Infectious diseases in schools

How to manage cases of infectious illness in schools, including when children should be absent. 

When should children be absent from school?

The basic principle advocated by the UK Health Security Agency in guidance on this area, is that people who are showing the symptoms of an infectious disease or have been diagnosed by a health professional or diagnostic test could be advised to stay away from their setting for the minimum period recommended, if required, and until well enough.

To find out if, and how long, people should be advised to stay away, check the table for public health exclusions.

Many local authorities have published guidelines for their schools on dealing with cases of infectious disease and these should be followed.

Staff who work in hospital schools should be given full guidance on working with pupils who have infectious diseases or other medical conditions. Teachers who are employed as home tutors should also be given appropriate guidance where they are expected to visit pupils who are at home due to medical reasons.

Mpox

The NHS describes mpox (previously known as monkeypox) as a rare infection most commonly found in west or central Africa. There has recently been an increase in cases, but the risk of catching it is low. However, given current concerns around the spread of the mpox virus, the DfE advises education staff to continue following NHS guidance on mpox and UKHSA guidance for education settings on managing mpox cases.

Measles

MMR vaccination is the best protection against measles, mumps and rubella. Those infected must be excluded from settings for at least 4 days after the appearance of a rash (where the date of the rash onset is day 0). It is also important to follow standard infection control protocols such as frequently washing hands with soap and warm running water, and using tissues when coughing or sneezing before disposing of them in the bin.

Given the risk measles poses to pregnant education staff – increasing the risk of miscarriage, stillbirth, or preterm delivery – employers should be mindful of the particular risks to pregnant women and immuno-suppressed staff, and ensure they are supported to follow any medical advice.

Why not print out and post a copy of the NEU measles poster somewhere prominent in your school, like the staff room?

How to control the outbreak of infectious diseases in schools

The spread of some infectious diseases in schools – diarrhoea and vomiting illnesses, dysentery and hepatitis A – can be controlled through good hygiene procedures. Many employers give detailed guidance on hygiene control procedures which should be followed alongside the NEU advice.

Particular care needs to be taken to avoid transmission of infectious diseases to children from animals which are kept in schools or encountered during farm visits. The Department for Education (DfE) and most local authorities produce detailed guidance on hygiene procedures in these areas which should always be followed.

When should the school notify the consultant in communicable disease control?

Whenever there are any cases of notifiable diseases in the school among either pupils or staff, the consultant in communicable disease control (CCDC) must be notified. The CCDC should also be contacted if there appears to be an unusual number of cases of an infectious disease in a school or nursery. The CCDC’s advice should be sought urgently if a food handler in the school is suffering from diarrhoea or vomiting.

During outbreaks of infectious diseases, in particular serious conditions such as meningitis, it is important that parents, pupils and staff are fully and regularly informed. It is sensible for schools to hold information on infectious diseases and on steps that may need to be taken if there are cases at the school. In the same way that all schools have a named individual to deal with accidents and injuries, schools are recommended to have a named person who will co-ordinate the response to infectious disease outbreaks.

How can staff protect themselves against infection from pupils?

The most important measure is to ensure that children who are infectious are excluded as advised above. In the case of diarrhoea or vomiting, hygiene control measures are also essential.

In other cases, immunisation may be necessary. Due to the resurgence of tuberculosis (TB) in certain parts of the country, staff may wish to consult their GP to discuss whether they are sufficiently protected against this disease. Staff working with children who are in high-risk groups for hepatitis B may also wish to discuss with their GP if immunisation would be appropriate.

What if staff themselves become ill with an infectious disease?

Teaching staff and education professionals who become ill with an infectious disease should remain absent until they recover and no longer pose a risk of infection to others. In rare instances medical suspension may be necessary.

What about pregnant women at work?

During pregnancy, certain infectious diseases can pose dangers to unborn babies. Pregnant staff, parents or students must be informed of any outbreaks of rubella, chickenpox, slapped cheek disease (parvovirus) or cytomegalovirus (CMV) and immediate arrangements must be made to prevent pregnant women from being exposed to infection.

Pregnant staff should contact their GP or antenatal clinic if they are concerned about possible exposure to an infectious disease at school. Women who are considering becoming pregnant should check with their GP that they have immunity to rubella and chickenpox.

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