Managing specific infectious diseases: A to Z - GOV.UK
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Updated 3 October 2022
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Athlete's foot (Tinea pedis)
Athlete's foot is an infection caused by a fungus which affects the skin on feet.
The person affected may have scaling, peeling or cracking of the skin, especially between the toes and on soles of the feet, and it can sometimes be very itchy. They may also develop blisters. In some cases, it can cause toenails to become discoloured, thick and crumbly.
It is generally spread by direct or indirect contact with skin lesions of infected people. For example, when visiting places barefoot, such as contaminated floors in gyms (showers, locker room, around swimming pools). Spread can also occur when sharing socks, shoes or towels with a person who has the infection.
Note that symptoms may present differently dependent on the skin tone. This guidance is not intended to act as a diagnostic tool. If concerned, refer to a clinician and follow appropriate and proportionate measures in the meantime.
Exclusion is not required.
What you need to do
You do not need to contact your HPT.
Advise the parent or carer to:
- visit their local pharmacy or GP for advice and treatment
- take care to dry between the toes after bathing – this may include using a fungicidal dusting powder, which can be bought over the counter at a pharmacy, on the feet, between the toes and in the socks and shoes
- enable the individual to wear shoes that allow feet to breathe and change socks frequently
- ensure the individual covers the affected foot with a rubber sock when going swimming
Do not allow people who have the infection to share socks, shoes, towels or bathmats with others.
Chickenpox (varicella) and shingles
Chickenpox is a mild and common childhood illness that most children catch. Chickenpox is most common in children under the age of 10. Nine out of 10 adults are immune because they had chickenpox during childhood. Children usually catch chickenpox in winter and spring, particularly between March and May.
Chickenpox has a sudden onset with fever, runny nose, cough and a generalised rash. The spotty rash starts with fluid filled blisters which then scab over and eventually drop off. Some children have only a few spots, but other children can have spots that cover their entire body. In most children, the blisters crust up and fall off naturally within one to 2 weeks.
Chickenpox in children is considered a mild illness. There is no specific treatment but there are pharmacy remedies that may alleviate symptoms. These include paracetamol to relieve fever, and calamine lotion and cooling gels to ease itching.
Chickenpox tends to be more severe in adults and they tend to have a higher risk of developing complications.
Some children and adults are at higher risk of serious problems if they catch chickenpox, including:
- pregnant women
- newborn babies
- people with a weakened immune system
These people should seek medical advice as soon as they are exposed to chickenpox or if they develop chickenpox symptoms. They may need a blood test to check if they are protected from (immune) chickenpox.
Shingles presents as a blistering rash in the area supplied by the affected nerve, usually only one side of the body. It can be very painful. Most people recover fully. There is often altered sensation before the rash appears, accompanied by 'flu like' symptoms.
Chickenpox is highly infectious and spreads by respiratory secretions or by direct contact with fluid from blisters.
Direct contact with fluid from the blisters of a person that has shingles can cause chickenpox in someone who has never had it before.
People with chickenpox are generally infectious from 2 days before the rash appears and until all blisters have crusted over (usually 5 to 6 days after the start of the rash).
Note that symptoms may present differently dependent on the skin tone. This guidance is not intended to act as a diagnostic tool. If concerned, refer to a clinician and follow appropriate and proportionate measures in the meantime.
Exclusion is recommended.
What you need to do
Send any individual with chickenpox home. Keep the individual away from the setting until all blisters have crusted over. In cases of shingles, the decision to exclude an individual will depend on whether the rash or blisters can be covered.
Keep the individual away from the setting if they have a weeping shingles rash that cannot be covered.
You do not need to contact your UKHSA HPT, unless the setting also has cases of scarlet fever circulating.
Ensure that anyone who is at higher risk (pregnant women, newborn babies, and people with a weakened immune system) seek medical advice as soon as they are exposed to chickenpox or if they develop chickenpox symptoms.
Advise parent, caregiver or individual to:
- seek immediate medical advice if the individual is seriously ill or if they develop any abnormal symptoms such as:
- the blisters becoming infected
- a pain in their chest or difficulty breathing
- avoid contact with other people for at least 5 days from the onset of the rash and until all blisters have crusted over (if chickenpox) or can be covered (shingles)
Do not allow the individual back to educational or childcare settings until all the blisters have dried and crusted over.
