Protecting Families and Communities
Keeping children who are sick at home is one of the most effective ways to prevent the spread of contagious illnesses to family members, other children in educational and care settings, and vulnerable members of the community. When educators and parents work together to follow recommended exclusion periods, they help break the chain of infection and maintain healthier environments for everyone.
Call an ambulance (000) immediately if your child shows serious symptoms such as trouble breathing, extreme drowsiness that’s difficult to wake from, or signs of poor circulation (pale appearance with cold or blue-tinged hands and feet).
When to Keep Your Child Home
Staff and children displaying symptoms of infectious diseases may be required to stay home from school or childcare. In most cases, decisions about whether a child should be excluded depend on the specific symptoms and condition they may have. For questions about exclusion periods, contact your local public health unit on 1300 066 055 or reach Healthdirect on 1800 022 222 for free, around-the-clock health advice.
Understanding How Infections Spread
Infectious diseases spread through several pathways including droplet transmission when someone coughs or sneezes, airborne transmission through particles suspended in air, direct contact through skin-to-skin touch, or indirect contact via contaminated surfaces. In educational and childcare settings where children interact closely and frequently put objects in their mouths, diseases can spread rapidly. The most effective way to interrupt disease transmission is through keeping sick children home during their infectious period, practising good hand hygiene, maintaining respiratory etiquette, and ensuring vaccination is up to date.
Chickenpox (Varicella)
What to look for: Chickenpox typically presents as a mild childhood illness characterized by a rash of red, itchy spots that develop into fluid-filled blisters. These eventually crust over and form scabs that naturally drop off. While most children recover without complications, the infection can occasionally lead to pneumonia or brain inflammation.
Vaccine available: Yes – Children are vaccinated at 18 months of age.
Exclusion requirement: Children must stay home until all blisters have completely dried, which typically takes at least 5 days from when the rash first appeared.
COVID-19
What to look for: Symptoms can overlap with other respiratory viruses like influenza and RSV. COVID-19 may cause sore throat, fever, blocked or runny nose, coughing, sneezing, muscle or body aches, tiredness, difficulty breathing, loss of taste or smell, headache, diarrhoea, nausea, vomiting, or appetite loss.
Vaccine available: Yes – It’s important for family members, school staff, and childcare workers to keep their recommended COVID-19 vaccinations current.
Exclusion requirement: Children should stay home until they feel well again and symptoms have improved.
Conjunctivitis (Pink Eye)
What to look for: Conjunctivitis is a common eye condition causing swelling and redness of the white part of the eye. It can result from viral or bacterial infection (contagious) or from allergic reactions (non-contagious).
Vaccine available: No
Exclusion requirement: Children must stay home until the eye discharge has stopped completely.
Gastroenteritis (Gastro)
What to look for: Gastroenteritis is a bowel infection causing diarrhoea and sometimes vomiting. Diarrhoea involves runny, watery bowel motions. This condition can lead to dehydration, which poses particular risks for very young babies and small children.
Vaccine available: No
Exclusion requirement: Children should remain home until there have been no loose bowel motions for at least 48 hours.
Glandular Fever (Infectious Mononucleosis)
What to look for: Glandular fever is a common viral infection that can trigger fever, sore throat with fluid deposits around the tonsils and throat, and enlarged lymph nodes (glands). Symptoms typically develop 4 to 6 weeks after infection. In younger children, glandular fever usually causes mild or barely noticeable symptoms.
Vaccine available: No
Exclusion requirement: No exclusion is required unless the child is unwell. Most children can return to normal activities once they feel better.
Hand, Foot and Mouth Disease
What to look for: Hand, foot and mouth disease is a common viral infection (unrelated to foot-and-mouth disease in cattle) that causes tiny blisters on various body parts including the mouth, fingers, palms, buttocks, nappy area, soles of feet, and upper arms or legs. Blisters typically last slightly longer than a week.
Vaccine available: No
Exclusion requirement: Children must stay home until all blisters have completely dried up.
Head Lice
What to look for: Head lice are insects living in hair that feed on blood from the scalp. While they cause itching, they do not transmit disease or cause illness.
