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LOS Infection Control Policy

 
 
THE LONDON ORATORY SCHOOL
Infection Control Policy
 
Contents:
Statement of intent
Preventative measures
1. Legal framework
2. Ensuring a clean environment
3. Pupil immunisation
4. Staff immunisation
5. Contact with pets and animals
6. Water-based activities
In the event of infection
7. Preventing the spread of infection
8. Vulnerable pupils
9. Procedures for unwell pupils/staff
10. Exclusion
11. Medication
12. Outbreaks of infectious diseases
13. Pregnant staff members
14. Staff handling food
15. Managing specific infectious diseases
16. Monitoring and review Appendices
a) Managing Specific Infectious Diseases
b) Infection Absence Periods
c) Diarrhoea and Vomiting Outbreak Action Checklist
d) List of Notifiable Diseases
 
Statement of intent 
Infections can easily spread in a school due to:
• Pupils’ immature immune systems.
• The close-contact nature of the environment.
• Some pupils having not yet received full vaccinations.
• Pupils’ poor understanding of good hygiene practices.
 
Infections commonly spread in the following ways:
• Respiratory spread – contact with coughs or other secretions from an infected person.
• Direct contact spread – direct contact with the infecting organism, e.g., skin-on-skin contact during sports.
• Gastrointestinal spread – contact with contaminated food or water, or contact with infected faeces or unwashed hands.
• Blood borne virus spread – contact with infected blood or bodily fluids, e.g., via bites or used needles. 
 
We actively prevent the spread of infection via the following measures: 
• Maintaining high standards of personal hygiene and practice
• Following NHS advice and campaigns: Catch it, Bin it , Kill it campaign
• Maintaining a clean environment
• Routine immunisations
• Use of Public Health Campaign resources https://campaignresources.phe.gov.uk/schools
• Taking appropriate action when infection occurs
This policy aims to help school staff prevent and manage infections in school. It is not intended to be used as a tool for diagnosing disease, but rather a series of procedures informing staff what steps to take to prevent infection and what actions to take when infection occurs. 
 
Legal framework
This policy has due regard to legislation including, but not limited to, the following:
• Control of Substances Hazardous to Health Regulations 2002 (as amended 2004)
• Health and Safety at Work etc. Act 1974
• The Management of Health and Safety at Work Regulations 1999
• The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013
• The Health Protection (Notification) Regulations 2010
This policy has due regard to statutory guidance including, but not limited to, the following
• Public Health England (2017) ‘Health protection in schools and other childcare facilities’
• DfE (2015) ‘Supporting pupils at school with medical conditions’
 
This policy operates in conjunction with the following school policies and documents:
• Health and Safety Policy
• Supporting Pupils with Medical Conditions Policy 
• Administering Medication Policy
• First Aid Policy
• Swimming Risk Assessment
Preventative measures
Ensuring a clean environment
 
Sanitary facilities
Wall-mounted soap dispensers are used in all toilets – bar soap is never used.
A foot-operated waste paper bin is always made available where disposable paper towels are used.
 
Toilet paper is always available in cubicles. 
Suitable sanitary disposal facilities are provided where necessary. 
 
Cleaning contractors
A cleaning contractor is employed to carry out rigorous cleaning of the premises.  Cleaning  
equipment is maintained to a high standard and is colour coded according to  area of use. The DFO is responsible for monitoring cleaning standards and discussing any  issues that may arise with the contractor. 
 
Hand washing
All staff and pupils are advised to wash their hands after using the toilet, before eating or handling food.
 
Blood and other bodily fluids
Cuts and abrasions are covered with waterproof dressings.
When coughing or sneezing, all staff and pupils are encouraged to cover their nose and mouth with a 
disposable tissue and dispose of the tissue after use, and to wash their hands afterwards.
 
Personal protective equipment (PPE) are worn where there is a risk of contamination with blood or 
bodily fluids during an activity. Gloves are disposable, non-powdered vinyl or latex and CE 
(Conformité Européene) marked. If there is a risk of splashing to the face, goggles are worn.
 
