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Information in English - Communicable disease in childcare 

When should children stay home from childcare? Information for parents and childcare staff

Children who attend childcare centers are more vulnerable to more infections than other children. Usually, the child’s general health condition dictates the need to stay at home for a period, but some diseases may require longer absence to prevent the spread of infection to others.

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Colds, sore throat and ear infections are almost twice as common among childcare children compared with children who are not. Gastrointestinal infections are almost three times as common. In addition, there may be frequent outbreaks of head lice, impetigo and various rashes diseases.

Spread of infections are primarily through direct or indirect contact between children.

Prevention of infectious diseases in the nursery - hygiene advice (Information in Norwegian)
"Good food in childcare" - about food and hygiene advice (booklet from the Directorate of Health 2008) - (Information in Norwegian)

 

When children do not need to stay home

For some diseases, there is no reason to keep the children at home. This may be because the disease is often transmitted before the symptoms occur, or the risk of infection is very small once the child has recovered, or the condition is mild and common.

Examples of these diseases include the fifth disease (erythema infectiosum), mouth sores, warts and foot-and-mouth disease.

 

When to keep sick children home from childcare

Experience shows that strict rules to keep sick children out of childcare have limited effect on the spread of infection. This may be partly because the disease is already infectious before the symptoms appear. Nevertheless, in various cases, a sick child should be kept at home for a period to prevent the spread of infections to other children.

For infectious disease, the child's general condition will often require some time at home and must always be based on the parental discretion. As a rule of thumb, the child should feel well enough to participate in normal activities in childcare and must be free from fever.

For many diseases, such as impetigo, it can be difficult to set an exact time frame for when the child can return to childcare. In such cases, physician or parental assessment is needed.

The following list covers the most common symptoms and diseases among children who attend childcare or lower grades in school.

 

Fever

A child normal temperature may vary. A raised temperature is considered to be higher than 37.5 °C in the morning and 38 °C at night. Children with fever should stay home until the fever has gone, essentially for their own comfort and also to avoid the spread of possible infectious disease.

 

Diarrhea with or without vomiting

Children with diarrhea can return to childcare two days after they have been symptoms-free. This also applies to children who use diapers. Children who normally tend to loose stools do not need to stay home. Parents shall decide whether the child has an abnormal diarrhea condition.

Suspected diarrhea infection through food (such as after travelling abroad), the child should be examined by a doctor and other children in the childcare should be monitored for symptoms.
Diarrhea - helsenorge.no (Information in Norwegian)

 

Conjunctivitis (Pink eye)

There is no reason that children with mild to moderate conjunctivitis should be kept at home. Children who have severe conjunctivitis with abundant discharge should be kept home until the discharge has reduced, to prevent the risk of infections to other children. Severe conjunctivitis will often needed to be checked by a physician and the child's general condition will also largely determine the need to stay at home.

The parents should decide whether a child has conjunctivitis symptoms that must be examined by a doctor. Childcare staff cannot insist that a child with conjunctivitis symptoms must be examined or treated with eye drops before they can return to the kindergarten, but can discuss this with the parents if they are in doubt. If treatment is prescribed, the child may return to childcare the day after the treatment has begun.
Symptoms of conjunctivitis - helsenorge.no (Information in Norwegian)

 

Colds

Colds are the most common infections among children. They can return to childcare once they feel well enough.
Symptoms of colds - helsenorge.no (Information in Norwegian)

 

Influenza-like symptoms

Children can return to childcare once they feel well enough. It may be necessary to keep your child at home longer during influenza pandemics.

Influenza - advice to patients

 

Cough and other respiratory symptoms

Children can return to childcare when they have cough without fever and once they feel well enough. For prolonged or severe coughing, the child should be examined for whooping cough and other diseases.
Advice to the public about the use of antibiotics - for infections in children (Information in Norwegian)

 

Ear infection (Otitis)

Children can return to childcare once they feel well enough.
Advice to the public about the use of antibiotics - for ear infections and other infections (Information in Norwegian)

Otitis - helsenorge.no (Information in Norwegian)

 

Impetigo

Children with impetigo may return to childcare when blisters are under control and once there is no danger of other children to directly or indirectly infect through contact points.
Impetigo - helsenorge.no (Information in Norwegian)

 

Head Lice

If head lice are detected at childcare, it is not necessary to send the child home. The child can continue at childcare as soon as the treatment has begun.
Head lice - questions about lice in school / nursery (Information in Norwegian)

 

Whooping cough (Pertussis)

During early treatment of the disease, the child is usually infected for five days. Once treatment is initiated, the child should be kept home during this period. After the disease became less contagious, children may return to kindergarten after the treatment has begun.

Whooping cough - helsenorge.no (Information in Norwegian)

 

EHEC infection

Children who have been diagnosed with Enterohemorrhagic Escherichia Coli (EHEC) infection must have five negative control samples before the child can return to childcare. Any child who have a household member who had been diagnosed with EHEC infection, should be kept away from kindergarten until they have three negative stool samples.

E. coli - intestinal infection (Information in Norwegian)

 

Mumps

Unvaccinated children diagnosed with mumps can return to childcare nine days after the swelling occurs. If all the other children are vaccinated, the child’s general condition will determine the return to childcare.

 

Rubella

Children can return to childcare not earlier than five days after the rash appears. If the child had been vaccinated, it is unlikely to be rubella.

 

Varicella (chickenpox)

Children can return to childcare after the rash has begun to dry up.

 

Worm (Pin worm) / Roundworm

Children can return to childcare once treatment was initiated.

 

Ringworm

Children can return to childcare once treatment was initiated.

 

Scabies

Children can return to childcare once treatment was initiated.

 

Meningococcal Disease

Children may return to childcare once the illness is over. Siblings of children with meningococcal disease should be suspected as possibly being infected with meningococcal bacteria and should stay home for few days of observation after carrier treatment has begun.
Meningococcal Disease - guide for health) - Health Care (Information in Norwegian)

 

Measles

Children can return to childcare not earlier than four days after the rash appears, and if their general condition otherwise good.

 

Norovirus Infection

The infection risk is highest when symptoms of vomiting and diarrhea are present, children should be kept at home during this period. Wait for at least 48 hours until the diarrhea and vomiting have stopped before returning to childcare.