Fact Sheets: public consultation drafts
Asthma is a condition that affects the lungs, causing the airways to become inflamed and narrow. Symptoms include wheezing, coughing, tightness in the chest and feeling out of breath. People with asthma can experience flares, which are sometimes called an asthma attack. Flares canbe serious and require hospital treatment.
Exclusion period
Not excluded.
How it spreads
Asthma does not spread between people. It is not contagious.
Actions for educators and other staff
Ensure that you have a copy of an up-to-date action plan for each child in your care who has asthma. Reduce the risk of asthma being triggered by respiratory viruses by using appropriate cleaningpractices and hand hygiene.
Actions for parents and carers
If you think your child may have asthma, it is important to see a doctor for diagnosis and a treatmentplan. Give your childcare provider a copy of any asthma action plan that your child’s doctor has developed with you.
More information about asthma
See healthdirect for more information on prevention, diagnosis and treatment of asthma (healthdirect.gov.au/asthma). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Bronchiolitis is a potentially serious chest infection caused by a virus. The virus infects the small breathing tubes (bronchioles) of the lungs, which makes them inflamed. They then produce more mucus than normal, which causes breathing difficulties. Respiratory syncytial virus (RSV) is usually responsible for bronchiolitis, although other viruses may also cause bronchiolitis. Infections often occur in infants less than year old, usually in winter. The symptoms of the infection begin like a common cold, with a runny nose, cough and fever. The coughing may become worse over the next day or 2, and rapid breathing and wheezing can make feeding the child difficult. Wheezing when breathing out is characteristic of bronchiolitis in babies under 1 year old. The wheezing sound can last for a few days, but the cough can last for weeks.
Exclusion period
Exclude based on symptoms; otherwise not excluded. If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), exclude them if:
- the respiratory symptoms are new and getting worse (more frequent or severe), or
- they also have concerning symptoms (fever, rash, tiredness, pain, poor feeding).
A person can often have an ongoing cough after they have recovered from a respiratory infection. If their other symptoms have gone and they are feeling well, they can return to the service.
How it spreads
Bronchiolitis spreads by droplets in the air that contain the virus or direct contact with respiratory secretions. People get infected by:
- breathing in droplets when an infected person breathes, coughs or sneezes on them
- touching a surface contaminated with droplets – for example, hands, tissues, toys or eating utensils – and then touching their mouth.
Actions for educators and other staff
Ensure staff and children practise cough and sneeze etiquette and effective hand hygiene. Ensure staff are using appropriate cleaning practices.
Actions for parents and carers
Take your child to see a doctor if they develop rapid breathing or wheezing. Keep your child at home until their symptoms have gone and they are feeling well.
Teach them to cough or sneeze into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough or sneeze into their inner elbow instead of their hands.
Avoid contact between your child and other children, or frail and elderly people, until the child is feeling well.
More information about bronchiolitis
See healthdirect for more information on prevention, diagnosis and treatment of bronchiolitis (healthdirect.gov.au/bronchiolitis). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Bronchitis is a chest infection, usually caused by a virus. The virus makes the lining of the windpipe and bronchi (the tubes leading from the windpipe to the lungs) inflamed and swollen, so it produces more mucus than normal. This causes a cough and sometimes a pain in the throat or upper chest when coughing. Bronchitis is usually a mild illness in children. A child with bronchitis may have the usual signs of a cold, including a runny nose, sore throat and mild fever. Next, they develop a cough. The cough is often dry at first and then becomes moist after a couple of days. They may have a slight wheeze and shortness of breath. Children usually recover from an episode of bronchitis in 5 to 10 days. Some children keep having attacks of bronchitis and can develop ongoing symptoms (called chronic bronchitis). This can be due to allergies, people smoking around them or other problems in their lungs.
Exclusion period
Exclude based on symptoms; otherwise not excluded. If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), exclude them if:
- the respiratory symptoms are new and getting worse (more frequent or severe), or
- they also have concerning symptoms (fever, rash, tiredness, pain, poor feeding).
A person can often have an ongoing cough after they have recovered from a respiratory infection. If their other symptoms have gone and they are feeling well, they can return to the service.
How it spreads
Bronchitis spreads by droplets in the air that contain the virus or direct contact with respiratory secretions. People get infected by:
- breathing in droplets when an infected person kisses, breathes, coughs or sneezes on them
- touching a surface contaminated with droplets – for example, hands, tissues, toys or eating utensils – and then touching their mouth.
Actions for educators and other staff
If a staff member is ill, they should stay home until they are feeling well. Ensure staff and children practise cough and sneeze etiquette and effective hand hygiene. Ensure staff are using appropriate cleaning practices.
Actions for parents and carers
Keep your child at home until they are feeling well. Teach your child to cough or sneeze into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough or sneeze into their inner elbow instead of their hands.
Make sure your child washes their hands thoroughly and frequently. Avoid contact between your child and other children, or frail and elderly people, until the child is feeling well.
More information about bronchitis
See healthdirect for more information on prevention, diagnosis and treatment of bronchitis (healthdirect.gov.au/bronchitis). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Campylobacter infection is a type of gastroenteritis caused by Campylobacter bacteria. Symptoms usually start a few days after infection, and may include stomach cramps, diarrhoea (sometimes with blood in it), fever, nausea and vomiting. It may cause dehydration, which can be very dangerous for young children.
Exclusion period
Exclude until there has not been any diarrhoea or vomiting for 24 hours. Staff members with these symptoms should not handle food until they have not vomited or had diarrhoea for 48 hours (they can be assigned to other duties after 24 hours, or stay away from the service for 48 hours).
Check if your state or territory has different requirements for gastroenteritis.
How it spreads
You can get infected with the bacteria from an infected person, or by eating contaminated food, like undercooked chicken. You can also get it from touching infected animals or their faeces (poo).
Actions for educators and other staff
If you live in the Northern Territory, contact your local public health unit if you have 2 or more cases of Campylobacter infection in your service.
To avoid getting Campylobacter infection, wash your hands after going to the toilet or changing a nappy; and before and after handling food.
Regularly rake sandpits and remove any animal faeces. If possible, cover the sandpit when it is not in use.
Actions for parents and carers
Keep your child at home until 24 hours after diarrhoea stops. Wash hands before and after cooking.
Wash hands after using the toilet, changing nappies or cleaning up animal faeces. Teach your child to do the same.
More information about Campylobacter infection See healthdirect for more information on prevention, diagnosis and treatment of Campylobacter infection (healthdirect.gov.au/campylobacter-infection).
To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Chickenpox is a very contagious illness caused by the varicella-zoster virus. Symptoms may start with a fever, headache or feeling tired. This is followed by a characteristic spotty, itchy rash of small, fluid-filled blisters, which quickly spreads all over the body. Chickenpox is usually a mild disease in children, but complications can occur in around 1% of cases.
Exclusion period
Exclude until all blisters have dried – this is usually at least 5 days after the rash first appeared in unvaccinated children, and less in vaccinated children.
Contacts: Any child who is immunocompromised is at high risk of developing severe disease if exposed. Talk to the parents about the child’s potential risk and exposure and follow the child’s agreed action plan.
How it spreads
Chickenpox can spread quickly in childcare environments. It spreads through the air (airborne droplets) or by touching blisters on someone who is infected with chickenpox.
Risks in pregnancy
If you are pregnant and get chickenpox, it can cause serious problems for your baby. The type of problems depends on how far along your pregnancy is. The risk is highest in the first 3 months of pregnancy.
If you have not had a chickenpox vaccination and are not sure if you’ve had chickenpox before, see a doctor within 4 days of hearing you have been exposed to check if you are immune. If you are not immune, you can get an antibody injection. Vaccination for chickenpox during pregnancy is not recommended. Read more about chickenpox and pregnancy at pregnancybirthbaby.org.au/chickenpox-and-pregnancy.
Actions for educators and other staff
Follow exclusion period recommendations. Let pregnant staff know if there is a chickenpox case in the service. Encourage staff to be vaccinated.
Ensure staff and children have good respiratory and hand hygiene.
Ensure staff are using appropriate cleaning practices.
Actions for parents and carers
If your child has chickenpox, keep them at home until all blisters have dried. Wash your hands frequently, and keep your child away from family and friends until they are feeling well again. The best way to protect yourself and other children against chickenpox is to get vaccinated.
More information about chickenpox (varicella)
See healthdirect for more information on prevention, diagnosis and treatment of chickenpox (healthdirect.gov.au/chickenpox). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Cold sores are caused by the herpes simplex virus and are very common. About 20% of children will have been infected by the age of 5 years, and about 80% of people will have been infected by the time they are adults. Once a person is infected, the virus can reactivate and cause new cold sores throughout life. Cold sores usually start with a tingling or burning sensation on or around the lips, followed by the appearance of small, painful blisters. The blisters break, form a scab and then heal, usually without leaving a scar. Cold sores usually last 3 to 7 days. Cold sores can appear on the eye if the person touches an active cold sore and then touches their eye. Although this is rare, any child with a painful red eye should be seen by a doctor.
Exclusion period
Not excluded if the person can maintain hygiene practices to minimise the risk of transmission. If the person cannot maintain these practices (for example, because they are too young), exclude until the sores are dry. Cover sores with a dressing, where possible.
How it spreads
Cold sores spread by direct contact with sores, especially when there is fluid in the blister. They can also spread by sharing anything that is put in the mouth, including dummies, food and drink containers, and eating utensils. Even if a person does not have a visible cold sore, they may still be able to infect others.
Actions for educators and other staff
Ensure staff and children practise effective hand hygiene.
Ensure staff are using appropriate cleaning practices.
Staff members with cold sores may need to be given duties that do not involve direct contact with children.
Actions for parents and carers
Cover the sores with a waterproof dressing, where possible.
If your child can wash their hands frequently and does not pick or scratch the sores, they can attend childcare. If your child cannot cannot do this, they should stay home until the sores are dry.
More information about cold sores
See healthdirect for more information on prevention, diagnosis and treatment of cold sores (healthdirect.gov.au/cold-sores). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Colds are the most common cause of illness in both children and adults. Symptoms include a runny or blocked nose, sneezing and coughing, watery eyes, headache, sore throat and a possible slight fever. Children in education and care services may have as many as 8 to 12 colds a year. By the time they are 3 years old, children who attend group care have the same number of colds, or fewer, than children who are cared for only at home.
Exclusion period
Exclude based on symptoms; otherwise not excluded.
If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), exclude them if:
- the respiratory symptoms are new and getting worse (more frequent or severe), or
- they also have concerning symptoms (fever, rash, tiredness, pain, poor feeding).
A person can often have an ongoing cough after they have recovered from a respiratory infection. If their other symptoms have gone and they are feeling well, they can return to the service.
How it spreads
Colds spread through airborne droplets when a person coughs or sneezes. They can also spread indirectly if a person touches a surface that has been contaminated by the droplets (for example, hands, tissues, toys, eating utensils). Symptoms appear to 3 days after infection.
Actions for educators and other staff
Ensure staff and children practise good respiratory and hand hygiene.
Ensure staff are using appropriate cleaning practices.
Actions for parents and carers
Teach your child to cough or sneeze into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough or sneeze into their inner elbow instead of their hands.
Clean surfaces that your child has touched, sneezed on, or coughed on to reduce the risk of the infection spreading to others at home.
More information about common cold
See healthdirect for more information on prevention, diagnosis and treatment of common cold (healthdirect.gov.au/coughs-and-colds-in-children). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Conjunctivitis is an eye condition where the clear membrane that covers the white part of the eye and lines the inner surface of the eyelids (the conjunctiva) becomes red and swollen. People can also be sensitive to bright lights. The most common causes are infection, allergy and irritation. Only infectious conjunctivitis can spread to others. Infectious conjunctivitis can be caused by bacteria or viruses. Bacterial conjunctivitis may start in one eye, but almost always involves both eyes. There is likely to be a gritty feeling and thick white, yellow or green pus. Viral conjunctivitis may have a thinner, clear discharge. It may involve one or both eyes, making them red, itchy and watery.
Exclusion period
Exclude until discharge from the eyes has stopped (unless a doctor has diagnosed non-infectious conjunctivitis).
How it spreads
Infectious conjunctivitis is very contagious and can easily spread from person to person. It spreads by direct contact with eye secretions, or by contact with towels, wash cloths or tissues that have eye secretions on them.
Actions for educators and other staff
Follow exclusion period recommendations. Ensure staff and children have good hand hygiene. Ensure staff are using appropriate cleaning practices.
Actions for parents and carers
Take your child to a doctor for diagnosis and treatment – viral and bacterial conjunctivitis can look thesame but have different treatment options. Encourage your child to wash their hands regularly.
Follow exclusion period recommendations if the conjunctivitis is infectious (bacterial or viral) to protect others.
More information about conjunctivitis
See healthdirect for more information on prevention, diagnosis and treatment of conjunctivitis (healthdirect.gov.au/conjunctivitis). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
COVID-19 is a disease caused by infection with a coronavirus called SARS-CoV-2. Common symptoms include fever, cough, sore throat and shortness of breath. Other symptoms may include fatigue, loss of taste or smell, and congestion or runny nose. COVID-19 is usually milder in children than in adults.
Exclusion period
Refer to state or territory advice.
Exclude based on symptoms; otherwise not excluded.
If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), exclude them if:
- the respiratory symptoms are new and getting worse (more frequent or severe), or
- they also have concerning symptoms (fever, rash, tiredness, pain, poor feeding).