Spillages of blood, faeces, saliva, vomit, nasal and eye discharges are cleaned up immediately. They are cleaned using a mixture of detergent and disinfectant. Paper towels or cloths are used, always wearing PPE, and they are disposed of after use. The school spillage kit is stored in the Medical Room.  
 
Bites
If a bite does not break the skin, the affected area is cleaned with soap and water.
If a bite breaks the skin, the affected area is cleaned with soap and running water, the incident is 
recorded in the pupil accident log and medical advice is sought immediately. 
 
Hypodermic needles (sharps)
Injuries incurred through sharps found on school grounds will be treated in line with the school’s
 Medical Needs Policy. All sharps found on school premises will be disposed of in the sharps bin 
wearing PPE.
 
Pupil immunisation
The school keeps up-to-date with national and local immunisation scheduling and advice via
 www.nhs.uk/conditions/vaccinations/.
 
• Whilst the school encourages parents to have their children immunised, parental consent will always  be sought before a vaccination is given. 
 
• The school will ensure that any pupils with existing medical conditions are medically cleared to be given the vaccine in question. 
 
• A healthcare team will visit the school in order to carry out vaccinations and will be able to advise  pupils if there are any concerns.
 
• A risk assessment will be conducted before any vaccinations take place. 
 
• In Junior House  to Year 4 will be offered nasal flu vaccinations annually.
 
• [Secondary schools only]Pupils aged between 12 and 13 can choose to get the HPV vaccine to protect themselves against some types of cervical cancer. This vaccine comprises two injections 
given 6-12 months apart.
 
• [Secondary schools only] All pupils aged 14 will be offered the 3-in-1 teenage booster vaccination to  top-up the effects of the pre-school vaccines against diphtheria, polio and tetanus.
 
• [Secondary schools only] All pupils aged 14 will be offered the MenACWY vaccine as part of the 
routine adolescent schools programme. 
 
• Any pupils who become unwell after receiving a vaccination will be treated by the healthcare team  who administered the vaccine, or by the first aider, following the school’s procedures for sick and unwell pupils. 
 
• Any side effects from the vaccinations, such as becoming unwell, will be reported to the healthcare  team who administered the vaccination, allowing them to record the symptoms and the time that  the vaccine was administered. 
 
• Any medication required to relieve the side effects of a vaccination, such as painkillers, will be 
administered in accordance with the school’s Administering Medication Policy.
 
• Regular communication is maintained after pupils return to lessons, as some side effects can take  several hours to develop. 
 
• Members of staff will be with pupils before, during and after vaccinations, in order to keep the pupils  relaxed and create a calming atmosphere. 
 
• The school will ensure that the venue used is a clean, open, well-ventilated room, where pupils can  access water and fresh air. 
 
• Needles are kept away from pupils before and after the vaccine is administered.
 
• Some vaccinations may involve an exclusion period in which pupils are not required to attend school. 
 
• The administering healthcare team will provide advice in such cases.
 
Staff immunisation
All staff will undergo a full occupational health check prior to employment, which confirms they are 
up-to-date with their immunisations.
 
Staff should be up-to-date with immunisations; in particular, we encourage the following:
 
• Hepatitis B: We do not recommend Hepatitis B vaccines for staff in routine contact with infected children; however, where staff are involved with the care of children with severe learning disabilities or challenging behaviour, we encourage immunisation.
 
• Rubella: Female staff of childbearing age are encouraged to check with their GP that they are immune to the rubella (German measles) virus. If they are not immune, we encourage them to be immunised with the MMR vaccine, except during pregnancy. 
Water-based activities
Swimming lessons
• General swimming lessons are governed by the control measures outlined in our Swimming
Risk Assessment.
 
• Pupils who have experienced vomiting or diarrhoea in the weeks preceding the trip are not 
permitted to attend public swimming pools. 
 
Other activities
Alternative water-based activities are only undertaken at reputable centres. 
Children and staff cover all cuts, scratches and abrasions with waterproof dressings before taking 
part, and hands are washed immediately after the activity. No food or drink is to be consumed until hands have been washed.
 
In the event of infection
Vulnerable pupils
 
Pupils with impaired immune defence mechanisms (known as immune-compromised) are more
likely to acquire infections. In addition, the effect of an infection is likely to be more significant for 
such pupils. These pupils may have a disease that compromises their immune system or be 
undergoing treatment, such as chemotherapy, that has a similar effect. 
 
