When should children be absent from school?

The basic principle advocated by Public Health England (PHE) in guidance on this area, is that children who are unwell with an infectious disease should not be at school or nursery. When the risk of infection to others has passed and the children have recovered, they should return to school whether or not vestiges of the disease are visible. It is important that parents and school staff understand this principle in order that children do not return before they should do. It is also important that school staff know where they can find information and obtain advice about such matters as exclusion periods.

Many local authorities have published guidelines for their schools, often in co-operation with the health authorities, on dealing with cases of infectious disease. Such guidelines may include information on steps to be taken when children appear to be suffering from infectious disease, exclusion periods for particular conditions and requirements for notifying the local authority about cases of ‘notifiable diseases’ or outbreaks of other diseases. Where such local authority guidelines exist, they should in all cases be followed.

The situation is, of course, very different in hospital schools. 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 in any case where they are expected to visit pupils who are at home due to medical reasons.

How to control the outbreak of infectious diseases in schools

The spread of some infectious diseases in schools, particularly diarrhoea and vomiting illnesses, including dysentery and hepatitis A, can be controlled through good hygiene procedures. Many employers give detailed guidance on hygiene control procedures and these should always be followed in every case.

These procedures include effective hand washing with warm, running water and soap, after using the toilet and before eating. Paper towels or hand-dryers are best for drying hands. Spillages of body fluids, eg blood, faeces, saliva or vomit, should be cleaned up immediately. Disposable gloves should always be worn. Surfaces on which body fluids have been spilled should be disinfected with household bleach, diluted one part bleach to ten parts water. Some employers have banned the use of bleach. In such cases the recommended alternative should be used. Whatever cleaning fluid is used must be stored securely, away from the reach of children. Secure disposal procedures must also be followed.

Particular care needs to be taken to avoid transmission of infectious diseases to children from animals which are kept in schools or which are 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 in every case.

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, it is also sensible for each school to have a named person who will co-ordinate the school’s response to this type of issue.

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, the hygiene measures described above 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 teachers?

During pregnancy, certain infectious diseases can pose dangers to unborn babies. 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. Other diseases of possible concern include chickenpox and slapped cheek disease (parvovirus).