Should I keep my child at home?

We all agree that children are better nursed at home within familiar surroundings, and we recognise it is difficult for working parents to take time off to look after their sick children, but equally child care providers have a duty to protect other children in their care from infection.  
A helpful guide to sickness and infection at Playgroup

•	Children should not attend playgroup if they have been given fever reducing medication such as Calpol, within 4 hours of their session.
•	Children with a temperature may not return until they have been 24 hours fever free, without the need for medication to assist.
•	Children must not be left at the Pre-School if they are vomiting or have diarrhoea.  They MUST be kept away for 48 hours after the vomiting or diarrhoea has ceased.  PLEASE comply with this rule. 
•	Children with open sores e.g. impetigo should be kept at home until sores are crusted and healed or 48 hours after commencing antibiotic treatment 
•	Children with chicken pox must be kept at home until all scabs are dry (usually 5 days after the last crop of blisters).
•	Colds are infectious.  A mild cold will cause little distress.  However, a child with a heavy cold or flu who has a temperature should be nursed at home.
Other considerations:
Head lice
You should tell your child’s carer if they have head lice.  Check your child’s head regularly as continual vigilance will reduce the chance of occurrence.  For treatment use a recommended lotion. 
Infectious diseases
Parents should tell the Pre-School staff if their child has been diagnosed with measles, chicken pox, or serious stomach infections.  You MUST inform them if you child has rubella (German measles) in case they have been in contact with anyone in early pregnancy.
The following charts give some guidance on the control of the most common and more important infections encountered.
It is not intended to act as a guide to a diagnosis; this should only be undertaken by an appropriately qualified health professional.

Rashes & Skin	
Type 	Recommended time off	
Athlete’s foot
	None
Athlete’s foot is not a serious condition. Treatment is recommended	
Chickenpox 	5 days from onset of rash	
Cold sores (herpes simplex)
	Avoid kissing and contact with the sores. Cold sores are generally mild and heal without treatment
None 	
Conjunctivitis
	None
	
Diarrhoea and vomiting
	Whilst symptomatic and 48 hours after the last symptoms.
	
Diphtheria 
	Exclusion is essential.
Preventable by vaccination. Family contacts must be excluded until cleared to return by your local HPT
	
Flu (influenza)	Until recovered
	
German Measles Rubella (German measles)
	Four days from onset of rash
Preventable by vaccination with 2 doses of MMR (see national schedule @ www.nhs.uk). Promote MMR for all pupils and staff. Pregnant staff contacts should seek prompt advice from their GP or midwife
	
Glandular fever	None	
Hand, Foot & Mouth Disease  	None	
Head lice	None
Treatment recommended only when live lice seen
	
Hepatitis A
	Exclude until seven days after onset of jaundice (or 7 days after symptom onset if no jaundice)
In an outbreak of hepatitis A, your local HPT will advise on control measures	
Hepatitis B, C, HIV

	None
Hepatitis B and C and HIV are blood borne viruses that are not infectious through casual contact. 	
Impetigo	Until sores are crusted and healed or 48 hours after commencing antibiotic treatment 
Antibiotic treatment speeds healing and reduces the infectious period.	
Measles 	4 days from onset of rash 
Preventable by vaccination (2 doses of MMR). Promote MMR for all pupils and staff. Pregnant staff contacts should seek prompt advice from their GP or midwife	
Meningococcal meningitis/ septicaemia
	Until recovered
Meningitis ACWY and B are preventable by vaccination   	
Meningitis due to other bacteria
	Until recovered
Hib and pneumococcal meningitis are preventable by vaccination	
Meningitis viral
	None
Milder illness than bacterial meningitis. Siblings and other close contacts of a case need not be excluded.	
MRSA	None
Good hygiene, in particular hand washing and environmental cleaning, are important to minimise spread. Contact your local HPT for more information	
Mumps*
.
	Five days after onset of swelling
Preventable by vaccination with 2 doses of MMR (see national schedule @ www.nhs.uk). Promote MMR for all pupils and staff	
Ringworm 	None usually required
 Treatment is needed.	
Scabies 	Can return after first treatment
Household and close contacts require treatment at the same time.
	
Scarlet Fever	24 hours after commencing appropriate antibiotic treatment 
A person is infectious for 2-3 weeks if antibiotics are not administered.	
Slapped Cheek or Parvovirus  	None (once rash has developed)
If you are pregnant please consult with your GP or midwife.
None	
Threadworms

	None
Treatment recommended for child & household contacts	
Tonsillitis
	None
There are many causes, but most cases are due to viruses and do not need an antibiotic treatment	
Warts and verrucae
	None Verrucae should be covered in swimming pools, gyms and changing rooms
	
Whooping cough (pertussis)
	Two days from starting antibiotic treatment, or 21 days from onset of symptoms if no antibiotics
Preventable by vaccination. After treatment, non-infectious coughing may continue for many weeks	

Long term medication i.e. inhalers etc. also require recording if they are to be administered by the staff. In addition a health care plan will be drawn up following discussion with yourself and your child’s key person.  
Antibiotics
Children prescribed antibiotics to treat infections should remain at home for at least 48 hours to support them with their recovery returning only when they are well enough to participate in a normal day. Children who are regularly being prescribed antibiotics to deal with an ongoing medical condition may be allowed to attend during the first 24 hours at the discretion of the Manager or Senior staff.
Further information
Child minders, nurseries and Pre-schools are registered under the Children Act 1989.  They have to comply with a Code of Practice, which states: -
‘You must take precautions to ensure that the children you care for are not exposed to infectious diseases’
Taking precautions means protecting other children from an unpleasant illness that could have been avoided.