The school nurse will be notified if a child is “vulnerable”. Parents are responsible for notifying the 
school if their child is “vulnerable”. 
 
If a vulnerable child is thought to have been exposed to an infectious disease, the child’s parents will be informed and encouraged to seek medical advice from their doctor or specialist. 
 
Procedures for unwell pupils/staff
Staff are required to know the warning signs of pupils becoming unwell including, but not limited to, the following:
 
• Not being themselves
• Not eating at lunchtimes
• Wanting more attention/sleep than usual 
• Displaying physical signs of being unwell, e.g., watery eyes, a flushed face or clammy skin. Where a staff member identifies a pupil as unwell, the pupil is taken to the reception, where their temperature will be taken by the first aider, and the pupil’s parents will be informed of the situation.
 
• Pupils and staff displaying any of the signs of becoming unwell outlined in 9.1 will be sent home, and we will recommend that they see a doctor or follow any  Public Health advice in the case of a pandemic.
 
• If a pupil is identified with sickness and diarrhoea, the pupil’s parents will be contacted immediately and the child will be sent home, and may only return after 48 hours have passed without symptoms. 
 
• If a staff member is suffering from vomiting and diarrhoea, they will be sent home and may not return until 48 hours have passed without symptoms. 
 
• If the school is unable to contact a pupil’s parents in any situation, the pupil’s alternative emergency contacts will be contacted. 
 
Contaminated clothing
• If the clothing of the first-aider or a pupil becomes contaminated, the clothing is removed as soon as possible and placed in a plastic bag. The pupil’s clothing is sent home with the pupil, and parents are advised of the best way to launder the clothing. 
 
Exclusion
• Pupils suffering from infectious diseases will be excluded from school on medical grounds for the  minimum recommended period. 
 
• Pupils can be formally excluded on medical grounds by the Headmaster. 
 
• If parents insist on their child returning to school when the child still poses a risk to others, the LA may serve notice on the child’s parents to require them to keep the child away from school until the  child no longer poses a risk of infection.
 
• If a pupil is exposed to an infectious disease, but is not confirmed to be infected, this is not normally a valid reason for exclusion; however, the local health protection team(HPT) may be contacted to advise on a case-by-case basis.  
 
Medication
• Where a pupil has been prescribed medication by a doctor, dentist, nurse or pharmacist, the first 
• dose will be given at home, in case the pupil has an adverse reaction. 
 
• The pupil will only be allowed to return to school 24 hours after the first dose of medication, to allow it time to take effect.
All medicine provided in school will be administered in line with the Administering Medication 
Policy.
 
Outbreaks of infectious diseases
An incident is classed as on ‘outbreak’ where:
• Two or more people experiencing a similar illness are linked in time or place.
• A greater than expected rate of infection is present compared with the usual background rate, e.g.:
• Two or more pupils in the same classroom are suffering from vomiting and diarrhoea.
• A greater number of pupils than usual are diagnosed with scarlet fever.
• There are two or more cases of measles at the school. 
Suspected outbreaks of any of the diseases listed on the List of Notifiable Diseases will always be reported.
 
As soon as an outbreak is suspected (even if it cannot be confirmed), the Headmaster will contact 
the HPT to discuss the situation and agree if any actions are needed. 
 
The Headmaster will provide the following information:
1. The number of staff and children affected
2. The symptoms present
3. The date(s) the symptoms first appeared
4. The number of classes affected
If the Headmaster is unsure whether suspected cases of infectious diseases constitute an outbreak, they will contact the HPT.
 
The HPT will provide the school with draft letters and factsheets to distribute to parents. 
 
The HPT will always treat outbreaks in the strictest confidence; therefore, information provided to 
parents during an outbreak will never include names and other personal details.
 
If a member of staff suspects the presence of an infectious disease in the school, they will contact Senior Stafffor further advice. 
 
If a parent informs the school that their child carries an infectious disease, other pupils will be 
observed for similar symptoms by their teachers.
 
The parent of a pupil returning to the school following an infectious disease will be asked to contact the Housemaster.
 