A person can often have an ongoing cough after they have recovered from a respiratory infection. If their other symptoms have gone and they are feeling well, they can return to the service.
How it spreads
The virus spreads by becoming airborne during coughing, singing or talking. People become infected when they breathe in the virus.
Risks in pregnancy
If you are pregnant, there is a higher risk of complications for yourself and your baby if you catch COVID-19. There is a very rare risk of premature birth, mainly in unvaccinated women. Staying up to date with vaccinations, washing hands regularly and wearing masks can help reduce your risk of getting COVID-19. Read more at healthdirect.gov.au/covid-19/pregnancy-and-covid-19.
Actions for educators and other staff
Encourage good respiratory and hand hygiene for all staff and children (covering your mouth and nose when you cough or sneeze, and washing hands or using hand sanitiser). Encourage COVID-19 vaccination for eligible people.
Check with your state or territory health department for local advice on managing COVID-19 infections.
Actions for parents and carers
If your child is eligible, the best way to protect them against COVID-19 is to get them vaccinated.
Most children who get COVID-19 have a mild infection that is like a common cold. If your child has COVID-19, keep them at home until they no longer have symptoms. Teach them to cough and sneeze into a tissue, then throw the tissue into a bin and wash their hands.
Check with your state or territory health department for local advice on what to do when your child has COVID-19.
More information about COVID-19
See healthdirect for more information on prevention, diagnosis and treatment of COVID-19 (healthdirect.gov.au/covid-19). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Croup is a viral infection that causes a harsh, barking cough and noisy breathing due to the voicebox (larynx) and airways becoming inflamed and swollen. It often starts out like a common cold, with symptoms such as fever and runny nose, but then progresses to a cough that sounds like a seal or a barking dog. It usually affects children aged between 6 months and 3 years old, but can occur in other age groups. It is rare in adults because their airways are larger.
Exclusion period
Exclude based on symptoms; otherwise not excluded.
If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), exclude them if:
- the respiratory symptoms are new and getting worse (more frequent or severe), or
- they also have concerning symptoms (fever, rash, tiredness, pain, poor feeding).
A person can often have an ongoing cough after they have recovered from a respiratory infection. If their other symptoms have gone and they are feeling well, they can return to the service.
How it spreads
Croup spreads from person to person via droplets containing the virus that causes it. People can be infected by:
- breathing in droplets when an infected person breathes, coughs or sneezes on them or near them
- touching a surface contaminated with droplets – for example, hands, tissues, toys or eating utensils – and then touching their eyes, nose or mouth.
Actions for educators and other staff
Follow exclusion period recommendations.
Ensure staff and children have good respiratory and hand hygiene.
Ensure staff are using appropriate cleaning practices.
Actions for parents and carers
Keep your child at home until their symptoms have gone. Try to keep them calm, as breathing is more difficult when they are upset.
Avoid contact between your child and other children, or elderly people, until they are feeling well again.
Encourage your child to wash their hands regularly. Teach your child to cough or sneeze into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough or sneeze into their inner elbow instead of their hands.
More information about croup
See healthdirect for more information on prevention, diagnosis and treatment of croup (healthdirect.gov.au/croup). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Cryptosporidiosis is a type of gastroenteritis caused by a parasite called Cryptosporidium. Symptoms include stomach pain; feeling unwell; vomiting; and foul-smelling and watery diarrhoea. Symptoms can last for up to 2 weeks. It tends to be more common during the warmer months and is sometimes associated with swimming pools that have been contaminated by a person with the infection.
Exclusion period
Exclude until there has not been any diarrhoea or vomiting for 24 hours.
Staff members with these symptoms should not handle food until they have not vomited or had diarrhoea for 48 hours (they can be assigned to other duties after 24 hours, or stay away from theservice for 48 hours).
Check if your state or territory has different requirements for gastroenteritis.
How it spreads
Cryptosporidiosis spreads through infected faeces (poo) from people or animals. You can get it from drinking or swimming in contaminated water, eating food that infected people have touched, changing the nappy of an infected child and not washing your hands properly afterwards; or touching contaminated surfaces.
Actions for educators and other staff
Follow exclusion period recommendations.
Ensure staff and children practise effective hand hygiene.
Ensure staff are using appropriate cleaning practices.
If you have 2 or more cases of gastroenteritis in your service, contact your local public health unit for advice. This is a legal requirement in some states and territories.
Actions for parents and carers
Keep your child at home until at least 24 hours after their diarrhoea has stopped. Give them plenty to drink.
Do not allow your child to swim in a public pool for 2 weeks after the diarrhoea has stopped.
Encourage your child to wash their hands regularly.
More information about cryptosporidiosis
See healthdirect for more information on prevention, diagnosis and treatment of cryptosporidiosis (healthdirect.gov.au/cryptosporidiosis). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Cytomegalovirus (CMV) is a common viral infection, particularly in young children. In Australia, about 50% of young adults have been infected. Once a person is infected, they can carry the virus for the rest of their lives, even if they do not have any symptoms. Sometimes the virus can be reactivated, usually when the person has another illness or is stressed, and may then cause symptoms. Healthy children and adults do not usually develop symptoms when they are infected, but some may show symptoms that are similar to glandular fever (for example, tiredness, sore throat, swollen glands and fever).
Exclusion period
Not excluded.
How it spreads
CMV infection spreads through contact with body fluids such as urine, saliva, blood or breast milk. It can spread from person to person through close contact, such as sharing eating utensils, or through contact with contaminated objects such as toys or nappies. People can be infectious for months to years after their initial infection, because they can keep shedding the virus in their urine or saliva.
Risks in pregnancy
CMV infection can be dangerous for unborn babies if the mother gets infected during pregnancy. In rare cases, it can cause hearing loss, intellectual disability or even stillbirth. This risk is higher during the first half of the pregnancy. CMV infection occurs in 1% or less of pregnancies and, of these cases, less than 10% of babies are likely to have severe illness.
Educators and other staff at education and care services are at a higher risk of catching CMV because they work with young children. Pregnant educators and other staff who usually work with children under 2 may wish to be reassigned to work with older children until they give birth.
To avoid getting infected, wash your hands frequently, use gloves when changing nappies, and avoid sharing food, drinks or utensils with others.
Actions for educators and other staff
Ensure educators and other staff and children practise effective hand hygiene, especially after changing nappies or handling items contaminated with urine or saliva.
Ensure staff are using appropriate cleaning practices. Inform staff who are pregnant or considering pregnancy about CMV and how to protect themselves against infection.
Actions for parents and carers
If your child has CMV, make sure family members wash their hands properly after handling any items with the child's saliva or urine on them.
More information about CMV infection
See healthdirect for more information on prevention, diagnosis and treatment of CMV (healthdirect.gov.au/cytomegalovirus-cmv). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Gastroenteritis (or ‘gastro’) is a viral or bacterial infection that causes inflammation of the digestive system. It can cause diarrhoea, vomiting and stomach cramps. The symptoms can range from mild to severe and usually last for a few days. Gastroenteritis can cause dehydration because of the large amount of fluid lost through vomiting and diarrhoea.
Exclusion period
Exclude until there has not been any diarrhoea or vomiting for 24 hours.
If the diarrhoea and vomiting are confirmed to be due to norovirus, exclude for 48 hours.
Staff members with these symptoms should not handle food until they have not vomited or had diarrhoea for 48 hours (they can be assigned to other duties, or stay away from the service for 48hours).
Check if your state or territory has different requirements for gastroenteritis.
How it spreads
Gastrointestinal diseases spread when the germ enters the body by the mouth. This can happen when:
- people eat contaminated food or drink contaminated water
- infected people do not wash their hands effectively after using the toilet and their hands contaminate food or surfaces
- people don’t wash their hands effectively after changing the nappy of an infected baby.
People are infectious for as long as the germs are present in their faeces.
Actions for educators and other staff
Follow exclusion period recommendations.
If you have 2 or more cases of gastroenteritis in your service, contact your local public health unit for advice. This is a legal requirement in some states and territories.
Ensure staff and children practise effective hand hygiene.
Ensure staff are using appropriate cleaning practices.
Actions for parents and carers
Keep your child at home until at least 24 hours after their diarrhoea has stopped, or 48 hours if they have norovirus. Give them oral rehydration solution from a chemist to keep them hydrated.
If your child has diarrhoea and is also vomiting or cannot take extra fluids, take them to see a doctor.
Encourage your child to wash their hands regularly.
More information about gastroenteritis
See healthdirect for more information on prevention, diagnosis and treatment of gastroenteritis (healthdirect.gov.au/gastroenteritis). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Middle ear infections (also called otitis media) are common in young children. An ear infection can cause pain, fever and temporary hearing loss. It can be caused by bacteria or viruses, and often appears after a cold. Occasionally the eardrum may perforate and you may see fluid coming from the child’s ear. Outer ear infections (otitis externa) occur on the outside of the eardrum, involving the ear canal. They are often associated with swimming.
Rarely, a middle ear infection may spread to the mastoid bone behind the ear, causing mastoiditis. The area behind the ear will be red, and the ear lobe will stick out. A child with these symptoms should see a doctor as soon as possible – this is a serious infection.
Most children will have occasional ear infections that are not serious and resolve quickly. Children who have recurrent ear infections may develop ‘glue ear’ – when the middle ear is filled with a sticky fluid that looks similar to honey. This may last for many weeks or months and makes it harder for the child to hear.
Exclusion period
Not excluded unless associated with other concerning symptoms.
How it spreads
Isolated ear infections rarely spread from person to person. However, middle ear infections can follow a viral respiratory tract infection (for example, the common cold), which is very infectious.
Actions for educators and other staff
Treat any discharge from an ear as infectious – wash your hands thoroughly if they come in contact with ear discharge.
Ensure staff and children have good respiratory and hand hygiene.
Ensure staff are using appropriate cleaning practices.
Actions for parents and carers
Keep your child at home if they have a fever or there is any fluid coming out of their ear.
If your child has frequent ear infections, talk to your doctor to rule out any underlying conditions that may be contributing to the infections.
More information about ear infection
See healthdirect for more information on prevention, diagnosis and treatment of ear infection (healthdirect.gov.au/ear-infection). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Eye discharge refers to a sticky or runny fluid coming from the eyes that is not tears. It is normal to wake up with some discharge in the corner of the eye, and this is not a concern. Sometimes eye discharge is a sign of other conditions, such as conjunctivitis (see conjunctivitis factsheet) or blocked tear ducts. Blocked tear ducts in babies often improve without treatment by the age of year. Conjunctivitis can be caused by a virus or bacteria (called infectious conjunctivitis), a reaction to something in the eye, or an allergy. Infectious conjunctivitis can cause:
- watery or white discharge (viral conjunctivitis)
- yellow or green sticky discharge that can make it hard to open the eye (bacterial conjunctivitis).
Exclusion period
Exclude until discharge from the eyes has stopped (unless a doctor has diagnosed a non-infectious cause for the eye discharge).
How it spreads
Eye discharge caused by bacteria or a virus can spread easily between people (see conjunctivitis factsheet). It spreads by direct contact with eye secretions, or by contact with towels, wash cloths or tissues that have eye secretions on them.
Eye discharge caused by blocked tear ducts, allergic reactions or irritants in the eye is not contagious.
Actions for educators and other staff
Follow exclusion period recommendations.
Treat any discharge from an eye as infectious – wash your hands thoroughly if they come in contact with ear discharge.
Ensure staff and children practise effective hand hygiene.
Ensure staff are using appropriate cleaning practices.
Actions for parents and carers
Check the cause of your child’s eye discharge with a health professional, so that you can start any required treatment quickly.
If your child has an infectious eye discharge, keep them at home until the discharge has stopped.
More information about eye discharge
See healthdirect for more information on prevention, diagnosis and treatment of eye discharge (healthdirect.gov.au/eye-discharge). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
A fever is when a person’s body temperature is over 38.0°C. It can cause sweating, shivering, muscle aches and a headache. Fever is a common problem for children, and it is a normal response to many illnesses. The most common cause of fever is an infection.
Fever can be concerning for parents. However, it is usually more important to determine what is causing the fever rather than the temperature itself.
Exclusion period
Exclude until the temperature is normal, unless the fever has a known non-infectious cause. Fever on its own may not be cause for concern, but fever is usually combined with other symptoms.
If a doctor later diagnoses the cause of the child’s fever, follow the exclusion guidance for that disease.
How it spreads
Fever itself is not contagious and cannot be spread from person to person. However, the underlying infection or illness that is causing the fever may be contagious. Viruses that cause fever spread from person to person via droplets containing the virus. People get infected by:
- breathing in droplets when an infected person breathes, coughs or sneezes on them or near them
- touching a surface contaminated with droplets – for example, hands, tissues, toys or eating utensils – and then touching their eyes, nose or mouth.
Actions for educators and other staff
If you think a child has a fever, check their temperature. If their temperature is:
- between 37.5°C and 37.9°C – retest within 30 minutes
- 38°C and over – notify a parent and ask them to pick up their child. Separate the child from the other children while waiting for their parent or carer to arrive.
Ensure staff and children have good respiratory and hand hygiene.
Ensure staff are using appropriate cleaning practices.
Actions for parents and carers
Keep your child at home until their temperature has stayed under 38.0°C for 24 hours.
If your child is under 3 months and has a fever above 38°C, take them to the doctor, even if they have no other symptoms.
