Even if your child has an infection, it is not always necessary to keep the child at home from childcare. This could be because
- the disease is mostly contagious before symptoms appear
- the risk of transmission is very small when the child is healthy
- the condition is so common/mild that it does not justify keeping the child at home.
Examples of these diseases include the fifth disease (erythema infectiosum), cold sores, warts and hand, foot and mouth disease. Experience shows that strict rules to keep sick children out of childcare have a limited effect on transmission.
With infectious diseases, the child's general condition will often decide if the child needs to stay at home. The assessment is based on the parent or guardian's judgement. As a rule of thumb, a child should not have a fever and feel well enough to take part in normal activities in childcare.
The following list covers the most common symptoms and infectious diseases among children who attend childcare or the lower grades in school.
The child can return to childcare when all the blisters have formed scabs and the child feels better.
Colds and other respiratory tract infections
There can be many different causes of cold symptoms, for example, rhinovirus, influenza, RS and coronavirus.
The common cold is the most common infectious disease in children. The child can return to the childcare/ school when their general condition is better. This means that children with some residual symptoms after a cold, such as a runny nose/mucus or cough, can return to childcare when they are back to their normal state.
In the case of a cough without a fever, the child can return to childcare when their general condition is better. Some respiratory tract infections can cause stronger symptoms or a more severe disease course. In case of prolonged or severe coughing, the child should be examined for whooping cough. Always seek medical attention if you are concerned about your child's health.
Conjunctivitis (pink eye)
There is no reason why 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 lessened, to avoid the risk of infecting other children. Severe conjunctivitis will often need to be checked by a physician and the child's general condition will also largely determine the need to stay at home.
The child's guardians should decide if the child has conjunctivitis symptoms that ought to 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 childcare, but they can discuss this with the child's guardians if they are in doubt. If treatment is prescribed, the child may return to childcare on the day after treatment is begun.
Diarrhoea with or without vomiting
Children with diarrhoea can return to childcare two days after they have been symptom-free. This also applies to children who use nappies. Children who normally have loose stools do not need to be kept at home. The parents must decide if their child has unusual diarrhoea.
For some gastrointestinal infections, control tests are recommended before returning to nursery school, the doctor will give advice if this is needed.
For diarrhoea where contaminated food is suspected (such as after travelling abroad), the child should be examined by a doctor and the other children in childcare should be monitored for symptoms.
Ear infection (otitis)
Children can return to childcare when they feel well enough.
A child’s normal body temperature may vary. A rectal temperature higher than 38 °C is considered to be a fever. Children with fever should stay at home until the fever has gone, mainly for their own comfort. In some cases it can also be to avoid the spread of a potentially infectious disease, depending on the cause of the fever.
If head lice are detected at childcare or school, it is not necessary to send the child home. When the child comes home, the initial treatment should preferably begin that same evening. The child can return to childcare or school once treatment has begun. The childcare centre and contact network should be informed that lice have been detected so they can check for lice and avoid reinfection.
Head lice can be treated by using a lice treatment, by combing or by cutting head hair shorter than 0.5cm.
Children with impetigo can return to childcare when their blisters are under control. The decision must be based on that there is no longer a danger for transmission from infectious wound secretions to other children either directly or indirectly. In the case of few and small blisters, good covering should prevent this, but with widespread infection in several places on the body, it will be necessary for the blisters to be dry, healing, and in decline.
Children may return to childcare/school when the symptoms have passed. This also includes siblings or other close contacts who have been given antibiotics to prevent the disease.
Norovirus is the most common cause of gastroenteritis. The infection risk is highest when symptoms of vomiting and diarrhoea are present, so children should be kept at home during this period. Wait 48 hours until diarrhoea and vomiting have stopped before returning to childcare.
Children can return to childcare once treatment has started.
RS virus, coronavirus and other respiratory tract infections
Colds are the most common infections among children. They can return to childcare when they feel well enough. This means that children with some residual symptoms after a cold, such as a runny nose/mucus or cough, can return to the nursery when the child is otherwise back to their normal form.
Children can return to childcare if they have a cough without fever when they feel well enough. With prolonged or severe coughing, the child should be checked for whooping cough or other diseases.
The child should stay home from childcare or school for the first 24 hours after treatment has started.
Children can return to childcare the day after treatment has started.
Whooping cough (pertussis)
If treatment with antibiotics begins early in the course of the disease, the child is usually not contagious in the first five days after treatment begins, but the child should be kept home until then. If treatment begins later in the disease, they will be significantly less contagious, and may return to childcare the day after treatment began, or if it was considered too late to begin treatment.