Exclusion Periods for Common Infections

Illness and Infections	Length of time an Individual is to be kept away from setting (Exclusion Period)	Do Childhood Settings Including Nurseries/ Schools Need to Notify Public Health Wales? (AWARe)	Advice and Next Actions	Comments
Skin and Rashes
Unexplained rashes should be considered infectious until health advice is obtained from a clinician - NHS 111 Wales - Health A-Z : Skin rashes in babies and children
Athlete’s Foot	None	No	Do not allow people who have the infection to share socks, shoes, towels, or bathmats with others. Ensure the individual wears a rubber sock whilst swimming. Parents/guardians should seek advice from their local pharmacists. NHS 111 Wales - Health A-Z : Athlete's foot	Athletes’ Foot is not a serious condition, but treatment is recommended.
Chickenpox	YES, 5 days from onset of rash AND until all vesicles (blisters) have crusted over, (dried up).	Yes, BUT ONLY if Chickenpox and/or influenza are circulating at same time and same setting, (e.g., Classroom, Nursery) as Scarlet Fever.	Good hand hygiene. Increased touch point cleaning. Enhanced environmental cleaning. This includes toys, non-washable items, for example soft toys should be wiped or washed with a detergent using warm water and dried thoroughly. Discourage play with items/toys that are unable to be cleaned effectively. Play with sand or water should be temporary stopped. Encourage good “Cough etiquette” – Catch it, Bin it Kill it message. Send any individual with chickenpox home. Keep the individual away from the setting until all blisters have crusted over. NHS 111 Wales - Health A-Z : Chickenpox	Infectious for 24 hours before onset of rash. SEE: Vulnerable Individuals and Pregnancy (below). PHW will initially advise on management of the incident ONLY IF Chickenpox and/or Influenza are circulating at same time and same setting, (e.g., within the same classroom, and withing the same Nursery) as scarlet Fever.
Cold Sores (Caused by Herpes Simplex)	None	No	Spread by direct contact, especially contact with the fluid of a cold sore or the saliva of someone with the virus Contact local pharmacist if not improving. Avoid kissing and contact with the sores. Avoid the use of cups/utensils which may be shared in setting. Avoid sharing towels, flannels, toothbrushes, and razors NHS 111 Wales - Health A-Z : Cold sore	Cold Sores are generally mild and self-limiting.
German Measles (Rubella)*	YES, exclusion for five days from onset of rash. (1^st day of rash is classed as day 0)	Yes, if child attended the setting 7 days before and within the 7 days after the rash appeared. Notification normally received from GP or Clinician to AWARe, (Public Health Team).	Good hand hygiene. Increased touch point cleaning. Enhanced environmental cleaning. This includes toys, non-washable items, for example soft toys must be wiped or washed with a detergent using warm water and dried thoroughly. Discourage play with items/toys that are unable to be cleaned effectively. Play with sand or water should be temporary stopped. Encourage good “Cough etiquette” – Catch it, Bin it Kill it message. NHS 111 Wales - Health A-Z : Rubella (German measles)	Preventable by vaccination and covered by the routine immunisation schedule (MMR x 2 doses). SEE: Vulnerable individuals and Pregnancy (below) Pregnant staff should seek prompt advice from their GP or Midwife. Encourage all staff to find out their MMR status- if unsure, advise them to contact their GP to discuss.
Hand, Foot and Mouth (Coxsackie Viral Infection)	None	No	Spread is caused by direct contact with the secretions of the infected person (including faeces) or by aerosol spread such as coughing and sneezing. The virus can remain in the faeces for a few weeks after the initial infection. Encourage individuals to implement good hand hygiene practices, particularly in those staff who carry out nappy changing or assist with toileting in individuals with symptoms. NHS 111 Wales - Health A-Z : Hand, foot and mouth disease	Not to be confused with Foot and Mouth disease in animals. Not a known risk in pregnancy but any pregnant staff should discuss with their Midwife or GP. SEE: Vulnerable Individuals and Pregnancy (below).