All children with a temperature over 38.0°C AND any of the following symptoms should see a doctor right away:
- a stiff neck or light is hurting their eyes lethargic and not interested in interacting or participating in their usual activities
- vomiting and refusing to drink
- a rash, especially if accompanied by other concerning symptoms
- going to the toilet to pass urine less often or not at all (fewer wet nappies than usual in babies)
- pain that doesn’t get better with pain relief medication
- have had any fever for more than 3 days and there is no obvious cause seems to be getting more unwell.
Call 000 and ask for an ambulance if your child has a fever and any of the following symptoms:
- not responding to your voice
- having problems with breathing
- is pale and their hands and feet are cold to touch
- having a fit (febrile seizure) for the first time.
More information about fever
See healthdirect for more information on prevention, diagnosis and treatment of fever (healthdirect.gov.au/fever-and-high-temperature-in-children). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Fifth disease is a common viral infection that usually causes a mild illness in children. About 20% of infected children will have no symptoms. In others, symptoms include mild fever and muscle aches, followed 2 to 5 days later by a red rash on the face (hence the name ‘slapped cheek syndrome’) and a lacy red rash on the trunk and limbs. The rash can sometimes be itchy. It will usually disappear after 7 to 10 days, but can come and go for several weeks, often reappearing in response to heat. Fifth disease is a type of parvovirus. Animals such as cats and dogs can have other types of parvovirus infections, but they cannot catch human parvovirus from people, and they cannot pass their parvovirus infections to people.
Exclusion period
Not excluded.
How it spreads
Fifth disease spreads through airborne droplets, contact with infected saliva or mucus, or transmission to the baby during pregnancy.
Risks in pregnancy
If you catch fifth disease in the first 20 weeks of pregnancy, it can affect the baby. In less than 5% of cases, the baby develops a low red blood cell count (anaemia), resulting in miscarriage. Babies that survive if the mother is infected do not have birth defects.
Actions for educators and other staff
Ensure staff and children have good respiratory and hand hygiene.
Ensure staff are using appropriate cleaning practices.
Actions for parents and carers
Keep your child at home until symptoms have gone.
Encourage your child to wash their hands regularly.
Teach your child to cough or sneeze into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough or sneeze into their inner elbow instead of their hands.
Clean surfaces that your child has touched, sneezed on, or coughed on to reduce the risk of the infection spreading to others at home.
More information about fifth disease
See healthdirect for more information on prevention, diagnosis and treatment of fifth disease (healthdirect.gov.au/fifth-disease). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Influenza, or the flu, is a viral infection that affects the respiratory system. Symptoms may include fever, chills, headache, muscle aches and pains, a head cold and a mild sore throat. It can often cause a severe cough. The infected person usually recovers within a week. Children under 5 are at higher risk of developing serious complications from the flu, such as pneumonia.
Exclusion period
Exclude based on symptoms; otherwise not excluded.
If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), exclude them if:
- the respiratory symptoms are new and getting worse (more frequent or severe), or
- they also have concerning symptoms (fever, rash, tiredness, pain, poor feeding).
A person can often have an ongoing cough after they have recovered from a respiratory infection. If their other symptoms have gone and they are feeling well, they can return to the service.
How it spreads
Flu is highly infectious. It can spread through the air by coughing and sneezing, as well as by hands, cups and other objects that have been in contact with an infected person’s mouth or nose.
Risks in pregnancy
If you are pregnant, you have a higher risk of developing serious complications from the flu. The flu can also be dangerous for the developing baby, as it increases the risk of low birthweight and complications. You can protect yourself by getting a flu vaccination, having good hand and respiratory hygiene, and wearing a mask if you wish.
Actions for educators and other staff
Follow exclusion period recommendations.
Ensure staff and children have good respiratory and hand hygiene.
Ensure staff are using appropriate cleaning practices.
Encourage annual flu vaccination for staff.
If you have several cases of flu-like illness in your service, contact your public health unit for advice.
Actions for parents and carers
Keep your child at home until their symptoms have gone. Sometimes children recovering from respiratory viruses no longer have a fever and are back to normal activities, but still have an occasional cough. If this applies to your child, check with your childcare provider about whether they can return to care.
Teach your child to cough or sneeze into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough or sneeze into their inner elbow instead of their hands.
Encourage your child to wash their hands regularly.
Consider annual flu vaccinations for the whole family.
More information about flu
See healthdirect for more information on prevention, diagnosis and treatment of flu (healthdirect.gov.au/flu). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Tinea is a common fungal infection of the skin, which is usually found in moist, warm parts of the body. It causes a rash that is called ringworm if it is on the head or body, athlete’s foot if it is between the toes or on the feet, or jock itch if it is in the groin. Ringworm is not caused by a worm. Tinea can also infect the scalp, skin and nails. The condition looks different depending on where it is located.
Exclusion period
Exclude until the day after starting appropriate antifungal treatment.
How it spreads
The tinea fungus spreads by direct skin contact with an infected person or animal, or by touching contaminated clothing or soil.
Actions for educators and other staff
Follow exclusion period recommendations.
Ensure staff and children practise effective hand hygiene.
Ensure staff are using appropriate cleaning practices.
Actions for parents and carers
Take your child to a doctor for correct diagnosis and treatment. Tinea is treated with antifungal medications, usually as a cream or ointment. Sometimes oral medications are needed to treat tinea. Keep the affected area clean and dry. Keep your child at home until the day after treatment starts.
Do not share towels, clothing or shoes. Inspect other people in the family for signs of infection. Wash your hands thoroughly after applying treatment or touching the affected area. Encourage your child to wash their hands regularly.
If pets have ringworm, take them to a vet for treatment.
More information about fungal infections of the skin or nails
See healthdirect for more information on prevention, diagnosis and treatment of tinea and other fungal skin diseases (healthdirect.gov.au/tinea and healthdirect.gov.au/fungal-skin-diseases). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Giardiasis is a form of gastroenteritis caused by a parasite called Giardia lamblia or Giardiaduodenalis. This parasite can live in the bowel of people, wild animals, pets and farm animals. Untreated water that comes directly from lakes and rivers may also contain Giardia.
Symptoms include diarrhoea, foul-smelling faeces (poo), cramping, gas, fatigue, nausea, and sometimes vomiting and weight loss. Fever and bloody faeces are not usually symptoms of Giardia infections. Many infected people have no symptoms.
In education and care services, children and staff who have had Giardia may no longer have any symptoms but may still be infected with the parasite. This means their faeces can still infect others. A person with active diarrhoea is more likely to spread the disease than one who does not have diarrhoea, but still has the parasite in their faeces.
Exclusion period
Exclude until there has not been any diarrhoea or vomiting for 24 hours.
Staff members with these symptoms should not handle food until there has not been any diarrhoea or vomiting for 48 hours (they can be assigned to other duties, or stay away from the service for 48 hours).
Check if your state or territory has different requirements for gastroenteritis.
How it spreads
Giardia infections spread when:
- infected people do not wash their hands effectively after going to the toilet, and then contaminate food or surfaces
- people’s hands become contaminated while handling infected animals or changing the nappy of an infected child
- people drink contaminated water.
Actions for educators and other staff
Follow exclusion period recommendations.
Ensure staff and children practise effective hand hygiene.
Ensure staff are using appropriate cleaning practices.
If you have 2 or more cases of gastroenteritis in your service, contact your local public health unit for advice. This is a legal requirement in some states and territories.
Actions for parents and carers
See a doctor about treatment, as antibiotic therapy will be recommended if Giardia is found in your child’s faeces. Keep your child at home until 24 hours after their symptoms have gone.
Encourage your child to wash their hands regularly.
More information about Giardia infection
See healthdirect for more information on prevention, diagnosis and treatment of Giardia infection (healthdirect.gov.au/giardiasis). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Glandular fever is caused by Epstein–Barr virus. Once a person catches Epstein–Barr virus, the virus remains in their body for life, although it usually does not cause further sickness. By adulthood, 90 to 95% of people have Epstein–Barr virus.
Most people will not have any symptoms, including children less than 3 years old. Older children and young adults may develop symptoms including fever, tiredness, sore throat and swollen glands. Some people develop stomach pain and yellowing of the skin and eyes (jaundice), or a red, itchy rash. Symptoms can last for several weeks, and some people may feel tired for months after the infection.
Exclusion period
Not excluded.
How it spreads
Epstein–Barr virus spreads from person to person through contact with saliva, such as through kissing, sharing utensils and drinks, or coughing and sneezing. Young children may be infected by saliva on the hands of caregivers, or by sucking and sharing toys; however, the virus does not survive very well in the environment.
Actions for educators and other staff
Ensure staff and children have good respiratory and hand hygiene.
Ensure staff are using appropriate cleaning practices.
Actions for parents and carers
If your child feels unwell, keep them at home until their symptoms have gone. Avoid sharing utensils and drinks. Encourage your child to wash their hands regularly.
Teach your child to cough or sneeze into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough or sneeze into their inner elbow instead of their hands.
More information about glandular fever
See healthdirect for more information on prevention, diagnosis and treatment of glandular fever (healthdirect.gov.au/glandular-fever). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Hand, foot and mouth disease is a common viral infection due to a group of viruses known as enteroviruses.
It is not related to the disease in cattle with a similar name (foot-and-mouth disease).
Symptoms of hand, foot and mouth disease include tiny blisters on various parts of the body, including in the mouth, and on the fingers, palms of hands, buttocks, nappy area, soles of the feet, upper arms or upper legs. The blisters last a little longer than a week. The most troublesome symptom is often the blisters in the mouth, which make it difficult for the child to eat or drink. In adults, the disease is rare and may cause mild symptoms or no symptoms at all.
Exclusion period
Exclude until all blisters have dried.
How it spreads
The virus can be found in saliva, secretions, faeces (poo) and blister fluid. It is usually spread from person-to-person through close contact, including:
- touching an infected person
- direct contact with blister fluid
- touching an object or surface that has been contaminated with the virus
- changing the nappy of an infected child.
Symptoms usually appear 3 to 5 days after infection. People are infectious for as long as the blisters contain fluid. Faeces can remain infectious for several weeks.
Risks in pregnancy
In the vast majority of adults, infection is mild or asymptomatic. The risk associated with this disease during pregnancy is low; however, in extremely rare cases, it can cause miscarriage. If you are pregnant and become infected shortly before giving birth, the infection can pass to the baby. Most babies born with hand, foot and mouth disease have mild symptoms, but in very rare cases complications can occur.
Actions for educators and other staff
Follow exclusion period recommendations.
If you suspect a child has hand, foot and mouth disease, call the parent or carer and ask them to pick up their child.
Ensure staff and children have good respiratory and hand hygiene.
Ensure staff are using appropriate cleaning practices.
Actions for parents and carers
Keep your child at home until they are their fever has resolved, they are able to eat and drink normally and all blisters have dried.
Teach them to cough and sneeze into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough or sneeze into their inner elbow instead of their hands.
More information about hand, foot and mouth disease
See healthdirect for more information on prevention, diagnosis and treatment of hand, foot and mouth disease (healthdirect.gov.au/hand-foot-and-mouth-disease). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Head lice are tiny insects that live in hair and feed on blood. Young children are more likely to get head lice because they tend to have more head-to-head contact with other children, especially during playtime. They are a nuisance because they can cause itching of the scalp, but they do not cause disease or illness. Lice can affect anyone, and are not a sign of dirty hair or poor hygiene. Symptoms include itchiness on the scalp, seeing live lice or nits (lice eggs) in the hair, and sores or red bumps on the scalp or neck from scratching.
Exclusion period
Not excluded, as long as effective treatment begins before the next attendance at the service. The child does not need to be sent home immediately if head lice are detected.
How it spreads
Head lice spread from one person to another by direct head-to-head contact, or by sharing a comb or hairbrush. Lice cannot jump or fly, and cannot live long away from the human head. They do not live or breed on animals, bedding, furniture, carpets, clothes or soft toys.
Actions for educators and other staff
Follow exclusion period recommendations.
If one child in a class has head lice, it is likely that several others also have them. Do not isolate a child who is known to have lice.
Reduce head-to-head contact between children if you are aware someone at your service has headlice.
Tell families if there is someone in your service with head lice. Support families by providing factual information, reducing parental anxiety and not singling out individual children with head lice.
Actions for parents and carers
If your child has head lice, follow exclusion recommendations and treat them straight away. You may send your child back to the education and care service as soon as effective treatment has started.
Check for head lice in other family members as well.
Check your child’s head once a week for head lice. If you find any lice or eggs, begin treatment immediately. Check for lice every 2 days until no lice are found for 10 consecutive days.
More information about head lice
See healthdirect for more information on prevention, diagnosis and treatment of head lice (healthdirect.gov.au/head-lice). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Hepatitis A is a liver disease caused by the hepatitis A virus, which is very infectious. Symptoms can include fever, tiredness, stomach pain, loss of appetite and nausea. This is sometimes followed by dark urine and yellowing of the skin and eyes (jaundice). Symptoms can last from week to several months. Children under 3 years old rarely have any symptoms. Hepatitis A vaccine is effective and recommended for people at higher risk of being infected.
Exclusion period
Exclude until at least 7 days after jaundice starts, or if there is no jaundice, until 2 weeks after onset of other symptoms.