If a pupil is identified as having a notifiable disease, as outlined in the guide to Infection Absence Periods, the school will inform the parents, who should inform their child’s GP. It is a statutory requirement for doctors to then notify their local Public Health England centre. 
 
During an outbreak, enhanced cleaning protocols will be undertaken, following advice provided by  the local HPT. The DFO will liaise with the cleaning contractor to ensure these take place.
 
Pregnant staff members
• If a pregnant staff member develops a rash, or is in direct contact with someone who has a potentially contagious rash, we will strongly encourage her to speak to her doctor or midwife. 
 
• Chickenpox: If a pregnant staff member has not already had chickenpox or shingles, becoming infected can affect the pregnancy. If a pregnant staff member believes they have been exposed to chickenpox or shingles and have not had either infection previously, she will to speak to her midwife  or GP as soon as possible. If a pregnant staff member is unsure whether they are immune, we  encourage them to take a blood test. 
 
• Measles: If a pregnant staff member is exposed to measles, she will inform her midwife immediately. 
 
• All female staff under the age of 25, who work with young children, are asked to provide evidence of two doses of MMR vaccine or a positive history of measles. 
 
• Rubella (German measles): If a pregnant staff member is exposed to rubella, she will inform her  midwife immediately. All female staff under the age of 25, who work with young children, are asked  to provide evidence of two doses of MMR vaccine or a positive history of Rubella. 
 
• Slapped cheek disease (Parvovirus B19): If a pregnant staff member is exposed to slapped cheek disease, she will inform her midwife promptly.
 
Staff handling food
Food handling staff are covered by the catering company policy.
 
Managing Specific Infectious Diseases
 
Disease Symptoms Considerations Exclusion period
Athlete’s foot Scaling or cracking of the skin, particularly between the toes, or blisters containing fluid. The infection may be itchy. Cases are advised to see their GP for advice and treatment. Exclusion is not necessary.
Chicken pox Sudden onset of fever with a runny nose, cough and generalised rash. The rash then blisters and scabs over. Several blisters may develop at once, so there may be scabs in various stages of development. Some mild infections may not present symptoms. Cases are advised to consult their GP. Chickenpox is infectious from 48 hours prior to a rash appearing up to five days after the onset of a rash. 
 
Cases will be excluded from school for five days from the onset of a rash. 
 
It is not necessary for all the spots to have healed before the case returns to school.
Cold sores The first signs of cold sores are tingling, burning or itching in the affected area. Around 24 hours after the first signs appear the area will redden and swell, resulting in a fluid-filled blister. After blistering, they break down to form ulcers then dry up and crust over. Cases are advised not to touch the cold sore, or to break or pick the blisters. Sufferers of cold sores should avoid kissing people and should not share items such as cups, towels and facecloths. Exclusion is not necessary.
Conjunctivitis The eye(s) become reddened and swollen, and there may be a yellow or green discharge. Eyes may feel itchy and ‘gritty’.  Cases are encouraged to seek advice, wash their hands frequently and not to rub their eyes.
 
The HPT will be contacted if an outbreak occurs. Exclusion is not necessary.
Food poisoning Symptoms normally appear within one to two days of contaminated food being consumed, although they may start at any point between a few hours and several weeks later. The main symptoms are likely to be nausea, vomiting, diarrhoea, stomach cramps and fever. Cases will be sent home.
 
The HPT will be contacted where two or more cases with similar symptoms are reported. 
 
The cause of a food poisoning outbreak will always be investigated. Cases will be excluded until 48 hours have passed since symptoms were present. 
 
For some infections, longer exclusion periods may be required. The HPT will advise in such cases. Giardia Symptoms include abdominal pain, bloating, fatigue and pale, loose stools. Cases will be sent home.
 
The HPT will be contacted where two or more cases with similar symptoms are reported. Cases will be excluded until 48 hours have passed since symptoms were present. 
Salmonella Symptoms include diarrhoea, headache, fever and, in some cases, vomiting. Cases will be sent home.
 