Impetigo (Milder infections caused by group A streptococcus include scarlet fever, impetigo and ‘strep throat’. These can be easily treated with antibiotics)	YES, exclusion until affected areas are crusted and healed, or 48 hours after commencing antibiotic treatment	No	Encourage individuals to maintain good hand hygiene. Discourage children, young people and staff touching or scratching the sores, or letting others touch them. Do not allow towels, flannels, toothbrushes and eating and drinking utensils to be shared by others. Ensure that equipment, including toys and play equipment are thoroughly cleaned daily. Non-washable items, for example soft toys should be wiped or washed with a detergent using warm water and dried thoroughly. Discourage play with items/toys that are unable to be cleaned effectively. NHS 111 Wales - Health A-Z : Impetigo	Antibiotic treatment speeds up healing and reduces the infectious period.
Measles*	YES, four days from onset of rash. (1^st day of rash is classed as day 0).	YES, if child attended the setting 4 days before and the 4 days after the rash appeared. Notification normally received from GP or Clinician to AWARe, (Public Health Wales).	Good hand hygiene. Increased touch point cleaning. Enhanced environmental cleaning. This includes toys, non-washable items, for example soft toys should be wiped or washed with a detergent using warm water and dried thoroughly. Discourage play with items/toys that are unable to be cleaned effectively. Play with sand or water should be temporary stopped. Encourage good “Cough etiquette” – Catch it, Bin it Kill it message. If able discuss with parents’/guardians’ vaccination if individual is unvaccinated. NHS 111 Wales - Health A-Z : Measles	Preventable by vaccination and covered by the routine immunisation schedule (MMR x 2 doses is the recommended. Schedule in the UK). SEE: Vulnerable Individuals and Pregnancy (below). Pregnant individuals should contact their Midwife or GP as soon as possible to assess their immunity. Encourage all staff to find out their MMR status if unsure, advise them to contact their GP to discuss.
Molluscum Contagiosum	None	No	Should seek advice of Pharmacist or GP. Normal hand hygiene and personal hygiene should be maintained. NHS 111 Wales - Health A-Z : Molluscum contagiosum	A self-limiting condition that may continue for up to 18 months.
Ringworm	YES, until treatment has been commenced.	No	Good hand hygiene. Continue with high level of individual hygiene. If on individuals’ feet, ensure feet are covered. Ensure environmental cleaning is carried out daily. Refer to GP NHS 111 Wales - Health A-Z : Ringworm	Keep area affected covered. Treatment is recommended
Scabies	YES, affected individual can return 24 after first treatment.	Only notify HPT if more than two cases in the setting, (same classroom and similar time frame).	Affected cases should seek advice and treatment from either GP or local pharmacist. Household contacts of the case do not need to be excluded but will need to be treated at the same time as the affected individual. Do not share towels or flannels during the treatment phase. Ensure good hand hygiene maintained. Consider a deep clean of soft furnishings/soft toys and dressing up equipment if multiple cases in same setting. (Deep clean should be timed after 1^st treatment- also include laundry. Bed linen / blankets / towels etc – wash 60 degrees). NHS 111 Wales - Health A-Z : Scabies	Household and close contacts require concurrent treatment
