Infectious diseases in children

A child with an infectious disease may show general signs of illness. This can include fever, shivering, vomiting, diarrhea, etc.  

In these circumstances, parents/guardians should be contacted so that they can collect the child. In the meantime, the child should be kept comfortable away from the other children.  Once they are better they should return unless they pose a risk of infection to others. They should not return to school or nursery until the risk has passed.  

The following table outlines the recommendations for exclusion from school or daycare for particular infectious diseases: 

Rashes and Skin Infections 

Recommended period to be kept away from school and other childcare settings 

Additional Information 

Athlete’s Foot 

None 

Treatment is recommended. 

Chickenpox (Varicella) 

Exclude for five days from the onset of rash 

Preventable by immunization.  

Cold Sores 

None 

Avoid kissing and contact with sores. 

German measles (Rubella) 

Exclude for six days from onset of rash 

 

Preventable by immunization.  

Hand, foot and mouth  

(Coxsackie virus) 

Exclude until blisters are crusted and dried and there are no ulcers in the mouth 

Contact the Epidemiology and Surveillance Unit if a large number of children are affected.  

Impetigo 

Exclude until lesions are crusted and healed, or 24 hours after commencing antibiotic treatment 

Antibiotic treatment speeds healing and reduces the infectious period. 

Measles 

Exclude for four days from onset of rash 

 

Preventable by immunization.  

Molluscum contagiosum 

None 

 

Ringworm - skin/scalp 

Exclusion not usually required 

Treatment is required.  

Roseola (infantum) 

Exclude until fever-free for 24 hours without the use of fever-reducing medications 

 

Scabies 

Exclude until first treatment completed 

Household and close contacts require treatment 

Scarlet fever 

Exclude for 24 hours after commencing appropriate antibiotic treatment, provided he/she has no fever. 

 

Slapped cheek/fifth disease Parvovirous B19 

Exclude until fever-free for 24 hours without the use of fever-reducing medications 

Shingles 

Exclude only if rash is weeping and cannot be covered 

Can cause chicken pox in those who are not immune. It is spread by very close contact and touch.  

Warts and verrucae 

None 

Verrucae should be covered, especially  in swimming pools, gymnasiums and changing rooms 

 

Diarrhoea and Vomiting Illness (including food-borne illness/food poisoning) 

Recommended period to be kept away from school and other childcare settings 

Additional Information 

 (i.e. salmonella, shigella, campylobacter, norovirus, rotavirus, Giardia, etc.) 

Exclude for 48 hours from last episode of diarrhoea or vomiting 

 

 

Further exclusion may be required for young children under five and those who have difficulty in adhering to hygiene practices. 

 

Respiratory Infections 

Recommended period to be kept away from school and other childcare settings 

Additional Information 

Flu (influenza) 

Until recovered 

Immunization recommended annually for all children from 6 months of age.  

Whooping cough (pertussis) 

Exclude for five days after commencing antibiotic treatment, or 21 days from onset of illness if no antibiotic treatment 

Preventable by immunization. After treatment, non-infectious coughing may continue for many weeks. The Epidemiology and Surveillance Unit will organise any contact tracing necessary. 

Strep Throat 

Exclude for 24 hours after commencing appropriate antibiotic treatment, provided he/she has no fever. 

 

 

Other Infections 

Recommended period to be kept away from school and other childcare settings 

Additional Information 

Conjunctivitis 

Exclude until prescribed treatment has been given for 24-48 hours or condition improves. 

If an outbreak/cluster occurs, consult the Epidemiology and Surveillance Unit. 

Diphtheria 

Exclusion is essential until cleared by a physician.  

Preventable by immunization. Family contacts must be excluded until cleared to return by a physician. The Epidemiology and Surveillance Unit must be notified and will organise any contact tracing necessary. 

Mononucleosis 

Exclude until fever-free for 24 hours without the use of fever-reducing medications 

 

Head lice 

Exclude children with live lice until appropriate treatment has begun 

Students diagnosed with live head lice do not need to be sent home early from school; they can go home at the end of the day, be treated, and return to class after appropriate treatment has begun.  

Hepatitis A 

Exclude until seven days after onset of jaundice (or seven days after symptom onset if no jaundice) 

In an outbreak of hepatitis A, The Epidemiology and Surveillance Unit will advise on control measures. 

Hepatitis B, C, HIV/AIDS 

None 

Hepatitis B and C and HIV are blood-borne viruses that are not infectious through casual contact. For cleaning of blood and body fluid spills   

Meningitis (bacterial)/septicemia 

Exclude child has received appropriate antibiotic treatment and is fever-free for 24 hours without the use of fever-reducing medications 

Preventable by immunization. There is no reason to exclude siblings or other close contacts of a case. The Epidemiology and Surveillance Unit will advise on any action needed. 

Meningitis (viral) 

Exclude until fever-free for 24 hours without the use of fever-reducing medications 

Milder illness. There is no reason to exclude siblings and other close contacts of a case.  

MRSA 

None, unless directed by a physician or wound is draining and cannot be covered 

Good hygiene, in particular hand-washing and environmental cleaning, are important to minimise any danger of spread. If further information is required, contact the Epidemiology and Surveillance Unit. 

Mumps 

Exclude until nine days after onset of swelling 

Preventable by immunization. The Epidemiology and Surveillance Unit will organise any contact tracing necessary. 

Pinworms/Thread worms 

None  

In some cases, treatment is recommended for the child and household contacts.  

Tonsillitis 

Exclude until fever-free for 24 hours without the use of fever-reducing medications 

There are many causes, but most cases are due to viruses and do not need an antibiotic. 

For more details, see the

In the event of an outbreak of an infectious disease at a Bermuda school or childcare facility, the Department of Health urges staff to use its

File

to track illnesses.