How it spreads
Hepatitis A spreads when the virus enters the body by the mouth. This can happen when:
- people eat contaminated food or drink contaminated water
- infected people do not wash their hands effectively after using the toilet and their hands contaminate food or surfaces a person changes the nappy of an infected child and does not wash their hands effectively.
The virus can survive on unwashed hands or room-temperature food for several hours. Heating or freezing food may not always kill the virus on contaminated food.
Actions for educators and other staff
Contact your local public health unit for advice if you have a case of hepatitis A in your service.
Follow exclusion period recommendations.
Ensure staff and children practise effective hand and toileting hygiene.
Ensure staff are using appropriate cleaning practices.
Encourage staff to be vaccinated against hepatitis A.
Actions for parents and carers
Take your child to a doctor to discuss caring for them and vaccination options for family members.
Make sure you and your child wash their hands regularly, especially after going to the toilet or changing nappies.
Follow exclusion recommendations. You will need a medical certificate of recovery from a doctor before your child can return to the care service.
More information about hepatitis A
See healthdirect for more information on prevention, diagnosis and treatment of hepatitis A (healthdirect.gov.au/hepatitis-a).
To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Hepatitis B is a viral infection that affects the liver. About 50% of adults and 90% of children do not develop any symptoms at the time of infection. If they do occur, symptoms may include fever, tiredness, stomach pain, nausea, dark urine and yellowing of the skin and eyes (jaundice). In some cases, hepatitis B can lead to liver damage or liver cancer. Vaccination can prevent hepatitis B and is part of the routine childhood vaccination schedule in Australia.
Exclusion period
Not excluded.
How it spreads
Hepatitis B spreads through contact with an infected person's blood or body fluids. The virus can survive outside the body for up to 7 days, so surfaces or objects contaminated with blood or saliva can also spread the virus. Hepatitis B does not spread through food or water, or through ordinary social contact.
Actions for educators and other staff
Routinely check the vaccination status of children and staff. Follow standard procedures for handling blood and body fluids, as you may not know if someone has the virus. Make sure your service has a protocol for managing exposure to blood, body fluids or needlestick injuries. Cover open wounds with a waterproof dressing to reduce exposure to blood.
Actions for parents and carers
If your child has been diagnosed with hepatitis B, follow your doctor's advice and keep your child at home until they are feeling better. Cover any cuts or wounds with a waterproof dressing. Vaccination against hepatitis B is available under the National Immunisation Program. See your doctor if you or any family members have not been vaccinated.
More information about hepatitis B
See healthdirect for more information on prevention, diagnosis and treatment of hepatitis B (healthdirect.gov.au/hepatitis-b). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Hepatitis C is a viral infection that affects the liver. The disease is slow acting and often has no symptoms, so around half of infected people do not know they are infected. If people do experience symptoms, they can include fever, tiredness, stomach pain, nausea, dark urine and yellowing of the skin and eyes (jaundice). In the long term, hepatitis C can lead to liver damage and liver cancer. There is no vaccine, but effective treatment is available.
Exclusion period
Not excluded.
How it spreads
Hepatitis C spreads through direct contact with infected blood or body fluids. Hepatitis C does not spread through food or water, or through ordinary social contact.
Actions for educators and other staff
Follow standard procedures for handling blood and body fluids, as you may not know if someone has the virus.
Make sure your service has a protocol for managing exposure to blood, body fluids or needlestick injuries.
Cover open wounds with a waterproof dressing to reduce exposure to blood.
Actions for parents and carers
If your child has been diagnosed with hepatitis C, follow your doctor's advice. To prevent further liver infections get your child vaccinated against hepatitis A and B (if they are not already vaccinated).
Cover any cuts or wounds with a waterproof dressing.
More information about hepatitis C
See healthdirect for more information on prevention, diagnosis and treatment of hepatitis C (healthdirect.gov.au/hepatitis-c). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Hepatitis E is a liver disease caused by the hepatitis E virus. It is rare in Australia. Some people, especially children, will have no symptoms. If symptoms do occur, they can include fever, tiredness, stomach pain, loss of appetite and nausea. This is sometimes followed by dark urine and yellowing of the skin and eyes (jaundice).
Exclusion period
Exclude until at least 7 days after jaundice starts, or if there is no jaundice, until 2 weeks after onset of other symptoms.
How it spreads
Hepatitis E spreads when the virus enters the body by the mouth, for example when people eat contaminated food or drink contaminated water. Most Australians who get hepatitis E catch it overseas. Within Australia, people sometimes become infected after eating undercooked pork (pig) products. Person-to-person transmission is not common.
Actions for educators and other staff
Contact your local public health unit for advice if you have a case of hepatitis E in your service.
Follow exclusion period recommendations.
Ensure staff and children practise effective hand and toileting hygiene.
Ensure staff are using appropriate cleaning practices.
Actions for parents and carers
Make sure you and your child wash their hands regularly, especially after going to the toilet or changing nappies.
Follow exclusion recommendations. You will need a medical certificate of recovery from a doctor before your child can return to the care service.
More information about hepatitis E
See healthdirect for more information on prevention, diagnosis and treatment of hepatitis E (healthdirect.gov.au/hepatitis). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Despite its name, the germ that causes this infection is not related to influenza (‘the flu’). Until a vaccine was introduced in 1993, Hib was one of the most common cause of life-threatening infections in Australian children under 5 years old. Hib can cause swelling in the throat, which interferes with breathing, causing noises when breathing. It may block breathing altogether. It can also cause pneumonia (infection in the lungs) and infect the membranes covering the brain (meningitis), the joints, or the tissue under the skin (usually on the face).
Symptoms of Hib meningitis are very similar to other types of meningitis. These include severe headache, stiff neck, fits, severe sleepiness, difficulty waking up and loss of consciousness.
Exclusion period
Exclude until the person has received appropriate antibiotic treatment for at least 4 days.
How it spreads
Hib spreads from person to person via droplets in the air that contain the germ. People get infected by:
- breathing in droplets when an infected person breathes, coughs or sneezes on them
- touching a surface contaminated with droplets – for example, hands, tissues, toys or eating utensils – and then touching their mouth.
Actions for educators and other staff
Follow exclusion period recommendations.
Contact your local public health unit for advice if you have a case of Hib in your service.
Check the immunisation records of all children who have come into contact with a child with Hib. Unvaccinated children who have had close contact with the infected child will need special antibiotics.
Ensure staff and children practise cough and sneeze etiquette and effective hand hygiene.
Ensure staff use appropriate cleaning practices.
Actions for parents and carers
Ensure your baby is vaccinated against Hib.
If your child has symptoms of Hib, contact your doctor immediately so they can give your child the correct treatment.
Keep your child at home until they are feeling well and have completed the course of special antibiotics prescribed.
Teach them to cough or sneeze into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough or sneeze into their inner elbow instead of their hands.
Make sure your child washes their hands thoroughly and frequently.
More information about Hib
See healthdirect for more information on prevention, diagnosis and treatment of Hib (healthdirect.gov.au/haemophilus-influenzae-type-b-hib). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
HIV is a virus that is carried in blood and body fluids and damages the immune system. Untreated infection with HIV can lead to AIDS (acquired immunodeficiency syndrome). When a person has AIDS, their immune system can no longer protect their body from other diseases such as infections and cancers. HIV is a lifelong infection.
Effective treatment is now available and people who take it have a near-normal life expectancy.
Exclusion period
Not excluded.
If the person is severely immunocompromised, they will be vulnerable to other people’s infections.
How it spreads
First, how it doesn’t spread: HIV doesn’t spread through social contact in schools, at home, or in the workplace. It doesn’t spread through air or water; swimming pools or toilets; sharing of plates, cups or cutlery; or kissing, coughing, sneezing or spitting. Mosquitoes or other biting insects don’t spread HIV. HIV spreads through direct contact with infected blood and body fluids, usually through needle puncture, broken skin, or a break in the mucous membranes (for example, the lining of the reproductive organs). In Australia, most HIV infections are caused by:
- unprotected sex
- sharing drug-injecting equipment
- spread of the virus from mother to infant during pregnancy, birth or breastfeeding
- receiving blood or blood products before screening for HIV was introduced in 1985.
Actions for educators and other staff
Maintain confidentiality if a child or staff member has HIV.
Practise standard precautions for handling blood and other body fluids at all times – you may not know if people are carrying the virus.
Ensure open wounds are covered with a waterproof dressing.
Actions for parents and carers
You may choose to tell educators or other staff if your child has HIV, but you don’t have to.
Children with HIV are more likely to get severe infections than other children are. Ask your doctor about which vaccines your child should get.
Keep children with HIV at home during outbreaks of infectious diseases in their childcare centre.
Keep open wounds covered with a waterproof dressing.
More information about HIV
See healthdirect for more information on prevention, diagnosis and treatment of HIV (healthdirect.gov.au/hiv-infection-and-aids). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Human metapneumovirus (HMPV) is a respiratory virus that causes a mild infection similar to a common cold or respiratory syncytial virus infection. Symptoms include cough, fever, runny or blocked nose, headache and feeling tired. Complications such as bronchiolitis or pneumonia can occur in young children.
Exclusion period
Exclude based on symptoms; otherwise not excluded.
If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), exclude them if:
- the respiratory symptoms are new and getting worse (more frequent or severe), or
- they also have concerning symptoms (fever, rash, tiredness, pain, poor feeding).
A person can often have an ongoing cough after they have recovered from a respiratory infection. If their other symptoms have gone and they are feeling well, they can return to the service.
How it spreads
HMPV spreads from person to person via droplets containing the virus. People can be infected by:
- breathing in droplets when an infected person breathes, coughs or sneezes on them or near them
- touching a surface contaminated with droplets – for example, hands, tissues, toys or eating utensils – and then touching their eyes, nose or mouth.
Actions for educators and other staff
Ensure staff and children have good respiratory and hand hygiene.
Ensure staff are using appropriate cleaning practices.
Actions for parents and carers
Keep your child at home until their symptoms have gone.
Teach them to cough or sneeze into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough or sneeze into their inner elbow instead of their hands.
Sometimes children recovering from respiratory viruses no longer have a fever and are back to normal activities, but still have an occasional cough. If this applies to your child, check with your childcare provider about whether they can return to care.
More information about human metapneumovirus
See NSW Health for more information on prevention, diagnosis and treatment of respiratory viruses, including HMPV (health.nsw.gov.au/Infectious/factsheets/Pages/respiratory-viruses.aspx).
To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Impetigo is a skin infection that commonly occurs in school-aged children. It is caused by 2 types of bacteria, Staphylococcus and Streptococcus. Impetigo appears as flat, yellow, crusty or moist patches or blisters on the skin, usually on the face, arms and legs. The sores can measure 5 or more millimetres. The disease spreads easily.
These germs often live harmlessly on and in the body, such as on the skin and in the nose. Cuts, abrasions, or dry and cracked skin may allow them to get into deeper layers of the skin and cause infections. However, healthy, intact skin can sometimes develop sores.
Exclusion period
Exclude until appropriate antibiotic treatment has started. Cover any sores on exposed skin with a watertight dressing.
How it spreads
The sores are filled with the germs, which spread when others touch the sores or infected fluid. Because the sores can be itchy or painful, people can scratch or touch them, spreading the infection via their hands to other parts of their body or to other people. The infection also spreads by touching contaminated clothing or other items.
Actions for educators and other staff
Ensure staff and children practise effective hand hygiene.
Ensure staff are using appropriate cleaning practices.
Actions for parents and carers
Keep your child at home until they have had antibiotic treatment for at least 24 hours. If antibiotics are not used, keep the child at home until the sores are dry.
Cover any sores on exposed skin with a waterproof dressing.
Make sure your child washes their hands thoroughly and frequently, especially if they touch the sores.
More information about impetigo
See healthdirect for more information on prevention, diagnosis and treatment of impetigo (healthdirect.gov.au/impetigo). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Measles is a highly infectious and potentially serious disease caused by a virus. The initial symptoms are not specific and include a fever, cough, and sore, red eyes (conjunctivitis). This is followed by amore characteristic rash of large, lumpy, reddish to purplish blotches that often join up and completely cover the skin. The rash spreads over the entire body but usually disappears within 6 days. The reason that measles is so concerning is that it often causes very serious complications, including lung infections (pneumonia) and swelling of the brain. Because of this, measles should not be considered a minor disease. Children with measles can be very ill, and adults with measles are usually hospitalised. The number of cases of measles in Australia has fallen dramatically over the past 15 years because of vaccination programs and other public health measures. However, overseas travellers still bring measles into Australia, so people in Australia can still catch the virus.
Exclusion period
Exclude for 4 days after the rash appeared. Contacts:
- Vaccinated and immune contacts are not excluded.
- For unvaccinated contacts, talk to your public health unit for advice.
- Exclude all immunocompromised children until 14 days after the rash appears in the last case.
How it spreads
Measles spreads from person to person via mouth-to-mouth contact or droplets in the air that contain the measles virus. People get infected by:
- breathing in infected droplets. The virus is very infectious and can stay in the air for up to 2 hours after an infected person has left the room.
- touching a surface contaminated with droplets – for example, hands, tissues, toys or eating utensils – and then touching their mouth.
Risks in pregnancy
In very rare cases, measles can bring on premature birth. This is mainly seen in unvaccinated people. Getting vaccinated significantly reduces the risk.
