Overview
The table below summarises some key features regarding childhood infections and school exclusion.
| Infection | Key features | School exclusion |
| Chickenpox | Febrile prodromeItchy, vesicular rash, starting on the head and trunk before spreading Crusting occurs within 5 days of the rash | Exclude until all vesicles have crusted over (around 5 days after rash onset) Avoid contact with pregnant and immunocompromised people |
| Measles | Febrile prodrome and conjunctivitis Koplik’s spots Rash on ears and face before spreading to the rest of the body Notifiable disease – notify Public Health England | Exclude for at least 4 days after the initial development of rash, ideally until full recovery |
| Mumps | Febrile prodrome may be present Parotitis – bilateral in 75% of cases Orchitis may occur Notifiable disease – notify Public Health England | Exclude for 5 days from the onset of parotid gland swelling. |
| Rubella | Febrile prodrome may be present Pink/light-red maculopapular rash starting on the face before spreading to the body Suboccipital/post-auricular lymphadenopathy may be present Notifiable disease – notify Public Health England | Exclude for 5 days after the initial rash Avoid contact with pregnant people |
| Parvovirus B19 | Biphasic illness with febrile prodrome 1-2 days before the rash Rash develops as the child gets better – erythematous and macular on one or both cheeks resembling ‘slapped cheeks’ Rash may spread to the torso and extremities and becomes reticular | Exclusion is not necessary 1 day after the presence of a rash – no longer infectious at this point Avoid contact with pregnant people |
| Roseola | Febrile prodrome 3-5 days before the rash Rash – maculopapular rash on the trunk before spreading to the face, neck, and arms The rash itself does not usually cause discomfort and is not itchy Febrile convulsions occur in up to 15% of patients | Exclusion is not necessary |
| Scarlet fever | Due to Group A Streptococcus (Streptococcus pyogenes) Febrile prodrome for 12-48 hours with a sore throat Blanching rash on the trunk spreading to the rest of the body – red, pinpoint (punctuate), generalised, and rough (sandpaper-like) Rash may be accentuated in skin folds Strawberry tongue Circumoral pallor Notifiable disease – notify Public Health England | Exclude until 24 hours after taking antibiotics |
| Hand, foot, and mouth disease | Due to coxsackie A16 or enterovirus 71 Febrile prodrome followed by oral ulcers within 1-2 days Macules and papules appear on the hands and feet soon after the oral ulcers | Exclusion is not necessary |
