Paediatric Acute care Guidelines PMH Emergency Department

Many of the childhood infectious diseases require the patient /staff to be excluded from day care or school for a recommended period of time; if they are unable to provide evidence of immunisation against specific diseases that are known to be highly transmissible they will be excluded.

 

 

Background

  • While it is often difficult to prevent the transmission of common respiratory (colds/flu) and gastroenteritis infections that occur, every effort should be made to minimise the spread of infection.
  • Adults and children should stay at home in the early stages of illness as at this stage they can be infectious and shed the virus, bacteria or parasite through coughing, sneezing, contaminating surfaces and personal contact.
 

Management

Exclusion Periods for Communicable Diseases

Disease Exclusion Infectious Periods
Acute Febrile Respiratory Illness Do not exclude Usually for duration of symptoms 
Campylobacter sp Until asymptomatic

2-3 days treated

2-3 weeks untreated

Chicken Pox Exclude from at least 5 days after the rash appears and until vesicles have formed crusts.  Crusts alone do not warrant exclusion. 2 days before rash until all vesicles have formed crusts
Conjunctivitis Exclude until discharge from eyes has ceased While eye discharge is present
Cryptosporidiosis Exclude until diarrhoea has ceased 2-4 weeks
Diarrhoea Exclude until diarrhoea has ceased Days to weeks
Glandular Fever Do not exclude Months
Hand, Foot and Mouth Disease Exclude until vesicles have formed crusts As long as there is fluid in the vesicles.  Faeces remain infectious for several weeks.
 Head Lice Exclude until the day after treatment has commenced  Until lice and eggs are killed 
Haemophilus Influenzae Type B Do not exclude Infectious until treated with antibiotics 
Hepatitis A For 14 days after onset of illness if not jaundiced, or 7 days after jaundice appears 2 weeks before onset of symptoms to 7 days after jaundice appears
Hepatitis B Do not exclude  Weeks before to months after onset.  Carriers may be infectious for life 
Hepatitis C Do not exclude  Weeks before to months after onset. Carriers may be infectious for life 
Herpes Simplex I and II  Young children unable to comply with good oral hygiene practices should be excluded if lesions and uncovered and weeping 2-7 weeks 
HIV Do not exclude  As long as HIV infection persists 
Human Herpesvirus 6 Do not exclude  Unknown 
Impetigo Exclude for 24 hours after antibiotic treatment commenced.  Lesions on exposed skin surfaces should be covered with a waterproof dressing  As long as there is discharge from untreated lesions 
Influenza Do not exclude  Usually 3-7 days from on onset of symptoms
Measles Exclude for 4 days after onset of rash.  Unvaccinated or previously infected contacts should be excluded until 14 days after onset of rash of the last case. 4 days before to 4 days after rash appears
Meningococcal Disease Exclude for 24 hours after antibiotic commenced.  Contacts will be managed by the Department of Health. Until bacteria are no longer present in nose and throat secretions
Molluscum Contagiosum Do not exclude As long as lesions persist
Mumps Exclude for 9 days after onset of symptoms About 6 days before to 9 days after onset of salivary gland swelling
Parainfluenza Until asymptomatic 4 days to 3 weeks
Parvovirus B19 (Slapped Cheek Syndrome) Do not exclude Not infectious after the rash appears
Pertussis Exclude for 21 days from onset of cough, or 5 days after starting antibiotic treatment.  Contacts will be dealt with by the Department of Health From onset of running nose to 3 weeks after onset of cough
Pin Worm Do not exclude As long as eggs are excreted.  Eggs remain infective for up to 2 weeks.
Pneumococcal Disease Do not exclude Until Streptococcus pneumoniae are no longer present in nose and throat secretions
Ring Worm Exclude until 24 hours after treatment has commenced As long as lesions are present
Rotavirus Until asymptomatic 10 days
Rubella Exclude for 4 days after onset of rash From 7 days before to at least 4 days after onset of rash
RSV (Respiratory Syncytial Virus) Until asymptomatic 3 days – 4 weeks
Scabies Exclude until the day after treatment has commenced Until mites and eggs are destroyed
Shigella Until asymptomatic 4 weeks
Shingles Do not exclude unless rash is uncovered and weeping Up to 1 week after appearance of the lesions
Tuberculosis Exclude until medical certificate of recovery is obtained.  Contact management will be handled by the Department of Health. Infectious as long as bacteria are present in discharges
Typhoid Exclude until three stool specimens are negative Notifiable disease.  Infectious as long as Salmonella typhi are present in faeces or urine.
Warts Do not exclude As long as the wart remains

 

References

PMH ED Guidelines:  Exclusion Periods for Communicable Diseases – Last Updated November 2014

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