Actions for educators and other staff
Contact your local public health unit for advice if you have a case of measles in your service. Review vaccination records: Ensure children have received or 2 doses of measles–mumps–rubella (MMR) vaccine, depending on their age. The public health unit can advise if any children who have not been vaccinated will need to be excluded. Ensure that:
- all staff have received 2 doses of MMR if they were born during or after 1966
- staff and children practise cough and sneeze etiquette and effective hand hygiene
- staff are using appropriate cleaning practices.
Actions for parents and carers
Make sure your child is fully vaccinated against measles.
Keep your child at home for the recommended period, or longer, until they are feeling better.
Advise any friends, family or social contacts that your child has measles. These people may need to seek medical advice if they:
- are pregnant or considering starting a family aren’t vaccinated
- have a medical condition that lowers their immunity, such as cancer or HIV
- are taking certain medications.
More information about measles
See healthdirect for more information on prevention, diagnosis and treatment of measles (healthdirect.gov.au/measles). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Meningitis is an infection of the membranes that cover the spinal cord and brain. A lot of different viruses can cause meningitis, including the ones that cause gastroenteritis, measles, mumps, chickenpox and herpes.
Symptoms may include headache, fever, vomiting, neck stiffness, joint pain, drowsiness or confusion, and discomfort when looking at bright lights. Although symptoms may be severe, people usually recover completely.
Exclusion period
Exclude until the person is well.
How it spreads
How people get meningitis depends on the virus that causes it. Some viruses can spread via droplets in the air that contain the virus. Others can spread by touching a surface contaminated with droplets– for example, hands, tissues, toys or eating utensils – or by contact with infected faeces.
Actions for educators and other staff
Inform a parent or carer immediately if their child has symptoms of meningitis. Ensure staff and children practise cough and sneeze etiquette and effective hand hygiene. Ensure staff are using appropriate cleaning practices.
Actions for parents and carers
If your child has symptoms of meningitis, contact your doctor immediately. If your doctor is not available, go to your nearest emergency department or call triple zero (000) and ask for an ambulance.
Do not send your child back to the education and care service until they are feeling well again.
Teach your child to cough or sneeze into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough or sneeze into their inner elbow instead of their hands.
Make sure your child washes their hands thoroughly and frequently.
More information about meningitis
See healthdirect for more information on prevention, diagnosis and treatment of meningitis (healthdirect.gov.au/meningitis). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Meningococcal infection is caused by a germ called Neisseria meningitidis, also known as meningococcus. There are several different types of meningococcus, but group B and group C cause most infections in Australia. Infections with group C are much less common now there is a vaccine against this group. Meningococcal infection is severe and can cause meningitis (infection of the membranes that cover the brain and spinal cord). The germ can also infect the blood, joints, eyes, lungs and skin. Symptoms in infants and young children include fever, refusing feeds, fretfulness, vomiting, a rash of reddish-purple spots or bruises, a high-pitched or moaning cry, and pale or blotchy skin. The child may be difficult to wake up. Meningococcal blood infections (septicaemia) can cause shock and death within hours of symptoms starting. In Australia, 5–10% of people infected with meningococcus die, even if they are treated rapidly. Most cases occur in children under 5 years of age.
Exclusion period
Exclude until the person has completed appropriate antibiotic treatment.
How it spreads
The meningococcal germ can be found in the nose and throat of up to in 10 of people, where the germs are almost always harmless. These people are the ‘carriers’ of the germ. In a few people, for reasons that are not clear, the germ spreads into the bloodstream and can cause very serious illness. A person can be infected if they:
- are in close contact with an infected person for a long time
- breathe in droplets when an infected person breathes, coughs or sneezes on them.
The germs do not spread by contact with saliva from the front of the mouth. For example, sharing drinks or eating utensils does not spread meningococcus, even if a person is carrying it in the back of their throat.
Actions for educators and other staff
Contact your local public health unit for advice about antibiotics and/or vaccination for people who were in the same room as the person with meningococcal disease.
Seek urgent medical attention for any person with any of the signs of meningococcal infection, such as rapid onset of illness, or a rash of reddish-purple spots or bruises.
Seek advice from your local public health unit.
Ensure staff and children practise cough and sneeze etiquette and effective hand hygiene.
Ensure staff use appropriate cleaning practices.
Actions for parents and carers
Make sure your child is vaccinated against meningococcal infection.
Contact your doctor immediately if your child shows any of the signs of meningococcal infection, such as rapid onset of illness, or a rash of reddish-purple spots or bruises.
Keep your child at home for the required period, or longer, until they are feeling well.
Your doctor can advise if very close contacts (such as family members) of someone with meningococcal disease need to take antibiotics. This is to kill any germs they may be carrying. Usually,all very close contacts are treated because there is no easy and quick way of finding out who is the carrier.
More information about meningococcal infection
See healthdirect for more information on prevention, diagnosis and treatment of meningococcal infection (healthdirect.gov.au/meningococcal-disease). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Molluscum contagiosum is a common skin infection caused by the molluscipox virus. The virus causes a rash of pearly, skin-coloured lumps that can appear anywhere on the body. The most common places to find them are under the arms, at the back of the knees, on the inside of the elbows, and at the tops of the thighs. The lumps are usually small, with a white centre and an indented surface. The disease is not serious and usually disappears without treatment, but this may take several months, or even longer in people whose immune defences are not working well. The infection is most common in children but has no long-term effects.
Exclusion period
Not excluded.
How it spreads
The virus spreads by direct skin-to-skin contact with an infected person, especially when there are small breaks in the skin. It can also spread in bath or pool water, on towels, face washers or clothing.
Actions for educators and other staff
Ensure staff and children practise effective hand hygiene.
Ensure staff use appropriate cleaning practices.
Avoid sharing towels and face washers.
Actions for parents and carers
Make sure your child washes their hands thoroughly and frequently.
Do not share towels, face washers or clothing. Wash and dry children’s bath toys after use.
Drying the affected area last after showering your child and wash your hands thoroughly after touching the spots.
Treatment is not generally needed, but see your child’s doctor if the child develops many spots or the spots become infected.
More information about molluscum contagiosum
See healthdirect for more information on prevention, diagnosis and treatment of molluscum contagiosum (healthdirect.gov.au/molluscum-contagiosum). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Diseases that spread through mosquito bites are called mosquito-borne diseases. Mosquitoes may pick up germs from infected animals or infected humans, but in Australia most mosquitoes do not carry disease-causing germs. The mosquito-borne diseases reported most often in Australia are Ross River virus infection, Barmah Forest virus infection, dengue fever (in northern Queensland and the Torres Straits) and malaria (only acquired overseas). Other mosquito-borne diseases such as Japanese encephalitis, Murray Valleyencephalitis and Chikungunya virus are very rare.
Mosquito-borne diseases cause a range of symptoms, which often include fever, headache, muscle and joint pain, and rash. Some can have rare but serious complications. For details on individual diseases, see healthdirect (healthdirect.gov.au/mosquito-borne-diseases).
Exclusion period
Not excluded.
How it spreads
Mosquito-borne diseases are not spread directly from person to person. The mosquito picks up the virus from an infected person or animal and then spreads it when it feeds on another person or animal.
Actions for educators and other staff
Contact your public health unit for advice if you have a mosquito-borne disease in your service.
If in a mosquito-prone area, check with parents if they would like staff to apply insect repellents on their child. Personal ‘tropical strength’ insect repellents containing DEET or picaridin are most effective. When using insect repellents on infants and young children, always read the label and follow the manufacturer’s instructions carefully.
Ensure insect screens are in good condition, with no holes. Put a screen with holes of less than millimetre over inlets and overflow outlets of rainwater tanks.
To stop mosquitoes breeding:
- remove any objects that can hold water
- empty outside pot-plant trays at least once a week, or put sand in the trays to take up the water.
Actions for parents and carers
Keep your child indoors when mosquito bites are most likely to happen. Some mosquitoes will bite during the day, but many are most active for 2 to 3 hours around sunset and sunrise.
When using insect repellents on infants and young children, always read the label and follow the manufacturer’s instructions carefully. Personal ‘tropical strength’ insect repellents containing DEET, picaridin or oil of lemon eucalyptus are most effective. Make sure insect screens are in good condition, with no holes.
In highly mosquito-prone areas or when mosquitoes are most active, dress your child in long-sleeved, loose, light-coloured clothing that covers as much of the body as possible. Mosquitoes can bite through tight clothing.
Remove any objects that can hold water, such as old tyres or troughs – mosquitoes breed in still water.
Empty pot-plant trays at least once a week or put sand in the trays to take up the water.
Keep fish, such as small native fish, in fishponds or unused swimming pools to eat the baby mosquitoes before they turn into adults.
Empty paddling pools each day as soon as children have finished playing in them.
Empty birdbaths and pets’ water bowls at least once a week.
Put a screen with holes of less than millimetre over inlets and overflow outlets of rainwater tanks.
More information about mosquito-borne diseases
See healthdirect for more information on prevention, diagnosis and treatment of mosquito-borne diseases (healthdirect.gov.au/mosquito-borne-diseases). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Mumps is an infection caused by a virus that is now uncommon in Australia because we have a vaccine for it. About one-third of people with mumps only have mild symptoms or no symptoms at all. When symptoms do occur, they include swelling of the glands that produce saliva, high fever and headache. Men and adolescent boys may have tender testicles. Very rarely, women and adolescent girls may have abdominal pain due to inflammation of the ovaries. Serious complications can sometimes occur, including swelling of the spinal cord and brain, and hearing loss. Very rarely, a person can become infertile. In extremely rare cases, a person may die.
Exclusion period
Exclude for 9 days or until swelling goes down (whichever is sooner).
How it spreads
The mumps virus spreads from person to person via droplets in the air that contain the virus. People get infected by breathing in droplets when an infected person breathes, coughs or sneezes on them.
Actions for educators and other staff
Follow exclusion period recommendations.
Contact your local public health unit for advice if you have a case of mumps in your service.
Ensure staff and children practise cough and sneeze etiquette and effective hand hygiene.
Ensure staff use appropriate cleaning practices.
Actions for parents and carers
Make sure your child is vaccinated against mumps.
Keep your child at home until they are feeling well – but they must stay home either until the swelling has gone down, or it is 9 days after the swelling started.
Teach your child to cough or sneeze into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough or sneeze into their inner elbow instead of their hands.
More information about mumps
See healthdirect for more information on prevention, diagnosis and treatment of mumps (healthdirect.gov.au/mumps). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Norovirus is a common viral cause of gastroenteritis (or ‘gastro’). Vomiting is usually the main initial symptom, and there can be large quantities of vomit. Other symptoms may include diarrhoea, nausea, stomach cramps, fever, headache and muscle aches. Norovirus gastroenteritis can cause dehydration because of the large amount of fluid lost through vomiting and diarrhoea. Outbreaks are common because norovirus spreads very easily and it only takes a small number of virus particles to make someone sick. The disease is more common in Australia from late winter to early summer. People who have had norovirus in the past can be reinfected as new strains of the virus spread around the world every few years.
Exclusion period
Exclude until there has not been any diarrhoea or vomiting for 48 hours.
How it spreads
The disease spreads when norovirus enters the body by the mouth. This can happen when:
- infected people do not wash their hands effectively after using the toilet and their hands contaminate food or surfaces
- people inhale droplets produced when an infected person vomits
- people don’t wash their hands effectively after changing the nappy of an infected baby.
The virus is relatively resistant to cleaning with disinfectants. This means that it is important to isolate people who are unwell, as well as cleaning bathrooms and high-touch surfaces. This reduces the risk of large outbreaks.
Actions for educators and other staff
Follow exclusion period recommendations.
Contact your local public health unit if 2 or more people are ill with gastroenteritis in your service. Public health workers may be able to identify how the germ has spread through the centre, which will help prevent further infection and a large-scale outbreak.
Ensure staff and children practise effective hand hygiene.
Ensure staff use appropriate cleaning practices.
Actions for parents and carers
Keep your child at home for the required exclusion period at a minimum, and longer if they are still not feeling well.
Keep your child hydrated – consider using an oral rehydration solution from a chemist. See a doctor if your child cannot take extra fluids due to vomiting. Make sure your child washes their hands thoroughly and frequently, especially after going to the toilet.
More information about norovirus infection
See healthdirect for more information on prevention, diagnosis and treatment of norovirus (healthdirect.gov.au/norovirus-infection). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Pneumococcal disease is caused by a type of bacteria called Streptococcus pneumoniae. The germ can cause a range of illnesses, from mild ear or throat infections to severe lung infections(pneumonia) and meningitis (infection of the membranes covering the brain and spinal cord). In Australia, pneumococcal disease tends to be more common during winter and spring. It is a leading cause of death in children under 5 years of age, especially in First Nations children, but seniors are also at risk of pneumococcal pneumonia. There is a vaccine against pneumococcal disease that is included in the Australian National Immunisation Program.
Exclusion period
Exclude until the person has received antibiotic treatment for at least 24 hours and feels well.
How it spreads
Pneumococcal disease spreads from person to person via infected droplets in the air. People get infected by:
- breathing in droplets when an infected person breathes, coughs or sneezes on them
- touching a surface contaminated with infected droplets – for example, hands, tissues, toys or eating utensils – and then touching their mouth or face.
Actions for educators and other staff
Follow exclusion period recommendations.
Ensure staff and children practise cough and sneeze etiquette and effective hand hygiene.
Ensure staff use appropriate cleaning practices.
Actions for parents and carers
Protect your child against pneumococcal disease by being up to date with their childhood immunisations.