Further information
Chickenpox: public health management and guidance
Shingles: guidance and vaccination programme
Cold sores
Cold sores are caused by a virus called herpes simplex and usually appear on and around the lips. They sometimes also appear on other areas of the face and nose. It is estimated that more than half of us carry the virus but most of us do not develop cold sores.
It is usually a mild self-limiting virus. Most people who get cold sores will have been infected early in life.
The first signs are tingling, burning or itching in the area where the sore is going to appear. This phase may last for as little as 24 hours. There is reddening and swelling of the infected area resulting in fluid filled blisters which are usually clumped together in patches. Cold sores can be painful, and the blisters may form ulcers. They then dry up and crust over.
Cold sores may be triggered by factors such as having a cold, fever, other infection, stress, sunlight, or a weakened immune system.
The virus is spread by direct contact. People are at risk of getting a cold sore if they come in contact with the fluid of a cold sore or the saliva of someone who has the virus.
Note that symptoms may present differently dependent on the skin tone. This guidance is not intended to act as a diagnostic tool. If concerned, refer to a clinician and follow appropriate and proportionate measures in the meantime.
Exclusion is not required.
What you need to do
You do not need to contact your HPT.
Advise individual to try not to touch the cold sore or pick at the blisters to prevent spread.
Advise children, young people and staff to avoid contact with the sores and blisters by avoiding:
- kissing an affected individual
- sharing their food or eating and drinking utensils
- sharing towels, flannels, toothbrushes, and razors
Advise the individual who had a cold sore to avoid touching their eyes, including taking extra care when applying or removing make-up.
Conjunctivitis
Conjunctivitis is an inflammation of the outer lining of the eye and eyelid causing a sore or itchy red eye(s) with a sticky or watery discharge. It can be caused by bacteria or viruses or allergies.
The eye(s) become(s) reddened and swollen and there may be a sticky or watery discharge. Eyes usually feel sore or itchy and 'gritty'. Topical ointments or eye drops can be obtained from a pharmacy to treat the infection.
Conjunctivitis is spread by contact with discharge from the eye such as when an affected person rubs their eyes with their hands, or a towel then handles another person's face or towel. Prompt treatment and good hand hygiene helps to prevent spread.
Exclusion is not required.
What you need to do
You do not need to contact your HPT.
Advise parents, carers or staff to seek advice from their local pharmacist.
Encourage the individual not to rub their eyes and to wash their hands frequently.
Advise affected individual to avoid sharing towels, flannels and pillows.
Cryptosporidiosis
Cryptosporidiosis is an infection caused by Cryptosporidium, a microscopic parasite.
Cryptosporidiosis is spread from those with the infection to others when the parasite enters the gut by the mouth for example when contaminated hands or objects are put in the mouth or after eating or drinking contaminated food or drinks. It can also be spread by direct contact with farm animals particularly cattle and sheep. Spread by contaminated or untreated water and milk has also been reported.
Cryptosporidum's high tolerance to chlorine enables it to survive for long periods of time in chlorinated drinking and swimming pool water. This means people swallowing contaminated water could get infected.
Symptoms include abdominal pain, diarrhoea and occasionally vomiting. The incubation period is between 7 to 10 days but can sometimes be as long as 28 days. Shedding of the parasite by infected people begins when the symptoms begin and can last for weeks after the symptoms stop.
Exclusion is recommended.
What you need to do
Exclude individual until 48 hours after symptoms have stopped and they are well enough to return.
Contact your UKHSA HPT if there are 2 or more cases with cryptosporidium. Your UKHSA HPT or the local authority environmental health officer (EHO) will advise you if any actions need to be taken
Encourage children, young people and staff to implement good hand hygiene practices.
Clean kitchen and toilet areas regularly (for more details, see cleaning)
Use personal protective equipment (PPE) when handling blood or body substances such as vomit or diarrhoea.
Do not allow individuals with cryptosporidium to go to a swimming pool until 14 days after the last diarrhoeal episode.