The HPT will be contacted where two or more cases with similar symptoms are reported. Cases will be excluded until 48 hours have passed since symptoms were present.
Typhoid and paratyphoid fever Symptoms include tiredness, fever and constipation. The symptoms or paratyphoid fever include fever, diarrhoea and vomiting. 
All cases will be immediately reported to the HPT. Cases will be excluded whilst symptomatic and for 48 hours after symptoms have resolved. 
 
Environmental health officers or the HPT may advise the school to issue a lengthened exclusion period. 
 
E.coli (verocytotoxigenic or VTEC) Symptoms vary but include diarrhoea, abdominal cramps, headaches and bloody diarrhoea. Cases will immediately be sent home and advised to speak to their GP. Cases will be excluded whilst symptomatic and for 48 hours after symptoms have resolved. 
 
Where the sufferer poses an increased risk, for example, food handlers, they will be excluded until a negative stool sample has been confirmed. 
 
The HPT will be consulted in all cases.
Gastroenteritis Symptoms include three or more liquid or semi-liquid stools in a 24-hour period. The HPT will be contacted where there are more cases than usual. Cases will be excluded until 48 hours have passed since symptoms were present. 
 
If medication is prescribed, the full course must be completed and there must be no further symptoms displayed for 48 hours following completion of the course before the cases may return to school. 
 
Cases will be excluded from swimming for two weeks following their last episode of diarrhoea. 
Bacillary dysentery (Shigella) Symptoms include bloody diarrhoea, vomiting, abdominal pain and fever.It lasts four to seven days on average, but potentially several weeks. The school will contact the HPT. Microbiological clearance is required for some types of shigella. The HPT will advise. 
Campylobacter Symptoms include diarrhoea, headache, fever and, in some cases, vomiting. Cases will be excluded until 48 hours have passed since symptoms were present.
 
Cryptosporidiosis Symptoms include abdominal pain, diarrhoea and occasional vomiting. Cases will be excluded until 48 hours have passed since symptoms were present.
 
Coronavirus Symptoms include a cough,a high temperature and shortness of breath.COVID-19 is a new illness that can affect your lungs and airways. These symptoms can also be signs of flu so important to see advice from 111 helpline. Immediate advice will be sought from Public Health. 
Students or staff will be asked to go home and self- isolate for 14 days  as per the NHS guidance and use the NHS 111 online coronavirus service to find out what to do next
Glandular fever Symptoms include severe tiredness, aching muscles, sore throat, fever, swollen glands and occasionally jaundice. The sufferer may feel unwell for several months and the school will provide reasonable adjustments where necessary. Exclusion is not necessary and cases can return to school as soon as they feel well.
 
Hand, foot and mouth disease Symptoms include a fever and rash with blisters on cheeks, hands and feet. Not all cases will have symptoms. Exclusion is not necessary.
Head lice Other than the detection of live lice or nits, there are no immediate symptoms until two to three weeks after infection, where itching and scratching of the scalp occurs. Treatment is only necessary when live lice are seen. 
 
Staff are not permitted to inspect any pupil’s hair for head lice. 
 
If a staff member incidentally notices head lice in a pupil’s hair, they will inform the pupil’s parents and advise them to treat their child’s hair. 
 
When a pupil has been identified as having a case of head lice, a letter will be sent home to all parents notifying them that a case of head lice has been reported and asking all parents to check their children’s hair. Exclusion is not necessary.
 
Hepatitis A Symptoms include abdominal pain, loss of appetite, nausea, fever and tiredness, followed by jaundice, dark urine and pale faeces. The illness in children usually lasts one to two weeks, but can last longer and be more severe in adults. Cases are excluded while unwell and for seven days after the onset of jaundice (or the onset of symptoms if no jaundice presents), the case is under five years of age or where hygiene is poor. 
 
There is no need to exclude older children with good hygiene. 
Hepatitis B Symptoms include general tiredness, nausea, vomiting, loss of appetite, fever and dark urine, and older cases may develop jaundice. The HPT will be contacted where advice is required. 
 
The procedures for dealing with blood and other bodily fluids will always be followed. 
 
The accident book will always be completed with details of injuries or adverse events related to cases. Acute cases will be too ill to attend school and their doctor will advise when they are fit to return.
 
Chronic cases will not be excluded or have their activities restricted. 
 