Scarlet Fever*	YES, individuals can return after full 24 hours of appropriate antibiotics, if not treated with antibiotics the individual should not return until symptoms have resolved.	YES, only if there are 2 or more confirmed cases in a classroom setting, within 10 days of each other. Please consult with the Health Protection Team if Flu and/or Chickenpox is circulating at same time as Scarlet Fever in the setting, or if an individual has attended or been hospitalised.	Each single case of Scarlet Fever should be notified to PHW via the GP or Clinician assessing the individual. Encourage good hand hygiene. Increased touch point cleaning. Enhanced environmental cleaning. This includes toys, non-washable items, for example soft toys should be wiped or washed with a detergent using warm water and dried thoroughly. Discourage play with items/toys that are unable to be cleaned effectively. Play with sand or water maybe temporary stopped. Encourage good “Cough etiquette” – Catch it, Bin it Kill it message. Discourage play with items/toys that are unable to be cleaned effectively. NHS 111 Wales - Health A-Z : Scarlet fever	Antibiotic treatment recommended for the affected individual. Please consult with Health Protection Team if Flu and/or Chickenpox circulating at same time and the same setting as Scarlet Fever or if you are aware a child has attended or been hospitalised due to Scarlet Fever.
Streptococcal A (also known as Strep Throat) See also Tonsillitis. (Milder infections caused by group A streptococcus include scarlet fever, impetigo and ‘strep throat’. These can be easily treated with antibiotics)	YES, individual can return after full 24 hours of appropriate antibiotics.	No, not unless there are several cases, any hospitalised individuals or cocirculating Chickenpox and or Influenza, (Flu)	Good hand hygiene. Increased touch point cleaning. Enhanced environmental cleaning. This includes toys, non-washable items, for example soft toys should be wiped or washed with a detergent using warm water and dried thoroughly. Discourage play with items/toys that are unable to be cleaned effectively. Play with sand or water Should be temporary stopped. Encourage good “Cough etiquette” – Catch it, Bin it Kill it message. NHS 111 Wales - Health A-Z : Streptococcus A (Strep A)	Some Pharmacists will offer point of care throat swabbing to test for Streptococcus Group A.
Slapped Cheek/Fifth Disease/Parvovirus B19	None	No	Any pregnant, (especially under 20 weeks gestation), or any immunocompromised individuals need to seek clinical advice either from their GP, Midwife, or their Consultant Specialist. NHS 111 Wales - Health A-Z : Slapped cheek syndrome	SEE: Vulnerable Individuals and Pregnancy (below) Once rash has appeared the individual is no longer infectious, (cannot pass the virus on to other). Pregnant individuals should contact their Midwife or GP as soon as possible.
Shingles, (this infection is caused by the same virus as Chickenpox, this virus can remain in the body and sometimes is reactivated, and this is known as Shingles).	Individual only to be kept away from setting if rash is weeping and cannot be covered.	No but need to notify PHW if cocirculating Scarlet Fever, Flu or Chickenpox	If the child is attending School/Nurseries ensure all dressings are clean, dry and intact. If not contact parents/guardians to discuss collecting the child. In cases of shingles, the decision to exclude an individual will depend on whether the rash or blisters can be covered. Keep the individual away from the setting if they have a weeping shingles rash that cannot be covered. NHS 111 Wales - Health A-Z : Shingles	Can cause chickenpox in those who are not immune i.e., have not had chickenpox. It is spread by contact with the vascular fluid from blisters). Pregnant individuals should contact their Midwife or GP as soon as possible. SEE: Vulnerable Individuals and Pregnancy (below)
Warts and Verrucae	None	No	Verrucae should be covered in swimming pools, gymnasiums and changing rooms. NHS 111 Wales - Health A-Z : Warts and verruca’s	Treatment can be sourced at the local Pharmacist or GP Practice.