Further information
Detailed guidance in public health management of gastrointestinal infections
Diarrhoea and vomiting (gastroenteritis)
Diarrhoea and/or vomiting may be due to a variety of causes including bacteria, viruses, parasites, toxins or non-infectious diseases. Gastrointestinal infections are spread when the germs enter the gut by the mouth or when contaminated hands or objects are put in the mouth or after eating or drinking contaminated food or drinks.
The most commonly reported bacterial infections are salmonella and campylobacter, usually associated with food poisoning. The most commonly reported viral infection is norovirus, usually associated with person-to-person transmission.
However, as a general principle, all cases of gastroenteritis should be regarded as potentially infectious unless there is good evidence to suggest otherwise.
A liquid stool is more likely to contaminate hands and the environment than a formed stool and is therefore a greater risk. Vomit, like liquid stool, may also be highly infectious such as when there is norovirus circulating in the education or childcare setting. Infection can also be spread when the affected person vomits. This is because aerosols can spread the organism directly to others and contaminate the environment. A person will be infectious while symptoms remain.
People affected by infectious gastrointestinal diseases may have diarrhoea and/or vomiting.
Diarrhoea is defined as 3 or more liquid or semi-liquid stools (type 6 or 7) within a 24-hour period in adults and older children or any change in bowel pattern in young children.
The incubation period (the delay between infection and the appearance of symptoms) will vary depending on the cause of the infection.
Exclusion is recommended.
What you need to do
Exclude individual until 48 hours after symptoms have stopped and they are well enough to return. If medication is prescribed, ensure that the full course is completed and there is no further diarrhoea and/or vomiting for 48 hours after the course is completed.
Contact your UKHSA HPT if there are a higher than previously experienced and/or rapidly increasing number of children, young people and staff absences due to diarrhoea and vomiting.
For some gastrointestinal infections, longer periods of exclusion are required. For these groups, your UKHSA HPT, or the local authority EHO will advise you if any action is required.
Encourage children, young people and staff to implement good hand hygiene practices.
Clean kitchen and toilet areas regularly (for more details, see cleaning).
Use PPE when handling blood or body substances such as vomit or diarrhoea.
Further information
Detailed guidance in public health management of gastrointestinal infections
E. coli STEC (Shiga Toxin-producing E.Coli)
Escherichia coli (E. coli) are bacteria found in the environment, food, and guts of people and animals. There are several different types of E. Coli and most are harmless.
Some types, known as Shiga Toxin-producing E. coli (STEC), produce a toxin, which can cause illness. These types of E. coli live in the guts of animals, particularly cattle and sheep.
Symptoms vary depending on the severity of the infection but include diarrhoea (which might be bloody), abdominal pain, and sometimes vomiting and fever. The incubation period is 1 to 10 days and cases are infectious as long as bacteria are present in the faeces. Symptoms usually resolve within 5 to 7 days but on rare occasions infection can cause serious complications such as kidney failure.
Spread is mainly by eating contaminated food (such as undercooked meat, unpasteurised milk and cheese, unwashed vegetables which may have been contaminated by manure from infected animals) or contact with infected animals or their faeces.
Person-to-person spread is by direct contact with someone who has the infection particularly within families and childcare settings. Outbreaks and sporadic cases have also been linked with handling animals. Therefore, adults should supervise children and young people while washing their hands during visits to petting zoos and farm centres. For more information, see additional considerations for outdoor learning.
Exclusion is recommended.
What you need to do
Exclude individual until 48 hours after diarrhoea and/or vomiting symptoms have stopped, and they are well enough to return.
For some groups (for example pre-school infants, food handlers, and care staff working with vulnerable people), longer periods of exclusion may be required. This could include people who have tested positive but do not have symptoms. The UKHSA HPT will advise you if any action is required.
Encourage staff and children and young people to implement good hand hygiene practices.
Clean kitchen and toilet areas regularly (for more details, see cleaning.
Use PPE when handling blood or body substances such as vomit or diarrhoea.
Further information
Detailed guidance in public health management of gastrointestinal infections
Food poisoning
Food poisoning is a general term used for gastrointestinal (GI) infections caused by consuming contaminated food or drink or by person-to-person spread.