Prevention tip: Check your child’s head once weekly for lice or eggs. If found, begin treatment immediately. Verify treatment effectiveness every 2 days until no lice are detected for ten consecutive days.
Vaccine available: No
Exclusion requirement: No exclusion is necessary if effective treatment begins before the child’s next school attendance. Children do not need to be sent home immediately upon lice detection.
Hepatitis A
What to look for: Hepatitis A is a viral infection that causes abdominal pain, appetite loss, nausea, fever, and fatigue. In some cases, it progresses to jaundice (yellowing of skin and eyes), dark urine, and pale faeces.
Vaccine available: Yes – A safe and effective vaccine exists. A 2-dose course, spaced 6 months apart, is recommended for lasting protection.
Exclusion requirement: Children must stay home until a doctor provides a medical certificate confirming recovery, and until at least 7 days after jaundice appears. If jaundice doesn’t develop, exclusion should continue for 2 weeks from when other symptoms began.
Impetigo (School Sores)
What to look for: Impetigo is a bacterial skin infection producing sores that initially appear red, moist, and weepy. Later, flat, crusty yellow or honey-coloured scabs may develop. Sores usually appear around the nose and mouth, arms, and legs, though they can occur anywhere. Children with numerous sores may also experience fever or swollen lymph nodes.
Vaccine available: No
Exclusion requirement: Children should stay home until antibiotic treatment has started. Any exposed skin sores must be covered with a watertight dressing.
Influenza (Flu)
What to look for: Influenza is a viral infection that causes fever, cough, chills, sore throat, runny or stuffy nose, headache, muscle aches, joint pain, and fatigue. Some children experience nausea, vomiting, or diarrhoea. Influenza is more serious than the common cold and can lead to pneumonia, heart or brain inflammation, and sepsis in severe cases.
Vaccine available: Yes – Annual flu shots provide the best protection. Free vaccinations are available for young children aged 6 months to under 5 years.
Exclusion requirement: Children must stay home until they feel well again.
Measles
What to look for: Measles is a highly contagious and serious viral disease. Initial symptoms include fever, cough, and sore, red eyes (conjunctivitis). A rash of large, flat, reddish blotches follows, often joining together and covering the entire skin. The rash spreads across the body and typically disappears within 6 days.
Vaccine available: Yes – Children receive routine measles vaccination at 12 and 18 months of age. Infants travelling to areas where measles is circulating can be vaccinated from 6 months.
Exclusion requirement: Children must stay home for at least 4 days after the rash appears. Non-vaccinated children who have been exposed to measles should be excluded for at least 2 weeks from the date of exposure.
Meningococcal Disease
What to look for: Meningococcal disease is a bacterial infection that can cause severe illness. Symptoms may include sudden fever, headache, neck stiffness, joint pain, a rash of red-purple spots or bruises, sensitivity to bright light, nausea, and vomiting. Infants and young children may show less specific signs like irritability, difficulty waking, a high-pitched or moaning cry, refusal to eat, or pale or blotchy skin.
Suspected meningococcal disease requires urgent medical attention immediately.
Vaccine available: Yes – Multiple vaccines are available to reduce disease risk, but no single vaccine protects against all meningococcal serogroups. Vaccination does not eliminate the need to watch for symptoms.
Molluscum Contagiosum
What to look for: Molluscum contagiosum is a common viral skin infection producing pearly, skin-coloured lumps. In children, lumps typically appear on the face, trunk, and upper arms and legs. They are usually small with a white centre and indented surface.
Vaccine available: No
Exclusion requirement: No exclusion is necessary. Children can attend school or childcare.
Mumps
What to look for: Mumps is a viral infection that causes swelling of glands around the jaw (salivary glands), high fever, and headache. Boys may experience tender testicles, while girls may have lower abdominal pain.
Vaccine available: Yes – Children receive routine mumps vaccination at 12 and 18 months of age.
Exclusion requirement: Children must stay home for 9 days or until swelling subsides, whichever comes first.
Respiratory Syncytial Virus (RSV)
What to look for: Respiratory syncytial virus (RSV) symptoms resemble other respiratory viruses, including runny nose, sneezing, sore throat, fever, headache, cough, wheezing, and difficulty breathing.