If your child has symptoms of the disease, see your doctor.
Keep your child at home until they are feeling well, and for at least 24 hours after they have started taking antibiotics.
Teach your child to cough or sneeze into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough or sneeze into their inner elbow instead of their hands.
Make sure your child washes their hands thoroughly and frequently.
More information about pneumococcal disease
See healthdirect for more information on prevention, diagnosis and treatment of pneumococcal disease (healthdirect.gov.au/pneumococcal-disease).
To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Pneumonia is a lung infection that can be serious in young children. It can be caused by bacteria, viruses or fungi. People can develop pneumonia after they have common infections such a cold, the flu or respiratory syncytial virus. People with pneumonia may have symptoms of a cold that get worse over time, rather than better. Symptoms of pneumonia include a moist cough, fever, difficulty breathing and feeling tired.
Exclusion period
Exclude based on symptoms; otherwise not excluded.
If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), exclude them if:
- the respiratory symptoms are new and getting worse (more frequent or severe), or
- they also have concerning symptoms (fever, rash, tiredness, pain, poor feeding).
A person can often have an ongoing cough after they have recovered from a respiratory infection. If their other symptoms have gone and they are feeling well, they can return to the service.
How it spreads
The germs that cause pneumonia are generally common and spread from person to person, but only cause illness in a small proportion of people. Pneumonia is a significant illness in pregnancy and immunocompromised people.
Actions for educators and other staff
Follow exclusion period recommendations.
Ensure staff and children have good respiratory and hand hygiene.
Ensure staff are using appropriate cleaning practices.
Actions for parents and carers
Take your child to see a doctor if you think they may have pneumonia. If your child’s pneumonia iscaused by bacteria, they will need antibiotics. Follow your doctor’s treatment plan and keep your child at home until their symptoms have gone.
Keep your child up to date with their recommended vaccinations. Vaccination can prevent someillnesses that lead to pneumonia.
Teach your child to cough or sneeze into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough or sneeze into their inner elbow instead of their hands.
Sometimes children recovering from pneumonia no longer have a fever and are back to normal activities, but still have an occasional cough. If this applies to your child, check with your childcare provider about whether they can return to care.
More information about pneumonia
See healthdirect for more information on prevention, diagnosis and treatment of pneumonia (healthdirect.gov.au/pneumonia). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Rashes are common among children. Many rashes do not need urgent attention, especially if the child is happy and the rash does not appear to bother them.
Urgent medical attention is needed if a child has a rash of flat spots that do not whiten if you press on them. The spots can be very small or quite large, and are coloured red or purple. These rashes are caused by burst blood vessels under the skin. They may indicate a serious infection such as meningococcal disease.
Some rashes can be a sign of a severe allergic reaction (anaphylaxis). The parents of children who are known to have severe, life-threatening allergies should provide the education and care service with an anaphylaxis action plan for their child. Staff should follow this plan if the child has an anaphylactic reaction.
Exclusion period
Exclude if rash develops rapidly or it is combined with fever or other concerning symptoms. Otherwise not excluded.
How it spreads
Spread depends on the cause of the rash. Most rashes are not infectious, but ringworm and school sores are.
Actions for educators and other staff
Follow exclusion period recommendations.
Ensure staff and children practise cough and sneeze etiquette and effective hand hygiene.
Ensure staff use appropriate cleaning practices.
Actions for parents and carers
If your child is unwell, take them to the doctor to find out what is causing the rash.
Your child should stay at home until they are feeling well, especially if the rash is infectious.
Teach your child to cough or sneeze into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough or sneeze into their inner elbow instead of their hands.
Make sure your child washes their hands thoroughly and frequently if they have an infectious rash.
More information about rash
See healthdirect for more information on prevention, diagnosis and treatment of serious rashes in children (pregnancybirthbaby.org.au/serious-childhood-rashes). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Respiratory symptoms include cough, sneezing, runny or blocked nose, and sore throat. Australian preschoolers have around 6 respiratory tract infections per year, which are usually caused by viruses. Cough is a common sign of illness in children. The most common cause of cough is an infection of the respiratory tract, like a cold.
A runny or blocked nose is a common symptom and can be caused by many different conditions or diseases. Some causes are infectious, such as a cold, the flu (influenza), COVID-19, respiratory syncytial virus, or other viral infection. Some causes are not infectious, such as allergies (hayfever) or having something stuck in the nose.
A sore throat often results from an infection with a virus. Viral sore throats are not usually serious and disappear in a few days. Bacterial sore throats can be caused by a streptococcal infection.
Exclusion period
Exclude based on symptoms; otherwise not excluded. If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), exclude them if:
- the respiratory symptoms are new and getting worse (more frequent or severe), or
- they also have concerning symptoms (fever, rash, tiredness, pain, poor feeding).
A person can often have an ongoing cough after they have recovered from a respiratory infection. If their other symptoms have gone and they are feeling well, they can return to the service.
How it spreads
Short-term cough can be caused by viruses that spread when infected people cough or sneeze on or near others. Long-term cough (lasting more than 3 weeks) may have other causes. For information on other things that can cause coughs, see healthdirect (healthdirect.gov.au/coughs-and-colds-in-children). Viruses that cause runny or blocked nose and sore throat spread from person to person via droplets in the air containing the virus. People get infected by:
- breathing in droplets when an infected person breathes, coughs or sneezes on them or near them
- touching a surface contaminated with droplets – for example, hands, tissues, toys or eating utensils – and then touching their eyes, nose or mouth.
Actions for educators and other staff
Follow exclusion period recommendations.
Ensure staff and children practise cough and sneeze etiquette and effective hand hygiene.
Ensure staff use appropriate cleaning practices.
Actions for parents and carers
If your child has respiratory symptoms, keep them at home until they are feeling well.
Teach your child to cough into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough into their inner elbow instead of their hands.
Make sure your child washes their hands thoroughly and frequently.
Clean surfaces that your child has touched, sneezed on, or coughed on to reduce the risk of spreading the infection to others at home.
See your doctor if your child’s runny or blocked nose gets worse over time, or lasts for more than a week.
More information about respiratory symptoms
See healthdirect for more information on prevention, diagnosis and treatment of cough and colds in children (healthdirect.gov.au/coughs-and-colds-in-children). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Roseola is caused by a virus. It is a mild disease and is common in children aged 6 months to 3 years. It usually begins with a high fever that starts suddenly. The fever lasts 3 to 5 days and then a rash appears, usually as the child’s temperature returns to normal. The rash is usually fine, raised, red spots and can last from several hours to several days. The rash first appears on the trunk of the body and spreads to the arms and legs. The rash turns white (blanches) when pressed.
Exclusion period
Not excluded.
How it spreads
Roseola spreads to others before symptoms appear in the infected child. Once your child has a fever and/or rash, they are no longer contagious. Roseola spreads from person to person via droplets in the air that contain the virus. People get infected by:
- breathing in droplets when an infected person breathes, coughs or sneezes on them or near them
- direct contact with infected saliva (such as through sharing a cup or eating utensils)
- touching a surface contaminated with droplets – for example, hands, tissues or toys – and then touching their eyes, nose or mouth.
Actions for educators and other staff
Ensure staff and children practise cough and sneeze etiquette and effective hand hygiene.
Ensure staff use appropriate cleaning practices.
Actions for parents and carers
It is best to keep your child at home until their fever has resolved and they are feeling well.
Teach your child to cough or sneeze into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough or sneeze into their inner elbow instead of their hands.
Make sure your child washes their hands thoroughly and frequently.
More information about roseola
See healthdirect for more information on prevention, diagnosis and treatment of roseola (healthdirect.gov.au/roseola-infantum). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Rotavirus is a common cause of gastroenteritis (or ‘gastro’) in children. Symptoms include vomiting, fever and watery diarrhoea. It usually starts suddenly. Rotavirus mainly affects infants and young children up to 3 years of age. In temperate regions of Australia, rotavirus peaks in mid to late winter. In the northern tropical and arid regions of Australia, disease peaks are less predictable. Rotavirus gastroenteritis can cause dehydration because of the fluid losses through vomiting and diarrhoea. There is a vaccine against rotavirus infection that is included in the Australian National Immunisation Program. Rotavirus vaccination is effective in preventing severe disease that would have otherwise required medical review or a hospital admission.
Exclusion period
Exclude until there has not been any diarrhoea or vomiting for 24 hours.
Staff members with these symptoms should not handle food until they have not vomited or had diarrhoea for 48 hours (they can be assigned to other duties after 24 hours, or stay away from the service for 48 hours).
Check if your state or territory has different requirements for gastroenteritis.
How it spreads
The disease spreads when rotavirus enters the body by the mouth. This can happen when:
- infected people do not wash their hands effectively after using the toilet and their hands contaminate food or surfaces
- people inhale droplets produced when an infected person vomits
- people don’t wash their hands effectively after changing the nappy of an infected baby.
The virus is relatively resistant to cleaning with disinfectants. This means that it is important to isolate people who are unwell, as well as cleaning bathrooms and high-touch surfaces. This reduces the risk of large outbreaks.
Actions for educators and other staff
Follow exclusion period recommendations. If you have 2 or more cases of gastroenteritis in your service, contact your local public health unit foradvice. This is a legal requirement in some states and territories.
Ensure staff and children practise effective hand hygiene.
Ensure staff use appropriate cleaning practices.
Actions for parents and carers
Make sure your child is vaccinated against rotavirus by being up to date with their childhood immunisations.
Keep your child at home until they are feeling well and have not had any symptoms for at least 24hours.
Keep your child hydrated – consider using an oral rehydration solution from a chemist. See a doctor if your child cannot take extra fluids due to vomiting. Make sure your child washes their hands thoroughly and frequently, especially after going to the toilet.
More information about rotavirus
See healthdirect for more information on prevention, diagnosis and treatment of rotavirus (healthdirect.gov.au/rotavirus). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
RSV is a common virus affecting the lungs and breathing passages. RSV in children usually causes mild to moderate cold-like symptoms lasting from 8 to 15 days. Symptoms include fever, runny nose, coughing and wheezing.
In young children and babies under 12 months old, RSV can cause a chest infection called bronchiolitis. Signs of bronchiolitis include wheezing and difficulty breathing. This may get worse over the first 3 to 4 days of the illness, before starting to improve. Some children and adults (particularly the elderly) need hospital treatment for their RSV lung infection.
Exclusion period
Exclude based on symptoms; otherwise not excluded.
If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), exclude them if:
- the respiratory symptoms are new and getting worse (more frequent or severe), or
- they also have concerning symptoms (fever, rash, tiredness, pain, poor feeding).
A person can often have an ongoing cough after they have recovered from a respiratory infection. If their other symptoms have gone and they are feeling well, they can return to the service.
How it spreads
RSV is very contagious. It spreads quickly from person to person via droplets containing the virus. People can be infected by:
- breathing in droplets when an infected person breathes, coughs or sneezes on them or near them
- touching a surface contaminated with droplets – for example, hands, tissues, toys or eating utensils – and then touching their eyes, nose or mouth.
The virus can live on surfaces for several hours, and on unwashed hands for 30 to 60 minutes. Infected people usually develop symptoms 5 days after exposure to the virus. This can range from 2 to 8 days. People with RSV can usually pass the virus to others for 8 days from the start of their symptoms.
Actions for educators
Follow exclusion period recommendations.
Ensure staff and children have good respiratory and hand hygiene.
Ensure staff are using appropriate cleaning practices.
If you have several cases of flu-like illness in your service, contact your public health unit for advice.
Actions for parents
Keep your child at home until their symptoms have gone or substantially improved.
Teach your child to cough or sneeze into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough or sneeze into their inner elbow instead of their hands.
Clean surfaces that your child has touched, sneezed on, or coughed on to reduce the risk of the infection spreading to others at home.
More information about RSV
See healthdirect for more information on prevention, diagnosis and treatment of RSV (healthdirect.gov.au/respiratory-syncytial-virus-rsv). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Rubella is caused by a virus and is usually a mild illness. Symptoms begin like a cold, with a slight fever, sore throat and enlarged glands in the neck. The characteristic rash appears 2 to 3 days later, beginning on the face and spreading to the trunk. The spots are pale pink at first and merge to form patches. The rash disappears after a few days.
Rubella is now rare in Australia because we have a vaccine. It is included in the Australian National Immunisation Program, with the first dose recommended at age 12 months.
Exclusion period
Exclude until the person has fully recovered or for at least 4 days after the rash appears.
How it spreads
Rubella spreads from person to person via droplets in the air that contain the virus. People can be infected by:
- breathing in droplets when an infected person breathes, coughs or sneezes on them or near them
- direct contact with infected saliva – for example, sharing a cup or eating utensils with an infected person
- touching a surface contaminated with droplets – for example, hands, tissues or toys – and then touching their eyes, nose or mouth.
Risks in pregnancy
If a woman catches rubella during pregnancy, the virus can pass to her baby through the bloodstream. If this happens, there is a risk of miscarriage or serious birth defects, especially if infection occurs in the first 16 weeks of pregnancy.
If you are pregnant and have been exposed to rubella, see your doctor to get a blood test to check if you are immune. You can protect yourself by getting vaccinated before becoming pregnant. For more information, see pregnancybirthbaby.org.au/rubella-and-pregnancy.
Actions for educators and other staff
Follow exclusion period recommendations.
Contact your local public health unit for advice if you have a case of rubella in your service.