Gastrointestinal infections can be caused by a variety of bacteria, viruses or parasites; the most commonly reported bacterial infections are salmonella and campylobacter, usually associated with food poisoning. However, as a general principle, all cases of gastroenteritis should be regarded as potentially infectious unless there is good evidence to suggest otherwise.
A liquid stool is more likely to contaminate hands and the environment than a formed stool and is therefore a greater risk. Vomit, like liquid stool, may also be highly infectious such as when there is norovirus circulating in the education or childcare setting. Infection can also be spread when the affected person vomits. This is because aerosols can spread the organism directly to others and contaminate the environment. A person will be infectious while symptoms remain.
Food poisoning outbreaks can occur when people eat the same contaminated food. Or if food is prepared by someone who has the infection and did not wash their hands properly before preparing the food.
People affected by infectious gastrointestinal diseases may have diarrhoea and/or vomiting. Diarrhoea is defined as 3 or more liquid or semi-liquid stools (type 6 or 7) within a 24-hour period in adults and older children or any change in bowel pattern in young children.
The incubation period (the delay between infection and the appearance of symptoms) will vary depending on the cause of the infection.
Symptoms of food poisoning usually begin within 1 to 2 days of eating contaminated food, although they may start at any point between a few hours and several weeks later depending on the cause. The main symptoms include feeling sick (nausea), vomiting, diarrhoea, abdominal pain and fever.
Exclusion is recommended.
What you need to do
Exclude individual until 48 hours after diarrhoea and/or vomiting symptoms have stopped, and they are well enough to return.
For some gastrointestinal infections, longer periods of exclusion are required. For these groups, your UKHSA HPT will advise you if any action is required.
Inform your UKHSA HPT if there are 2 or more cases with similar symptoms linked in time or place or a greater than expected rate of infection compared with the usual rate.
All outbreaks of food poisoning should be investigated, your UKHSA HPT will work with the education or childcare setting and EHOs from the local authority.
Encourage staff and children and young people to implement good hand hygiene practices.
Clean kitchen and toilet areas regularly (for more details, see cleaning).
Use PPE when handling blood or body substances such as vomit or diarrhoea.
Further information
Detailed guidance in public health management of gastrointestinal infections
Giardiasis
This parasitic disease is caused by Giardia, a microscopic parasite, that causes diarrhoea. Many infections are picked up while travelling abroad.
Giardiasis is spread from those with the infection to others when the parasite enters the gut by the mouth for example when contaminated hands or objects are put in the mouth or after eating or drinking contaminated food or drinks.
Infection with giardia may not cause any symptoms. When symptoms do occur, they may include abdominal pain, bloating, fatigue and pale, loose stools or diarrhoea. Cases may need treatment. The incubation period is between 5 and 25 days, and symptoms generally last anywhere from 2 to 6 weeks but may last longer in people with weakened immune systems.
Exclusion is recommended.
What you need to do
Exclude individual until 48 hours after the symptoms have stopped, and they are well enough to return.
Inform your UKHSA HPT if 2 or more cases with similar symptoms linked in time or place or a greater than expected rate of infection compared with the usual background rate.
Encourage staff and children and young people to implement good hand hygiene practices.
Clean kitchen and toilet areas regularly (for more details, see cleaning).
Use PPE when handling blood or body substances such as vomit or diarrhoea.
Do not allow children, young people, or staff with Giardia to go to a swimming pool until 14 days after the last diarrhoeal episode.
Further information
Detailed guidance in public health management of gastrointestinal infections
Glandular fever
Glandular fever is a viral infection that mostly affects young adults, it is caused by the Epstein-Barr virus.
Symptoms present as fatigue, aching muscles, sore throat, fever, swollen glands in the neck and occasionally jaundice (yellowing of the skin and eyes). In children, the disease is generally mild. The incubation period is about 4 to 6 weeks.
Symptoms of glandular fever can be unpleasant, but most pass within 2 to 3 weeks. Fatigue, however, can occasionally last longer.
The virus is found in the saliva of infected people and can be spread by direct contact with saliva such as kissing, being exposed to coughs and sneezes, sharing of eating and drinking utensils. It can also be spread by indirect contact via contaminated objects if hands are not washed adequately.
Exclusion is not required.
What you need to do
You do not need to contact your HPT.
Encourage children, young people and staff to implement good hand hygiene and respiratory hygiene practices.
