is required

Roseola (infantum)

None

None

Scabies

Child can return after first treatment

Household and close contacts require treatment

Scarlet fever*

Child can return 24 hours after starting appropriate antibiotic treatment

Antibiotic treatment is recommended for the affected child

Slapped cheek/fifth disease. Parvovirus B19

None (once rash has developed)

See: Vulnerable Children and Female Staff – Pregnancy

Shingles

Exclude only if rash is weeping and cannot be covered

Can cause chickenpox in those who are not immune, ie have not had chickenpox. It is spread by very close contact and touch. If further information is required, contact your local PHE centre. See: Vulnerable Children and Female Staff – Pregnancy

Warts and verrucae

None

Verrucae should be covered in swimming pools, gymnasiums and changing rooms

* 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). In addition, organisations may be required via locally agreed arrangements to inform their local PHE centre.

 

Diarrhoea and vomiting illness

Infection or complaint

Recommended period to be kept away from school, nursery or childminders

Comments

Diarrhoea and/or vomiting

48 hours from last episode of diarrhoea or vomiting

 

E. coli O157 VTEC Typhoid* [and paratyphoid*] (enteric fever) Shigella (dysentery)

Should be excluded for 48 hours from the last episode of diarrhoea. Further exclusion may be required for some children until they are no longer excreting

Further exclusion is required for children aged five years or younger and those who have difficulty in adhering to hygiene practices.

Children in these categories should be excluded until there is evidence of microbiological clearance. This guidance may also apply to some contacts who may also require microbiological clearance. Please consult your local PHE centre for further advice

Cryptosporidiosis

Exclude for 48 hours from the last episode of diarrhoea

Exclusion from swimming is advisable for two weeks after the diarrhoea has settled

 

* 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). In addition, organisations may be required via locally agreed arrangements to inform their local PHE centre.


 

Respiratory infections

Infection or complaint

Recommended period to be kept away from school, nursery or child minders

Comments

Conjunctivitis

None

If an outbreak/cluster occurs, consult your local PHE centre

Diphtheria *

Exclusion is essential. Always consult with your local HPT

Family contacts must be excluded until cleared to return by your local PHE centre. Preventable by vaccination. Your local PHE centre will organise any contact tracing necessary

Glandular fever

None

 

Head lice

None

Treatment is recommended only in cases where live lice have been seen

Hepatitis A*

Exclude until seven days after onset of jaundice (or seven days after symptom onset if no jaundice)

In an outbreak of hepatitis A, your local PHE centre will advise on control measures

AIDS

None

Hepatitis B and C and HIV are bloodborne viruses that are not infectious through casual contact. For cleaning of body fluid spills see: Good Hygiene Practice

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. In case of an outbreak, it may be necessary to provide antibiotics with or without meningococcal vaccination to close school contacts. Your local PHE centre will advise on any action is needed

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. Your local PHE centre will give advice on any action needed

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 handwashing and environmental cleaning, are important to minimise any danger of spread. If further information is required, contact your local PHE centre

Mumps*

Exclude child for five days after onset of swelling

Preventable by vaccination (MMR x2 doses)

Threadworms

None

Treatment is recommended for the child and household contacts

Tonsillitis

None

There are many causes, but most cases are due to viruses and do not need an antibiotic

* 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). In addition, organisations may be required via locally agreed arrangements to inform their local PHE centre.

 

Vulnerable children

Some medical conditions make children vulnerable to infections that would rarely be serious in most children, these include those being treated for leukaemia or other cancers, on high doses of steroids and with conditions that seriously reduce immunity. Schools and nurseries and childminders will normally have been made aware of such children. These children are particularly vulnerable to chickenpox, measles or parvovirus B19 and, if exposed to either of these, the parent/carer should be informed promptly and further medical advice sought. It may be advisable for these children to have additional immunisations, for example pneumococcal and influenza.

 

Female staff – pregnancy

If a pregnant woman develops a rash or is in direct contact with someone with a potentially infectious rash, this should be investigated according to PHE guidelines by a doctor. The greatest risk to pregnant women from such infections comes from their own child/children, rather than the workplace. Some specific risks are:

·         chickenpox can affect the pregnancy if a woman has not already had the infection. Report exposure to midwife and GP at any stage of exposure. The GP and antenatal carer will arrange a blood test to check for immunity. Shingles is caused by the same virus as chickenpox, so anyone who has not had chickenpox is potentially vulnerable to the infection if they have close contact with a case of shingles

·         German measles (rubella). If a pregnant woman comes into contact with german measles she should inform her GP and antenatal carer immediately to ensure investigation. The infection may affect the developing baby if the woman is not immune and is exposed in early pregnancy

·         slapped cheek disease (parvovirus B19) can occasionally affect an unborn child. If exposed early in pregnancy (before 20 weeks), inform whoever is giving antenatal care as this must be investigated promptly

·         measles during pregnancy can result in early delivery or even loss of the baby. If a pregnant woman is exposed she should immediately inform whoever is giving antenatal care to ensure investigation

 

This advice also applies to pregnant students.

 

Immunisation schedule

For the most up-to-date immunisation advice see the NHS Choices website at www.nhs.uk or the school health service can advise on the latest national immunisation schedule.

 

Two months old

Diphtheria, tetanus, pertussis, polio and Hib (DTaP/IPV/Hib)

Pneumococcal (PCV13)

Rotavirus vaccine

One injection

One injection

Given orally

Three months old

Diphtheria, tetanus, pertussis, polio and Hib (DTaP/IPV/Hib)

Meningitis C (Men C)

Rotavirus vaccine

One injection

One injection

Given orally

Four months old

Diphtheria, tetanus, pertussis, polio and Hib (DTaP/IPV/Hib)

Pneumococcal (PCV13)

One injection

One injection

Between 12-13 months old

Hib/meningitis C

Measles, mumps and rubella (MMR) Pneumococcal (PCV13)

One injection

One injection

One injection

Two, three and four years old

Influenza (from September)

Nasal spray

or one injection

Three years and four months old or soon after

Diphtheria, tetanus, pertussis, polio (DTaP/IPV or dTaP/IPV)

Measles, mumps and rubella (MMR)

One injection

One injection

Girls aged 12 to 13 years

Cervical cancer caused by human papilloma virus types 16 and 18. HPV vaccine

Two injections given 6-24 months apart

Around 14 years old

Tetanus, diphtheria, and polio (Td/IPV)

One injection

Meningococcal C (Men C)

One injection