Staff with chronic hepatitis B infections will not be excluded. 
Hepatitis C Symptoms are often vague but may include loss of appetite, fatigue, nausea and abdominal pain. Less commonly, jaundice may occur. The procedures for dealing with blood and other bodily fluids will always be followed. 
 
The accident book will always be completed with details of injuries or adverse events related to cases. Cases will not be excluded or have their activities restricted. 
Impetigo Symptoms include lesions on the face, flexures and limbs. Towels, facecloths and eating utensils will not be shared by pupils.
 
Toys and play equipment will be cleaned thoroughly. Cases will be excluded until lesions have healed and crusted or 48 hours after commencing antibiotic treatment. 
Influenza Symptoms include headache, fever, cough, sore throat, aching muscles and joints, and tiredness. Those in risk groups will be encouraged to have the influenza vaccine. 
 
Anyone with flu-like symptoms will stay home until they have recovered.
Pupils under 16 will not be given aspirin. Cases will remain home until they have fully recovered.
Measles Symptoms include a runny nose, cough, conjunctivitis, high fever and small white spots around the cheeks. Around the third day, a rash of flat red or brown blotches may appear on the face then spread around the body. All pupils are encouraged to have MMR immunisations in line with the national schedule.
 
Staff members should be up-to-date with their MMR vaccinations. 
 
Pregnant staff members and those with weak immune systems will be encouraged to contact their GP immediately for advice if they come into contact with measles. Cases are excluded for four days after the onset of a rash.
Meningitis Symptoms include fever, severe headaches, photophobia, stiff neck, non-blanching rash, vomiting and drowsiness. Meningitis is a notifiable disease. Once a case has received any necessary treatment, they can return to school. 
Meningococcal meningitis and meningitis septicaemia Symptoms include fever, severe headaches, photophobia, stiff neck and a non-blanching rash. Medical advice will be sought immediately. 
 
The confidentiality of the case will always be respected.
 
The HPT and school health advisor will be notified of a case of meningococcal disease in the school. The HPT will conduct a risk assessment and organise antibiotics for household and close contacts. 
 
The HPT will be notified if two cases of meningococcal disease occur in the school within four weeks. When the case has been treated and recovered, they can return to school. 
 
Exclusion is not necessary for household or close contacts unless they have symptoms suggestive of meningococcal infection. 
Meningitis (viral) Symptoms include headache, fever, gastrointestinal or upper respiratory tract involvement and, in some cases, a rash. The case will be encouraged to consult their GP.
 
If more than once case occurs, the HPT will be consulted. No exclusion is required. 
Meticillin resistant staphylococcus aureus (MRSA) Symptoms are rare but include skin infections and boils. All infected wounds will be covered. No exclusion is required. 
 
Mumps Symptoms include a raised temperature and general malaise. Then, stiffness or pain in the jaws and neck is common. Following this, the glands in the cheeks and under the jaw swell up and cause pain (this can be on one or both sides). Mumps may also cause swelling of the testicles. The case will be encouraged to consult their GP.
 
Parents are encouraged to immunise their children against mumps. Cases can return to school five days after the onset of swelling, if they feel able to do so. 
 
Ringworm Symptoms vary depending on the area of the body affected. Pupils with ringworm of the feet will wear socks and trainers at all times and cover their feet during physical education.  No exclusion is usually necessary. 
 
For infections of the skin and scalp, cases can return to school once they have received treatment. 
 
Rotavirus Symptoms include severe diarrhoea, stomach cramps, vomiting, dehydration and mild fever. Cases will be sent home if unwell and encouraged to speak to their GP. Cases will be excluded until 48 hours have passed since symptoms were present. 
 
Rubella (German Measles) Symptoms are usually mild, with a rash being the first indication. There may also be mild catarrh, headaches or vomiting. There may be a slight fever and some tenderness in the neck, armpits or groin, and there may be joint pains. MMR vaccines are promoted to all pupils. Cases will be excluded for six days from the appearance of the rash. 
Scabies Symptoms include tiny pimples and nodules on a rash, with burrows commonly seen on the wrists, palms, elbows, genitalia and buttocks. All household contacts and any other very close contacts should have one treatment at the same time as the second treatment of the case. 
 