All staff should be immunised. However, vaccination during pregnancy is not recommended.
If pregnant staff members are concerned, refer them to their doctor.
Ensure staff and children practise cough and sneeze etiquette and effective hand hygiene.
Ensure staff use appropriate cleaning practices.
Actions for parents and carers
Make sure your child is vaccinated against rubella by keeping up to date with their childhood immunisations.
If your child has rubella, keep them at home for at least 4 days after the rash appears, and until they are feeling well again.
Advise any pregnant friends or family who may have been exposed to see their doctor.
Teach your child to cough or sneeze into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough or sneeze into their inner elbow instead of their hands.
Make sure your child washes their hands thoroughly and frequently.
More information about rubella
See healthdirect for more information on prevention, diagnosis and treatment of rubella (healthdirect.gov.au/rubella-german-measles). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Salmonella is a germ that causes gastroenteritis. Symptoms include diarrhoea (sometimes with blood or mucus in the faeces), fever, stomach pain, nausea and vomiting. The severity of the symptoms depends on the number of germs swallowed, the person’s age and their general health. Specific types of Salmonella cause typhoid and paratyphoid fever (see separate fact sheet). These can be more severe abdominal infections, but are generally only reported in returned travellers from countries where typhoid is common.
Exclusion period
Exclude until there has not been any diarrhoea or vomiting for 24 hours.
Staff members with these symptoms should not handle food until they have not vomited or had diarrhoea for 48 hours (they can be assigned to other duties after 24 hours, or stay away from the service for 48 hours).
Check if your state or territory has different requirements for gastroenteritis.
How it spreads
A person gets the disease by swallowing the germs. This can happen by:
- eating undercooked meat, especially chicken
- eating cooked food that has been contaminated with germs from raw food
- handling infected animals and not washing your hands afterwards.
Infection can also spread from person to person when:
- people with the germ in their faeces do not wash their hands well after going to the toilet – the virus on their hands can contaminate food that other people eat, or they contaminate other things that people touch
- people don’t wash their hands well enough when changing the nappy of an infected infant.
Actions for educators and other staff
Follow exclusion period recommendations.
If you have 2 or more cases of gastroenteritis in your service, contact your local public health unit for advice. This is a legal requirement in some states and territories.
Ensure staff and children practise effective hand hygiene, especially after handling any animals.
Ensure staff use appropriate cleaning practices.
Actions for parents and carers
Keep your child at home until they are feeling well and the diarrhoea has stopped for at least 24hours (or as advised by your service).
Make sure your child washes their hands thoroughly and frequently, especially after handling any animals.
More information about Salmonella infection
See healthdirect for more information on prevention, diagnosis and treatment of Salmonella infection (healthdirect.gov.au/salmonella). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Scabies is an infestation of the skin by tiny, insect-like creatures called mites. Scabies affects people of all ages, sexes, races and standards of personal hygiene. Having scabies does not mean that people are unclean. Scabies is specific to humans. Animals can get mite infections that look the same, but they don’t cause disease in humans. The tiny mites burrow under the skin, and itchy red bumps or blisters appear, especially on skin folds around the fingers, toes, wrists, elbows, armpits, waistline, thighs, genitals, stomach and bottom. Children under 2 years are likely to be infected on the head, neck, palms and soles of the feet, but they can have mites all over their body. People with scabies usually have itchy skin. Scratching can break the skin, allowing germs to enter and cause other dangerous infections on top of the scabies (for example, acute rheumatic fever).
Exclusion period
Exclude until the day after starting appropriate treatment.
How it spreads
Scabies usually spreads by prolonged skin-to-skin contact with an infected person – a quick handshake or hug will usually not spread the disease. Mites can sometimes spread on clothes or bedding that has been freshly contaminated by an infected person, but the mites can only live away from the body for 2 to 3 days.
Actions for educators and other staff
Follow exclusion period recommendations.
Ensure staff and children practise effective hand hygiene.
Ensure staff use appropriate cleaning practices. Wash bed linen used by children with mites in the 48 hours before treatment starts, using hot water and detergent. Place items that cannot be washed or dry-cleaned (such as toys, cushions and pillows) out in the sun for 2 or 3 hours to kill the mites.
Actions for parents and carers
Keep your child at home until the day after they have started treatment.
Treat all people who have skin-to-skin contact with your child, and other people in the household, at the same time, even if they have no itching or other symptoms.
Make sure your child washes their hands thoroughly and frequently.
Wash contaminated bedding or clothes used by people with the mites in hot water and detergent. These things are contaminated if the person used them in the 48 hours before treatment starts. Place items that cannot be washed or dry-cleaned (such as toys, cushions and pillows) out in the sun for 2 or 3 hours to kill the mites.
More information about scabies
See healthdirect for more information on prevention, diagnosis and treatment of scabies (healthdirect.gov.au/scabies). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Shigella is a germ that causes a severe bowel infection. It is a type of gastroenteritis. Symptoms include diarrhoea (sometimes containing blood or mucus), fever, vomiting and stomach cramps. Some infected people have no symptoms. Even very small numbers of the germs can cause an infection, so strict control measures are needed to stop it spreading.
Exclusion period
Exclude until there has not been any diarrhoea or vomiting for 24 hours.
Staff members with these symptoms should not handle food until they have not vomited or had diarrhoea for 48 hours (they can be assigned to other duties after 24 hours, or stay away from the service for 48 hours).
Check if your state or territory has different requirements for gastroenteritis.
How it spreads
Shigella spreads from person to person when people swallow the germs. This can happen when:
- people with the germ in their faeces do not wash their hands well after going to the toilet – the germ on their hands can contaminate food that other people eat, or contaminate other things that people touch
- people don’t wash their hands well enough when changing the nappy of an infected baby.
Actions for educators and other staff
Follow exclusion period recommendations.
If you have 2 or more cases of gastroenteritis in your service, contact your local public health unit for advice. This is a legal requirement in some states and territories.
Ensure staff and children practise effective hand hygiene.
Ensure staff use appropriate cleaning practices.
Actions for parents and carers
Keep your child at home until they are feeling well and diarrhoea has stopped for at least 24 hours.
Make sure your child washes their hands thoroughly and frequently, especially after going to the toilet.
More information about Shigella infection
See healthdirect for more information on prevention, diagnosis and treatment of shigella infection (healthdirect.gov.au/shigella-bowel-infection). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Shingles (also called herpes zoster) is a painful, blistering rash. It is caused when the virus that causes chickenpox (varicella-zoster virus) reactivates in the body. Shingles only affects people who have previously had chickenpox. Shingles can affect people of any age, but is more common in those over 50. It rarely affects children under 3 years old. If someone gets shingles, prompt treatment with antivirals can reduce the severity and duration of the disease. Antivirals should be started as soon as possible after diagnosis.
Exclusion period
Exclude children until blisters have dried and crusted.
Adults who can cover the blisters are not excluded (they are excluded if blisters can’t be covered).
How it spreads
Shingles itself does not spread between people. However, the varicella-zoster virus can spread from someone with shingles to others. This can cause chickenpox in people who are not immune.
The virus spreads through airborne droplets when an infected person coughs or talks. It can also spread if someone touches the fluid from the blisters and then touches their mouth, nose or eyes.
Risks in pregnancy
If you are infected with the varicella-zoster virus in the first 3 months of pregnancy, it may affect your unborn child.
Seek medical advice within 48 hours if you are exposed to someone who has shingles and you are pregnant, have not had chickenpox before, and have not been vaccinated. You may need a blood test to check if you have antibodies against the virus. If you don’t, you will need an injection of antibodies (known as varicella-zoster immunoglobulin, or VZIG).
You can be vaccinated against chickenpox, but vaccination is not recommended during pregnancy. Pregnancy should also be avoided for month after having a chickenpox vaccination.
Actions for educators and other staff
Follow exclusion period recommendations.
Talk to your public health unit for advice about pregnant women and anyone who is immunocompromised.
Anyone who works with children and has not previously had chickenpox should be immunised against chickenpox, or be certain that they are immune by having a blood test. Immunisation against shingles is also available. It is not free for people aged under 70, but staff should consult their doctor if they are interested in getting the shingles vaccine.
Ensure staff and children practise effective hand hygiene.
Ensure staff are using appropriate cleaning practices.
Actions for parents and carers
Keep your child at home until their blisters have dried and crusted. See your doctor if you think your child may have shingles, particularly if the rash is near their eyes.
The childhood vaccination schedule includes vaccinations against varicella (chickenpox). This will protect children who haven’t yet been infected.
More information about shingles
See healthdirect for more information on prevention, diagnosis and treatment of shingles (healthdirect.gov.au/shingles). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
The germ commonly known as staph (Staphylococcus aureus) is often found on the skin and in the nose and throat of healthy people. It generally causes no problems or illness, but sometimes it can cause infections. If the staph germs enter the body through damaged skin, they can cause skin infections such as impetigo (school sores), boils and abscesses. Sometimes they get into the blood and cause blood poisoning (septicaemia).
Staph can also cause food poisoning and lung infection (pneumonia).
Staph is sometimes mentioned in the media when it causes outbreaks of infections in hospitals or in the community. These outbreaks are caused by a type of staph known as golden staph. Golden staph causes the same kinds of infections as other types of staph. It is not more infectious, but it is more difficult to treat because it is resistant to commonly used antibiotics.
Exclusion period
Exclude until the person has received antibiotic treatment for at least 24 hours and feels well.
How it spreads
Staph skin infections spread from person to person by:
- directly touching infected areas of the skin, or by people touching their sores and then touching other people without washing their hands touching a surface contaminated with the germs – for example, clothing, tissues or toys.
- People usually get staph food poisoning if infected people who have not washed their hands well enough touch food that other people eat.
Actions for educators and other staff
Follow exclusion period recommendations.
Where possible, ensure that sores are covered with a waterproof dressing. Put all dressings in a lidded bin as soon as they are removed.
Ensure staff and children practise effective hand hygiene.
Ensure staff use appropriate cleaning practices.
Actions for parents and carers
If your child’s doctor has prescribed antibiotics, make sure your child takes the full course.
If your child has sores, cover them with a waterproof dressing where possible. Keep your child at home until sores have dried completely.
Make sure your child washes their hands thoroughly and frequently, especially if they touch sores.
More information about staph infection
See healthdirect for more information on prevention, diagnosis and treatment of staph infection (healthdirect.gov.au/staph-infections).
To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Strep throat is a type of throat infection caused by germs (bacteria) called Streptococcus pyogenes (Group A Streptococcus). The symptoms of strep throat can range from mild to severe. They include sore throat, painful swallowing, fever, swollen glands in the neck, and loss of appetite. Serious but uncommon complications of strep throat include scarlet fever, rheumatic fever, and kidney disease.
Exclusion period
Exclude until the person has received antibiotic treatment for at least 24 hours and feels well.
How it spreads
Strep throat spreads from person to person via infected droplets in the air. People get infected by:
- breathing in droplets when an infected person breathes, coughs or sneezes on them or near them
- direct contact with infected saliva – for example, sharing a cup or eating utensils with an infected person
- touching a surface contaminated with droplets – for example, hands, tissues or toys – and then touching their eyes, nose or mouth.
Actions for educators and other staff
Follow exclusion period recommendations.
Ensure staff with sore throats stay at home until they are feeling well.
Ensure staff and children practise cough and sneeze etiquette and effective hand hygiene.
Ensure staff use appropriate cleaning practices.
Actions for parents and carers
If you think your child has strep throat, see your doctor. They may need to take a course of antibiotics.
Keep your child at home until they have been on antibiotic treatment for at least 24 hours and are feeling well.
Teach your child to cough or sneeze into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough or sneeze into their inner elbow instead of their hands.
Make sure your child washes their hands thoroughly and frequently.
More information about strep throat
See healthdirect for more information on prevention, diagnosis and treatment of strep throat (healthdirect.gov.au/strep-throat).
To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Thrush is caused by a germ (yeast infection) called Candida. Most people have this germ on their skin, in their mouth and in their gut, where it doesn’t cause any trouble. However, it can sometimes cause infections, especially in moist places such as babies’ mouths, in skin folds or in the nappy area. It is often associated with nappy rash – if a nappy rash is not clearing after 3 days or not responding to the usual barrier cream, it may be thrush. Thrush is usually associated with irritation of the involved skin, but it is not usually dangerous. Thrush can also infect the vagina, or the nipples of breastfeeding mothers. Thrush may appear as white spots or flakes. When the skin is involved it usually appears red with small spots or pimples (pustules) in the surrounding area.
Exclusion period
Not excluded.
How it spreads
Thrush spreads from person to person by direct contact with the germs living on the skin, in the mouth or vagina, or in faeces. A baby may pick up Candida during birth. Candida lives in the human digestive tract from early infancy. Most of the time it does not cause disease.
Actions for educators and other staff
Do not allow children to share dummies, cups or eating utensils.
Regularly wash toys and other objects that children put in their mouths.
Ensure staff and children practise effective hand hygiene.
Ensure staff use appropriate cleaning practices.
Actions for parents and carers
Use the online symptom checker (see below) or see a pharmacist or GP to decide if your child needs treatment.
Clean and sterilise your baby’s bottle teats and dummies, and replace them regularly.
Do not share your baby’s eating utensils, food or drinking cups.
Thoroughly wash toys that your baby or toddler puts in their mouth.
