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Exclusion from childcare, preschool, school and work

The spread of certain infectious diseases can be reduced by excluding a person, known to be infectious, from contact with others who are at risk of catching the infection.

The following are recommended minimum periods of exclusion from school, preschool and childcare centres for cases of, and contact with, infectious diseases, based on guidelines issued by the National Health and Medical Research Council in December 2005 and the 10th edition of the Australian Immunisation Handbook, 2013.

These guidelines can also be applied to the general community and most workplaces. A childcare worker with gastroenteritis (also known as 'gastro': inflammation of the intestinal (bowesl)), should not return to work for at least 24 hours after vomiting or diarrhoea have stopped.

Exclusion periods

The need for exclusion depends on:

  • the ease with which the infection can be spread
  • the ability of the infected person to follow hygiene precautions
  • whether or not the person has some immunity to the infection (either from vaccination or past infection)
  • to a lesser extent, the severity of the disease.

Definitions

Exclusion periods are based on the time that a person with a specific disease or condition might be infectious to others.

Non-exclusion means there is not a significant risk of transmitting infection to others. A person who is not excluded may still need to remain at home because he or she does not feel well.

A contact is any person who has been close enough to an infected person to be at risk of having acquired the infection from that person.

Further information

For further information about diseases, please refer to the specific disease topics.

Exclusion periods

These guidelines can also be applied to the general community and most workplaces.