The second treatment must not be missed and should be carried out one week after the first treatment. Cases will be excluded until after the first treatment has been carried out. 
Scarlet Fever Symptoms include acute inflammation of the pharynx or tonsils, with tonsils reddening in colour and becoming partially covered with a thick, yellowish exudate. In severe cases, there may be a high fever, difficulty swallowing and tender, enlarged lymph nodes. A rash develops on the first day of fever and is red, generalised, pinhead in size and gives the skin a sandpaper-like texture, with the tongue developing a strawberry-like appearance.  Antibiotic treatment is recommended, as a person is infectious for two to three weeks if antibiotics are not administered. 
 
If two or more cases occur, the HPT will be contacted. Cases are excluded for 24 hours following appropriate antibiotic treatment. 
 
Slapped cheek syndrome, Parvovirus B19, Fifth’s Disease Where symptoms develop, they include a rose-red rash making the cheeks appear bright red. Cases will be encouraged to visit their GP. Exclusion is not required. 
 
Threadworm Symptoms include itching around the anus, particularly at night. Cases will be encouraged to visit their GP. Exclusion is not required.
 
Tuberculosis (TB) Symptoms include cough, loss of appetite, weight loss, fever, sweating (particularly at night), breathlessness and pains in the chest. TB in parts of the body other than the lungs may produce a painful lump or swelling. Advice will be sought from the HPT before taking any action, and regarding exclusion periods. Cases with infectious TB can return to school after two weeks of treatment if well enough to do so, and as long as they have responded to anti-TB therapy.
 
Cases with non-pulmonary TB, and cases with pulmonary TB who have effectively completed two weeks of treatment as confirmed by TB nurses, will not be excluded. 
 
Whooping cough (pertussis) Symptoms include a heavy cold with a persistent cough. The cough generally worsens and develops the characteristic ‘whoop’. Coughing spasms may be worse at night and may be associated with vomiting. Cases will be advised to see their GP. Parents are advised to have their children immunised against whooping cough. Cases will not return to school until they have had 48 hours of appropriate treatment with antibiotics and feel well enough to do so, or 21 days from the onset of illness if no antibiotic treatment is given.
 
Cases will be allowed to return in the above circumstances, even if they are still coughing. 
 
Infection Absence Periods
This table details the minimum required period for staff and pupils to stay away from school following an infection, as recommended by Public Health England. 
*Identifies a notifiable disease. It is a statutory requirement that doctors report these diseases to their local Public Health England centre.
 
Infection Recommended minimum period to stay away from school Comments
Athlete’s foot None Treatment is recommended; however, this is not a serious condition.
Chicken pox Until all vesicles have crusted over Follow procedures for vulnerable children and pregnant staff.
 
Cold sores None Avoid contact with the sores.
 
Coronavirus 14 days self- isolation and notification to Public Health Report outbreak to Public Health and DfE emergency schools number. Students parent/ guardian to seek immediate advice from NHS 111
 
Conjunctivitis None If an outbreak occurs, consult the HPT.
 
Diarrhoea and/or vomiting Whilst symptomatic and 48 hours from the last episode GPs should be contacted if diarrhoea or vomiting occur after taking part in water-based activities. 
Diphtheria* Exclusion is essential. Family contacts must be excluded until cleared by the HPT and the HPT must always by consulted.
 
Flu (influenza) Until recovered Report outbreaks to the HPT.
 
Glandular fever None
 
Hand foot and mouth None Contact the HPT if a large number of children are affected. Exclusion may be considered in some circumstances.
 
Head lice None Treatment recommended only when live lice seen.
 
Hepatitis A* Seven days after onset of jaundice or other symptoms If it is an outbreak, the HPT will advise on control measures.
 
Hepatitis B*, C* and HIV None Not infectious through casual contact. Procedures for bodily fluid spills must be followed.
 
Impetigo 48 hours after commencing antibiotic treatment, or when lesions are crusted and healed Antibiotic treatment is recommended to speed healing and reduce the infectious period.
 
Measles* Four days from onset of rash Preventable by vaccination (MMR). Follow procedures for vulnerable children and pregnant staff.
 