More information about thrush
See healthdirect for more information on prevention, diagnosis and treatment of thrush (healthdirect.gov.au/oral-thrush). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Toxoplasmosis is an infection caused by a parasite called Toxoplasma gondii. The parasite is found in all parts of the world. Toxoplasmosis is rarely a serious illness in healthy children or adults. Most people have no symptoms when infected with Toxoplasma gondii, but a minority will experience a flu-like illness, sometimes with swollen neck glands. It can, however, cause serious illness if a person’s immune system is compromised by illnesses such as cancer.
Exclusion period
Not excluded.
How it spreads
People may become infected through:
- eating raw or undercooked meat
- contact with environments contaminated by cat faeces (poo), such as cat litter boxes or soil
- eating raw food (vegetables or salad) or drinking water contaminated with cat faeces.
Risks in pregnancy
If you are infected with Toxoplasma gondii during pregnancy, it may pass to your baby through the bloodstream. Serious malformations may result, especially if infection occurs during the first half of pregnancy. If you are pregnant and have been exposed to toxoplasmosis, see your doctor to check if you are immune, or if you need treatment. If you are pregnant, avoid:
- cleaning cat litter trays
- eating raw or undercooked meat
- drinking untreated water
- contact with soil (for example, gardening; or wash hands thoroughly after gardening or spending time outdoors)
- eating raw fruit or vegetables without thoroughly washing and peeling beforehand.
For more information, see pregnancybirthbaby.org.au/toxoplasmosis.
Actions for educators and other staff
Ensure staff and children practise effective hand hygiene.
Ensure staff use appropriate cleaning practices.
Cover sandpits used by children when not in use.
Actions for parents and carers
Make sure your child washes their hands thoroughly and frequently, especially after playing outdoors or after touching pet cats.
Make sure you wash your hands thoroughly before and after meals and after handling raw meat. Wash knives and other kitchen utensils thoroughly after they have been in contact with raw meat.
Cook meat well, and wash all raw fruit and vegetables carefully before eating.
Dispose of cat droppings and dirty litter daily, because it can become infectious after 24 hours. If you are pregnant, get someone else to clean out your cat’s litter tray.
Cover your children’s sandpit when they are not playing in it to stop animal droppings getting in it.
More information about toxoplasmosis
See healthdirect for more information on prevention, diagnosis and treatment of toxoplasmosis (healthdirect.gov.au/toxoplasmosis). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Trachoma is an eye infection caused by a bacteria called Chlamydia trachomatis. Symptoms include red, sticky, itchy or painful eyes. Children may not show symptoms of trachoma, but repeated infections can cause blindness in adulthood. Trachoma can be treated with a single dose of an antibiotic. If left untreated, it can cause the eyelid to turn inward. The person's eyelashes then rub on the surface of the eye, damaging it. In Australia, trachoma is more common in remote areas with limited access to water, which makes good hygiene more difficult.
Exclusion period
Exclude until appropriate antibiotic treatment has started, and talk to your local public health unit for advice.
How it spreads
Trachoma spreads when people have contact with fluid from the eyes and nose of infected people. It can spread when people share face cloths or towels. Flies can also spread the bacteria between people.
Actions for educators
Contact your local public health unit for advice if you have a case of trachoma in your service.
Follow exclusion period recommendations.
Ensure staff and children wash their hands and do not share towels or face cloths.
Ensure staff are using appropriate cleaning practices.
Actions for parents
If your child has trachoma, your child and everyone who lives in the same house with them will need to get antibiotic treatment from your doctor.
You can help prevent repeated trachoma infections by teaching your child to wash their hands and face well, and making sure family members don't share face cloths or towels.
More information about trachoma
See healthdirect for more information on prevention, diagnosis and treatment of trachoma (healthdirect.gov.au/trachoma). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Tuberculosis (TB) is an infection that can affect almost any part of the body, but it mostly affects the lungs. It is rare in Australia but is very common in other areas of the world. People with TB may have symptoms such as fever, tiredness, sweating (especially at night), weight loss and a persistent cough that does not go away with normal treatment. The cough may produce phlegm and sometimes blood. A chest X-ray can help diagnose TB. TB infection and TB disease are different. People with TB disease are ill because the germs are active in their body. They usually have one or more symptoms of TB. These people can spread TB to others. People with TB infection (but not TB disease) have the germs that cause TB in their body, but they are not ill because the germs are not actively causing disease. These people cannot spread the infection to others. Most people with TB infection do not become ill. However, the TB germs can remain within their body for years.
Exclusion period
Talk to your local public health unit for advice about exclusion.
How it spreads
TB spreads from person to person via infected droplets in the air. People get infected by breathing in droplets when a person with active TB disease breathes, coughs or sneezes on them. Remember, people who are infected with TB but who do not have TB disease can't spread the infection.
Actions for educators and other staff
Follow exclusion period recommendations.
Talk to your public health unit for advice about screening, antibiotics or accessing TB clinics.
Ensure staff and children practise cough and sneeze etiquette and effective hand hygiene.
Ensure staff use appropriate cleaning practices.
Actions for parents and carers
Keep your child at home until the local public health unit says they can return to care.
Teach your child to cough or sneeze into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough or sneeze into their inner elbow instead of their hands.
More information about TB
See healthdirect for more information on prevention, diagnosis and treatment of TB (healthdirect.gov.au/tuberculosis). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Typhoid is a serious bacterial illness that needs immediate treatment. Symptoms usually develop to 3 weeks after exposure, and include fever, headache, tiredness and stomach pain. Tyhoid is caused by infection with the bacterium Salmonella Typhi. Paratyphoid fever is a similar illness caused by a different but related bacterium, Salmonella Paratyphi. Paratyphoid infections are usually less severe than typhoid infections. Typhoid and paratyphoid are not common in Australia, but people can catch them if they travel to countries where they are common, such as parts of India, Africa, Asia, South and Central America and the Middle East. There is a vaccine available to prevent typhoid fever, but no vaccine available for paratyphoid fever.
Exclusion period
Exclude until cleared by the local public health unit.
Contacts: Talk to your local public health for advice.
How it spreads
The bacteria causing these diseases are found in the faeces (poo) and urine of infected people. These diseases usually spread when people drink water or eat food that is contaminated with the bacteria. It can also spread if people touch contaminated surfaces such as taps, toilets, cutlery, toys and nappies.
Some people are carriers, which mean they have the bacteria in their faeces but don’t have symptoms of the disease.
Actions for educators and other staff
Follow exclusion period recommendations.
Contact your local public health unit for advice if you have a case of typhoid or paratyphoid in your service.
Ensure staff and children wash their hands after using the toilet.
Ensure staff are using appropriate cleaning practices.
Actions for parents and carers
See a doctor immediately if you think your child may have typhoid or paratyphoid.
Follow exclusion period recommendations. You will need a medical certificate of recovery before your child can return to the care service.
Make sure you and your child wash their hands regularly, especially after going to the toilet or changing nappies.
If you are planning to travel to a country where typhoid is common, you can get vaccinated before you go. See your doctor at least 6 weeks before you travel.
More information about typhoid and paratyphoid fever
See healthdirect for more information on prevention, diagnosis and treatment of typhoid and paratyphoid fever (healthdirect.gov.au/typhoid-and-paratyphoid). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Warts are skin growths that are usually harmless. They look like thickened skin that is clearly different from the skin around them. They are usually round or oval shaped. Warts are caused by a virus (called the human papillomavirus) that enters the skin through scratches or other skin damage. There are several types of warts and they can appear in different places on the body. Mostly, there are only or 2 warts, but sometimes there can be a lot in one area.
Exclusion period
Not excluded.
How it spreads
Warts can spread to other people, usually from skin-to-skin contact with another person. Picking or scratching warts can mean the warts are spread to other parts of the infected person’s body. Warts can also be spread by touching contaminated surfaces.
Actions for educators and other staff
Ensure staff and children practise effective hand hygiene.
Ensure staff use appropriate cleaning practices.
Actions for parents and carers
Try to stop your child picking or scratching the warts.
Make sure your child washes their hands thoroughly and frequently, especially if they touch the warts.
More information about warts
See healthdirect for more information on prevention, diagnosis and treatment of warts (healthdirect.gov.au/wart-treatments). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Whooping cough (pertussis) is a highly infectious disease caused by infection of the throat with a germ called Bordetella pertussis. It can affect babies, children and adults. Vaccination can prevent whooping cough. The disease usually starts like a cold, with a runny nose, tiredness and sometimes a mild fever. Then a cough develops. Usually the person coughs in short bouts that may be followed by a characteristic deep gasp, or whoop. Not every person makes the whooping sound – this is more common in children who are not vaccinated. The cough can last up to 3 months. Babies may stop breathing and sometimes turn blue during a coughing fit. About a quarter of children who catch the disease also develop a lung infection (pneumonia). Some children have fits (convulsions), and some develop swelling of the brain (encephalitis). Whooping cough is particularly serious in children under 12 months, and they often have to go to hospital if they catch it. Teenagers and adults may just have a persistent cough.
Exclusion period
Exclude until 5 days after starting appropriate antibiotic treatment, or for 2 days from the onset of coughing if they don’t receive antibiotics.
Contacts: Talk to your local public health for advice about excluding unvaccinated contacts.
How it spreads
Whooping cough spreads from person to person via infected droplets in the air. People get infected by:
- breathing in droplets when an infected person breathes, coughs or sneezes on them
- touching a surface contaminated with droplets – for example, hands, tissues, toys or eating utensils – and then touching their face.
Risks in pregnancy
If you catch whooping cough while you are pregnant, it can pass to the baby after birth and cause severe disease and even death. If you are 20 to 32 weeks pregnant, you can get a free vaccination under the National Immunisation Program. For more, see pregnancybirthbaby.org.au/whooping-cough-and-pregnancy.
Actions for educators and other staff
Follow exclusion period recommendations.
Contact your local public health unit for advice if you have a case of whooping cough in your service.
Review vaccination records of all staff and children.
Ensure staff and children practise cough and sneeze etiquette and effective hand hygiene.
Ensure staff use appropriate cleaning practices.
Actions for parents and carers
Make sure your child is fully vaccinated against whooping cough.
If your child has whooping cough, see your doctor straight away so they can treat your child with an effective antibiotic.
Keep your child at home for the recommended exclusion period. Keep them away from other children during this time. Tell your friends and contacts that your child has whooping cough.
Teach your child to cough or sneeze into a tissue, then throw the tissue into a bin and wash their hands. If there are no tissues nearby, teach them to cough or sneeze into their inner elbow instead of their hands.
Make sure your child washes their hands thoroughly and frequently.
More information about whooping cough
See healthdirect for more information on prevention, diagnosis and treatment of whooping cough (healthdirect.gov.au/whooping-cough). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.
Many types of worms can infect people. In Australia, threadworm (also called pinworm) is the most common worm in children, but worms can infect people of any age. Threadworms are small, white, thread-like worms that are 2 to 13 millimetres long. The worms only infect humans, so children cannot catch threadworms from pets. Other types of worms include roundworms, hookworms and tapeworms. One type of tapeworm, called hydatids, can cause hydatid disease. In people, the baby hydatids live inside fluid-filled ballscalled cysts that can grow in many different parts of the body, but mostly in the liver and lungs. Hydatid disease is more common in rural communities where dogs and livestock interact.
Exclusion period
Not excluded.
How it spreads
Threadworms
People get threadworms by swallowing worm eggs. Worm eggs are picked up and transferred to the mouth when an infected person scratches their bottom and then touches their mouth, or when they don’t wash their hands properly after going to the toilet. This keeps this infection going. The eggs can also be transferred to bedding, clothes and other surfaces, where other people can pick them up. Eggs can survive on surfaces for up to 2 weeks.
Hydatids
In Australia, people mostly get hydatids from infected dogs, but dingoes and foxes can also spread the infection. Animals such as sheep, goats, cattle and kangaroos spread the infection to dogs. People get infected by swallowing eggs passed in the droppings of an infected dog. This may happen when a person handles infected dogs, or things soiled with infected dog droppings, and then touches their mouth. They can also get infected if they swallow food or water contaminated with dog droppings. Hydatid disease does not spread directly from person to person, and a person cannot get infected by eating the meat of infected sheep or cattle.
Actions for educators and other staff
Ensure staff and children practise effective hand hygiene, especially after touching animals and before preparing or eating food.
Ensure any dogs that visit the service are regularly treated for worms.
Ensure staff use appropriate cleaning practices.
Actions for parents and carers
To minimise the chance of your child getting any kind of worms, make sure they wash their hands thoroughly and frequently. This is especially important after going to the toilet or touching animals, and before eating.
Threadworms
- You can get an effective treatment for threadworms from your chemist. You should treat all family members. Follow the directions on the label.
- Change bed linen and underwear daily for several days after treatment. Washing clothes and bed linen in hot water will kill threadworm eggs.
- Keep children’s fingernails short.
Hydatids
Prevention is important as treatment can be complicated.
- Regularly treat your dog for worms.
- Don’t let dogs lick people on the face.
- Dispose of dog droppings regularly, wearing gloves.
- Don’t feed dogs raw offal meat (such as liver or kidneys) because this is how they can become infected.
More information about worms
See healthdirect for more information on prevention, diagnosis and treatment of worms (healthdirect.gov.au/worms-in-humans). To find out if a child needs medical help, you can:
- use the online symptom checker (healthdirect.gov.au/symptom-checker)
- speak to a registered nurse by calling the 24-hour health advice hotline on 1800 022 222.