Illness and Infections	Length of time an Individual is to be kept away from setting (Exclusion Period)	Links
Chickenpox	YES, 5 days from onset of rash AND until all vesicles (blisters) have crusted over, (dried up).	NHS 111 Wales - Health A-Z : Chickenpox
Cold Sores (Herpes Simplex)	None	NHS 111 Wales - Health A-Z : Cold sore
German Measles (Rubella)*	YES, exclusion for five days from onset of rash. (1^st day of rash is classed as day 0)	NHS 111 Wales - Health A-Z : Rubella (German measles)
Hand, Foot and Mouth (Coxsackie Viral Infection)	None	NHS 111 Wales - Health A-Z : Hand, foot and mouth disease
Impetigo	YES, exclusion until affected areas are crusted and healed, or 48 hours after commencing antibiotic treatment.	NHS 111 Wales - Health A-Z : Impetigo
Measles*	YES, four days from onset of rash. (1^st day of rash is classed as day 0).	NHS 111 Wales - Health A-Z : Measles
Ringworm	YES, until treatment has been commenced.	NHS 111 Wales - Health A-Z : Ringworm
Scabies	YES, affected individual can return 24 after first treatment.	NHS 111 Wales - Health A-Z : Scabies
Scarlet Fever*	YES, individuals can return after full 24 hours of appropriate antibiotics, if not treated with antibiotics the individual should not return until symptoms have resolved.	NHS 111 Wales - Health A-Z : Scarlet fever
Streptococcal A (also known as Strep Throat) See also Tonsillitis	YES, individual can return after full 24 hours of appropriate antibiotics.	NHS 111 Wales - Health A-Z : Streptococcus A (Strep A)
Slapped Cheek/Fifth Disease/Parvovirus B19	None	NHS 111 Wales - Health A-Z : Slapped cheek syndrome
Shingles, (this infection is caused by the same virus as Chickenpox, this virus can remain in the body and sometimes is reactivated, and this is known as Shingles).	Individual only to be kept away from setting if rash is weeping and cannot be covered.	NHS 111 Wales - Health A-Z : Shingles
Warts and Verrucae	None	NHS 111 Wales - Health A-Z : Warts and verruca’s
Diarrhoea and/or vomiting	YES, 48 hours from last episode of diarrhoea or vomiting.	NHS 111 Wales - Health A-Z : Diarrhoea and vomiting
*E. coli* O157 STEC* Typhoid [and Paratyphoid] (Enteric Fever) * *Shigella (Dysentery)**	YES, keep away from the setting for 48 hours from the last episode of diarrhoea as a minimum. Some individuals may need to be kept away from the setting until they are no longer excreting the bacteria in their faeces. Microbiological clearance may be required. Always consult with your local Environmental Health Officer/Health Protection Team.	NHS 111 Wales - Health A-Z : Dysentery NHS 111 Wales - Health A-Z : Typhoid fever NHS 111 Wales - Health A-Z : Food poisoning
Acute Respiratory Illness e.g., COVID-19 (Coronavirus-19) * (Please also see influenza)	Please follow current Welsh Government Guidance on Self-Isolation: Guidance for people with symptoms of a respiratory infection, including COVID-19 \| GOV.WALES or What are the latest rules around COVID-19 in schools, colleges, nurseries and other education settings? - The Education Hub (blog.gov.uk) if you become symptomatic (high temperature > 37.8⁰C; new continuous cough; or loss of/change in sense of smell or taste), if you are asymptomatic.	111.wales.nhs.uk/selfassessments/symptomcheckers/covid19.aspx NHS 111 Wales - Health A-Z : Cold, common NHS 111 Wales - Health A-Z : Chest infection, Adult
Flu (Influenza)	YES, 5 days after onset of symptoms. Can return when no longer symptomatic. Cases who are unwell and have a high temperature should stay at home and avoid contact with others, where they can. They can return to childcare, education environments when they no longer have a high temperature for 48 hours, and they are well enough to attend.	NHS 111 Wales - Health A-Z : Flu NHS 111 Wales - Health A-Z : Flu vaccine, seasonal
Tuberculosis*	Always consult the Health Protection Team. Exclusion is only recommended for infective, (active), Tuberculosis.	https://www.nhs.uk/conditions/tuberculosis-tb/ https://www.gov.uk/government/publications/tuberculosis-tb-and-children NHS 111 Wales - Health A-Z : Tuberculosis (TB)
Whooping Cough (pertussis)*	YES, 48 hours from commencing antibiotic treatment, or 21 days from onset of illness if no antibiotic treatment.	NHS 111 Wales - Health A-Z : Whooping cough
Conjunctivitis	No	NHS 111 Wales - Health A-Z : Conjunctivitis
Eye and Ear Infections	None	NHS 111 Wales - Health A-Z : Eye injuries NHS 111 Wales - Health A-Z : Ear infection
Glandular Fever	None	NHS 111 Wales - Health A-Z : Glandular fever
Head Lice	None	NHS 111 Wales - Health A-Z : Head lice and nits
Meningococcal Meningitis/Septicaemia*	YES, until they have received the appropriate antibiotic treatment. Always consult the Health Protection Team.	NHS 111 Wales - Health A-Z : Meningitis
Haemophilus Influenzae Type B (Hib) Meningitis/Septicaemia*	YES, until they have received the appropriate antibiotic treatment. Always consult the Health Protection Team.	NHS 111 Wales - Health A-Z : Hib (Haemophilus influenzae type b)
Meningitis viral*	No	NHS 111 Wales - Health A-Z : Meningitis
Methicillin Resistant Staphylococcus Aureus (MRSA)	None	NHS 111 Wales - Health A-Z : MRSA
Mumps*	YES, five days after onset of jaw/neck swelling.	NHS 111 Wales - Health A-Z : Mumps
Threadworms	None	NHS 111 Wales - Health A-Z : Threadworms
Tonsillitis	None usually. If tonsillitis caused by Group A Streptococcus (sometimes referred to as ‘Strep throat’), individual can return 24 hours after commencing appropriate antibiotic treatment.	NHS 111 Wales - Health A-Z : Tonsillitis

Interactive Bar

Google Services

Search

Translate

Log In

Exclusion Periods for Common Infections

Skin and Rashes

Cookies

Cookies

Website CMS

Matomo

reCaptcha

Cookie notice