Meningococcal meningitis*/ septicaemia* Until recovered Meningitis ACWY and Bare preventable by vaccination. 
 
The HPT will advise on any action needed.
 
Meningitis* due to other bacteria Until recovered Hib and pneumococcal meningitis are preventable by vaccination. The HPT will advise on any action needed.
 
Meningitis viral* None As this is a milder form of meningitis, there is no reason to exclude those who have been in close contact with infected persons.
 
MRSA None Good hygiene, in particular environmental cleaning and handwashing, is important to minimise the spread. The local HPT should be consulted.
 
Mumps* Five days after onset of swelling Preventable by vaccination with two doses of MMR.
Ringworm Exclusion is not usually required Treatment is required.
 
Rubella (German measles) Four days from onset of rash Preventable by two doses of immunisation (MMR). Follow procedures for pregnant staff.
 
Scarlet fever 24 hours after commencing antibiotic treatment Antibiotic treatment is recommended, as a person is infectious for two to three weeks if antibiotics are not administered. If two or more cases occur, the HPT should be contacted.
 
Scabies Can return to school after first treatment The infected person’s household and those who have been in close contact will also require treatment.
 
Slapped cheek/Fifth disease/Parvo Virus B19 None (once rash has developed) Follow procedures for vulnerable children and pregnant staff.
 
Threadworms None Treatment recommended for the infected person and household contacts.
Tonsillitis None There are many causes, but most causes are virus-based and do not require antibiotics.
 
Tuberculosis (TB) Pupils with infectious TB can return to school after two weeks of treatment if well enough to do so, and as long as they have responded to anti-TB therapy. Only pulmonary (lung) TB is infectious. It requires prolonged close contact to spread. Cases with non-pulmonary TB, and cases with pulmonary TB who have effectively completed two weeks of treatment as confirmed by TB nurses, should not be excluded. Consult the local HPT before disseminating information to staff and parents.
 
Warts and verrucae None Verrucae should be covered in swimming pools, gymnasiums and changing rooms.
 
Whooping cough (pertussis)* Two days from commencing antibiotic treatment, or 21 days from the onset of illness if no antibiotic treatment is given Preventable by vaccination. Non-infectious coughing can continue for many weeks after treatment. The HPT will organise any necessary contact tracing. 
 
Diarrhoea and Vomiting Outbreak Action Checklist
Date:
Completed by:
 
Action taken?
Action Yes No Comments
A 48-hour exclusion rule has been enforced.
Liquid soap and paper hand towels are available.
Enhanced cleaning is undertaken twice daily and an appropriate disinfectant is used.
Appropriate personal protective equipment (PPE)is available.
Appropriate waste disposal systems are available for removing infectious waste.
Toys are cleaned and disinfected on a daily basis.
Infected linen is segregated, and dissolvable laundry bags are used where possible.
Visitors are restricted, and essential visitors are informed of the outbreak.
New children joining the school are delayed from joining.
The health protection team (HPT) has been informed of any infected food handlers.
Staff work in dedicated areas and food handling is restricted.
All staff (including agency) are asked if they are unwell.
Staff are restricted from working elsewhere.
The HPT is informed of any planned events at the school.
The school nurse is informed.
Ofsted are informed if necessary.
 
List of Notifiable Diseases
Under the Health Protection (Notification) Regulations 2010, the following diseases will always be reported to the health protection team(HPT):
• Acute encephalitis
• Acute meningitis
• Acute poliomyelitis
• Acute infectious hepatitis
• Anthrax
• Botulism
• Brucellosis
• Cholera
• Diphtheria
• Enteric fever (typhoid or paratyphoid fever)
• Food poisoning
• Haemolytic uraemic syndrome (HUS)
• Infectious bloody diarrhoea
• Invasive group A streptococcal disease and scarlet fever
• Legionnaires’ disease
• Leprosy
• Malaria
• Measles
• Meningococcal septicaemia
• Mumps
• Plague
• Rabies
• Rubella
• SARS
• Smallpox
• Tetanus
• Tuberculosis
• Typhus
• Viral haemorrhagic fever (VHF)
• Whooping cough
• Yellow fever