Vaccine available: Yes – Two RSV immunisation products are currently available through the 2025 RSV Prevention Program to protect newborn babies: Abrysvo (a maternal RSV vaccine) and Beyfortus (nirsevimab, an RSV immunisation product).
Exclusion requirement: Children should stay home until they feel well again.
Ringworm
What to look for: Ringworm is a fungal infection that appears as flat, spreading, ring-shaped scaly patches on most skin areas. The outer edge is typically reddish. The affected area may contain fluid or pus, or it may be dry and scaly or moist and crusted.
Vaccine available: No
Exclusion requirement: Children must stay home until the day after anti-fungal treatment has started.
Rubella (German Measles)
What to look for: Rubella is a viral illness that causes mild fever, runny nose, swollen glands (lymph nodes), and a pink, blotchy rash that lasts briefly. Some people have no symptoms at all.
Vaccine available: Yes – Children receive routine rubella vaccination at 12 months and 18 months of age.
Exclusion requirement: Children must stay home until 7 days after the rash appears or until fully recovered, whichever is longer.
Scabies
What to look for: Scabies is caused by mites that burrow under the skin, triggering intense itching and sometimes a rash resulting from allergic reaction to the mites. The condition tends to be worse around wrists, armpits, buttocks, the groin, and between fingers and toes.
Vaccine available: No
Exclusion requirement: Children should stay home until the day after appropriate treatment has started.
Scarlet Fever
What to look for: Symptoms of scarlet fever typically develop 1 to 3 days after infection and include a very red sore throat, swollen glands, fever, and a red rash that feels like sandpaper.
Vaccine available: No
Exclusion requirement: Children must stay home until the day after starting appropriate antibiotics and once the child feels better.
Slapped Cheek Disease (Fifth Disease)
What to look for: Slapped cheek disease (also known as Fifth Disease) gets its name from its most distinctive symptom – a red rash making children’s cheeks look as though they’ve been slapped. Other symptoms include mild fever, an itchy lace-like rash, and possibly cough, sore throat, or runny nose.
Vaccine available: No
Exclusion requirement: No exclusion is required. Children can continue attending school or childcare.
Whooping Cough (Pertussis)
What to look for: Whooping cough (pertussis) typically begins like a cold with runny nose, tiredness, and sometimes mild fever. A cough then develops in short bursts followed by a deep gasping sound (the “whoop”). Not all children make the whooping sound—this is more common in unvaccinated children. The cough can persist for up to 3 months.
Important note: Whooping cough is particularly severe in children under 12 months of age, often requiring hospitalization.
Vaccine available: Yes – Children receive immunisations at 6 weeks, 4 months, 6 months, 18 months, and 4 years of age. Specific antibiotics treat whooping cough and may be recommended for close contacts to prevent infection.
Exclusion requirement: Children must stay home for 21 days from symptom onset or until they have taken appropriate antibiotics for at least 5 days, whichever comes first.
Breaking the Chain of Infection
Simple but consistent practices can significantly reduce disease transmission in educational and care environments. The most effective measures include maintaining current vaccinations, practising thorough hand hygiene (especially before eating and after toileting), covering coughs and sneezes, keeping surfaces clean, and most importantly, keeping sick children home during their infectious period. When parents and educators work together to follow exclusion recommendations, they protect not only the child who is ill, but also other children, staff members, pregnant workers, and vulnerable community members who may be at higher risk from these infections.
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References
NSW Health
https://www.health.nsw.gov.au/Infectious/factsheets/Pages/school-exclusion-periods.aspx
Healthdirect
https://www.healthdirect.gov.au/
NHMRC – Staying Healthy: Preventing Infectious Diseases in Early Childhood Education and Care Services (6th Edition)
https://www.nhmrc.gov.au/about-us/publications/staying-healthy-guidelines
NHMRC – Understanding Infection
https://www.nhmrc.gov.au/about-us/publications/staying-healthy-guidelines/understanding-infection
WHO – Infection Prevention and Control
https://www.who.int/health-topics/infection-prevention-and-control