Disease or condition Exclusion of case Exclusion of contacts
Amoebiasis (Entamoeba histolytica) Exclude until no diarrhoea for 24 hours. Not excluded
Campylobacter infection Exclude until no diarrhoea for 24 hours. Not excluded
Candidiasis See thrush.  
Chickenpox Exclude until all blisters have dried (usually 5 days) Any child with an immune deficiency (for example, leukaemia) or receiving chemotherapy should be excluded for their own protection. Otherwise not excluded.
Cytomegalovirus infection (CMV) Exclusion is not necessary. Not excluded
Cold sores (herpes simplex type 1, fever blisters) Young children and others unable to comply with good hygiene practices should be excluded while lesion is weeping. Lesions should be covered by a dressing where possible. Not excluded
Common cold Exclusion is not necessary, but a person with a cold should stay home until he or she feels well. Not excluded
Conjunctivitis Exclude until discharge from eyes has stopped (unless a doctor has diagnosed non-infectious conjunctivitis). Not excluded
Cryptosporidium infection Exclude until no diarrhoea for 24 hours. Not excluded
Diarrhoea (no organism identified) Exclude until no diarrhoea for 24 hours. Not excluded
Diphtheria Exclude until medical certificate of recovery from SA Health's Communicable Disease Control Branch is received following at least two negative throat swabs, the first not less than 24 hours after finishing a course of antibiotics and the second, at least the next 48 hours later. Exclude contacts living in same house until cleared by SA Health's Communicable Disease Control Branch
Food poisoning Exclude until well – no vomiting or diarrhoea for 24 hours. Not excluded
Giardia infection Exclude until no diarrhoea for 24 hours. Not excluded
Glandular fever (infectious mononucleosis, EBV or Epstein-Barr virus infection) Exclusion is not necessary. Not excluded
Hand, foot and mouth disease Exclude until all blisters are dry. Not excluded
Haemophilus influenzae type b (Hib) infection Exclude until person has received appropriate antibiotic treatment for at least 4 days. Not excluded
Head lice (pediculosis) Exclude until appropriate treatment has commenced. Not excluded
Hepatitis A Exclude until medical certificate of recovery is received, and until at least 7 days after onset of jaundice or illness. Not excluded
Hepatitis B Exclusion is not necessary. Not excluded
Hepatitis C Exclusion is not necessary. Not excluded
Hepatitis D Exclusion is not necessary. Not excluded
Hepatitis E Exclude for 2 weeks after illness onset, or if jaundice (yellow eyes or skin) occurs, for 7 days after the onset of jaundice. Not excluded
Herpes simplex infection, type 1 See cold sores  
Human immunodeficiency virus (HIV) infection Exclusion is not necessary. If the person is severely immune suppressed he or she will be vulnerable to other people’s infections. Not excluded
Hydatid disease Exclusion is not necessary. Not excluded
Impetigo See school sores.  
Influenza and influenza-like illnesses Exclude until well Not excluded
Legionnaires’ disease Exclusion is not necessary. Not excluded
Leprosy Exclude until clearance has been given by an infectious diseases physician, dermatologist or SA Health Communicable Disease Control Branch doctor. Not excluded
Measles Exclude until 4 days after the onset of the rash. Immunised and immune contacts are not excluded. Non-immunised contacts are excluded from childcare until 14 days after rash onset in the last case in the facility, unless given vaccine (within 72 hours of first exposure) or Normal Human Immunoglobulin (within 144 hours of first exposure). All immune suppressed children should be excluded until 14 days after rash onset in the last case in the facility.
Meningitis (bacterial) Exclude until well and has received appropriate antibiotics. Not excluded
Meningitis (viral) Exclude until well. Not excluded
Meningococcal infection Exclude until appropriate antibiotic treatment completed and until well. Not excluded
Molluscum contagiosum Exclusion is not necessary. Not excluded
Methicillin resistant Staphylococcus aureus (MRSA) skin infection Exclusion is not necessary unless infected skin lesions on exposed surfaces cannot be completely covered with a dressing. Not excluded
Mumps Exclude for 5 days after onset of swelling. Not excluded
Norovirus Exclude until no vomiting or diarrhoea for 24 hours. Not excluded
Parvovirus infection (fifth disease, erythema infectiosum, slapped cheek syndrome) Exclusion is not necessary. Not excluded, but people who are anaemic, immune suppressed, or pregnant should be informed of possible risk of getting infection.
Pertussis See whooping cough. Not excluded
Respiratory syncytial virus (RSV) infection Exclusion is not necessary. Not excluded
Ringworm/tinea Exclude until the day after appropriate treatment has commenced. Not excluded
Ross River virus Exclusion is not necessary. Not excluded
Rotavirus infection Exclude until no vomiting or diarrhoea for 24 hours. Not excluded
Rubella (German measles) Exclude until fully recovered or for at least 4 days after the onset of the rash. Not excluded
Salmonella infection Exclude until no diarrhoea for 24 hours. Not excluded
Scabies Exclude until the day after appropriate treatment has commenced. Not excluded
Scarlet fever See streptococcal sore throat.  
School sores (impetigo) Exclude until appropriate treatment has commenced. Any sores on exposed surfaces should be completely covered with a dressing. Not excluded
Shigella infection Exclude until no diarrhoea for 24 hours. Not excluded
Shingles Exclude until blisters have dried up unless rash can be covered with a dry dressing or clothing so others are not exposed. Not excluded
Streptococcal sore throat (including scarlet fever) Exclude until the person has received appropriate antibiotic treatment for at least 24 hours and feels well. Not excluded
Thrush (candidiasis) Exclusion is not necessary. Not excluded
Toxoplasmosis Exclusion is not necessary. Not excluded
Tuberculosis Exclude until medical certificate is produced from SA Tuberculosis Service of SA Health. Not excluded
Typhoid, paratyphoid Exclude until clearance has been given by a doctor or SA Health's Communicable Disease Control Branch. Not excluded unless considered necessary by SA Health's Communicable Disease Control Branch.
Varicella-zoster See chickenpox or shingles  
Viral gastroenteritis (viral diarrhoea) Exclude until no diarrhoea for 24 hours. Not excluded
Warts (common, flat and plantar) Exclusion is not necessary. Not excluded
Whooping cough Exclude from childcare, school or workplace and similar settings until 5 days after starting antibiotic treatment, or for 21 days from the start of any cough. For exclusion of contacts in a childcare setting, seek advice from SA Health's Communicable Disease Control Branch. Usually, childcare contacts (in the same childcare group or room) and household contacts of the case who are under 6 months of age and have received less than 3 doses of pertussis containing vaccine should be excluded from childcare for 14 days from the first exposure to the infectious case, unless he or she has completed 5 days of recommended antibiotic treatment, after which he or she may return to childcare.
Worms If diarrhoea present, exclude until no diarrhoea for 24 hours. Not excluded
Yersinia infection Exclude until no diarrhoea for 24 hours Not excluded

 

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