children learning how to wrap bandages

by Alison Buist

17 May 23

Sickness and Illness Policy

In order to take appropriate action of children become ill and to minimise the spread of infection we implement the following procedures:

  • If a child becomes ill during their time here, we contact their parent(s) and ask them to pick up their child as soon as possible. During this time we care for the child in a quiet, calm area wherever possible
  • We follow the guidance on Infection Prevention and Control in Childcare Settings (Day Care and Childminding Settings) given to us by the Infection Control Team Scotland and the exclusion criteria from the ‘Childcare and Childminding Settings’ guidance on exclusion times for specific illnesses, e.g. sickness and diarrhoea, measles and chicken pox to protect other children in the nursery
  • Should a child have an infectious disease, such as sickness and diarrhoea, they must not return until they have been clear for at least 48 hours
  • We thoroughly clean and sterilise all equipment and resources that may have come into contact with a contagious child to reduce the spread of infection
  • We exclude all children on antibiotics for the first 24 hours of the course
  • We have the right to refuse admission to a child who is unwell. This decision will be taken by the manager on duty and is non-negotiable
  • We make information/posters about head lice readily available and all parents are requested to regularly check their children’s hair. If a parent finds that their child has head lice we would be grateful if they could inform and child is allowed to return if being treated actively.

Dealing with an unwell child

  • Staff should respect and uphold the dignity and respect of the child. 
  • Staff should wear appropriate PPE and ensure child is sitting away from the other children to stop spread of illness.
  • If a child has a temperature of higher than 37.8 the child should be offered liquids and monitored. Their temperature should then be checked after 15 minutes and again in another 15 minutes. If the temperature has not came down, Parents should be phoned and ask to collect their child.
  • If a child has a sickness bug, parents should be informed their child cannot return after the 48 hours cleared. 
  • If a child’s wellbeing is decreasing and a parent cannot arrive within 40 minutes, parents should be informed that the emergency contact should be contacted. 
  • We do not accept non-prescribed medications such as paracetamol or ibuprofen to be given to a child.

Transporting children to hospital procedure

  • Call for an ambulance immediately if the sickness is severe. 
  • Whilst waiting for the ambulance, contact the parent(s) and arrange to meet them at the hospital
  • Redeploy staff if necessary to ensure there is adequate staff deployment to care for the remaining children. This may mean temporarily grouping the children together
  • Arrange for the most appropriate member of staff to accompany the child taking with them any relevant information such as registration forms, relevant medication sheets, medication and the child’s comforter
  • Inform a member of the management team immediately
  • Remain calm at all times. Children who witness an incident may well be affected by it and may need lots of cuddles and reassurance. Staff may also require additional support following the accident.

Exclusion criteria for childcare and childminding settings

Athletes FootNoneNot serious infection child should be treated.
Chickenpox (Varicella Zoster)Until all vesicles have crusted over (usually 5 days)Pregnant staff should seek advice from their GP if they have no history of having the illness.
Cold sores (herpes simplex)NonePreventable by vaccination (MMR x 2 doses). Pregnant staff should seek prompt advice from their GP
German measles (rubella)7 days before rash and 7 days afterPreventable by vaccination (MMR x 2 doses). Pregnant staff should seek prompt advice from their GP
Hand Foot and Mouth (coxsackie)NoneIf a large number of children affected contact HPT. Exclusion may be considered in some circumstances
Impetigo (Streptococcal Group A skin infection)Until lesions are crusted or healed or 48 hours after starting antibioticsAntibiotics reduce the infectious period
Measles4 days from onset of rashPreventable by immunisation.  (MMR x 2 doses). Pregnant staff should seek prompt advice from their GP
RingwormNot usually required unless extensiveTreatment is required
ScabiesUntil first treatment has been completed2 treatments are required including treatment for household and close contacts
Scarlet feverChild can return 24 hours after starting appropriate antibiotic treatmentAntibiotic treatment is recommended for the affected child
Slapped cheek/fifth disease. Parvovirus B19None (once rash has developed)Pregnant contacts of a case should consult their GP
ShinglesExclude only if rash is weeping and cannot be coveredCan cause chickenpox in those who are not immune, ie have not had chickenpox. It is spread by very close contact and touch
Warts and verrucaeNoneVerrucae should be covered in swimming pools, gymnasiums and changing rooms
Diarrhoea and/or vomiting48 hours from last episode of diarrhoea or vomiting
E. coli O157 STEC Typhoid and paratyphoid (enteric fever) Shigella (dysentery)Should be excluded for 48 hours from the last episode of diarrhoea for E. coli 0157. Further exclusion may be required for some children until they are no longer excreting.  Exclusion is also variable for enteric fever and dysentery.  HPT will adviseFurther exclusion is required for children aged 5 years or younger and those who have difficulty in adhering to hygiene practices
CryptosporidiosisExclude for 48 hours from the last episode of diarrhoeaExclusion from swimming is advisable for 2 weeks after the diarrhoea has settled
Flu (influenza)Until recoveredIf an outbreak/cluster occurs, consult your local HPT
TuberculosisAdvised by HPT on individual casesOnly pulmonary (lung) TB is infectious to others. Needs close, prolonged contact to spread
Whooping cough (pertussis)48 hours from starting antibiotic treatment, or 21 days from onset of illness if no antibiotic treatmentPreventable by vaccination. After treatment, non-infectious coughing may continue for many weeks
ConjunctivitisNoneIf an outbreak/cluster occurs, consult your local HPT
DiphtheriaExclusion is essential. 
Always consult your local HPT
Family contacts must be excluded until cleared to return by your local HPT. 
Preventable by vaccination
Glandular feverNone
Head liceNoneTreatment is recommended only in cases where live lice have been seen
Hepatitis AExclude until 7 days after onset of jaundice (or 7 days after symptom onset if no jaundice)
Hepatitis B, C, HIV/AIDSNoneHepatitis B and C and HIV are bloodborne viruses that are not infectious through casual contact
Meningococcal meningitis/ septicaemiaUntil recoveredMeningitis ACWY and B are preventable by vaccination. 
There is no reason to exclude siblings or other close contacts of a case
Meningitis due to other bacteriaUntil recoveredHib and pneumococcal meningitis are preventable by vaccination. There is no reason to exclude siblings or other close contacts of a case
Meningitis viralNoneMilder illness. There is no reason to exclude siblings and other close contacts of a case. Contact tracing is not required
MRSANoneGood hand hygiene and environmental cleaning
MumpsExclude child for 5 days afterPreventable by vaccination (MMR x2 doses)
ThreadwormsNoneTreatment is recommended for the child and household contacts
TonsillitisNoneThere are many causes, but most cases are due to viruses and do not need an antibiotic