Hand, foot and mouth disease
Hand, foot and mouth disease is a common viral illness in childhood. It is generally a mild illness caused by an enterovirus. In rare instances it can be more severe.
The individual may develop a fever, reduced appetite and generally feel unwell. One or 2 days later a rash may develop with blisters, on hands, feet, insides of their cheeks, gums and on the sides of the tongue. Not all cases have symptoms. The incubation period is 3 to 5 days. Persons affected are most infectious during the first week of the illness.
The illness is usually mild and clears up by itself in 7 to 10 days. If the individual develops the rare additional symptoms of high fever, headache, stiff neck, back pain, or other complications then they should seek prompt medical advice.
Spread is by direct contact with the secretions of the infected person (including faeces) or by aerosol spread such as coughing and sneezing. Younger children are more at risk because they tend to play closely with their peers.
There is a slight risk to pregnant people, and they may wish to avoid close contact with an affected individual. Women who develop any rash symptoms during pregnancy should seek advice from their general practitioner or midwife.
Do not confuse with foot and mouth disease which is found in animals. Children and young people do not need to be excluded from education or childcare settings if they are well.
Note that symptoms may present differently dependent on the skin tone. This guidance is not intended to act as a diagnostic tool. If concerned, refer to a clinician and follow appropriate and proportionate measures in the meantime.
Exclusion is not required.
What you need to do
You do not need to contact your HPT.
Encourage children, young people and staff to implement good hand hygiene practices, particularly in those affected and the staff who carry out nappy changing and/or assist with toileting. This should continue even after the child/young person is well because the virus can still be present in the faeces and saliva for a few weeks.
Encourage children, young people and staff to implement good respiratory hygiene practices.
Strongly encourage staff to adhere to toileting and sanitation guidance.
Head lice
Head lice and nits are common in young children and their families. They do not have anything to do with dirty hair and are picked up by head-to-head contact. They are tiny insects that only live on humans. The eggs are grey or brown and about the size of a pinhead which stick to the hair, close to the scalp. The eggs hatch in 7 to 10 days. Empty eggshells (nits) are white and shiny and are found further along the hair shaft as they grow out.
Head lice are spread by direct head-to-head contact and therefore tend to be more common in children because of the way they play. They cannot jump, fly or swim. Itching and scratching occurs 2 to 3 weeks after coming into close contact with someone who has headlice.
Exclusion is not required.
What you need to do
You do not need to contact your HPT.
Consider carefully before sending letters and notifications to parents or caregivers. These generally do not reduce the risk of transmission and may provoke anxiety.
Encourage parents or carers to give regular head checks and provide good hair care to help identify head lice early.
Hepatitis A
Hepatitis A is a viral infection which affects the liver. The hepatitis A virus is caught by eating or drinking contaminated food or water. The infection can also be spread by close contact with an infected person, especially where there is poor personal or public hygiene. The virus is very contagious and is found in the stools and blood of people who are infected.
People should be vaccinated against hepatitis A before travelling to countries where hepatitis A is common.
Symptoms include abdominal pain, loss of appetite, nausea, fever and fatigue, followed by jaundice (yellowing of the skin and eyes), dark urine and pale faeces. The severity of the disease varies from a mild illness lasting 1 to 2 weeks to a more serious illness lasting several months. Young children may have mild infections without jaundice or other symptoms, and many may have no symptoms at all.
Exclusion is recommended.
What you need to do
Exclude the child, young person or staff member for 7 days after the onset of jaundice or from the onset of symptoms if no jaundice is present.
Contact your UKHSA HPT if there are 2 or more cases with similar symptoms linked in time or place, or a greater than expected rate of infection compared with the usual background rate.
Encourage children, young people and staff to implement good hand hygiene practices.
Clean kitchen and toilet areas regularly (for more details, see cleaning).
Household and other close contacts of cases will be offered a hepatitis A vaccine if they are not immune.
Educate young people on safe sex to protect them from hepatitis infection (and other sexually transmitted infections) through sexual contact. A lesson plan is available to support.
Further information
Detailed guidance in public health management of gastrointestinal infections
Hepatitis B
Hepatitis B (HBV) is a liver disease caused by the hepatitis B virus. There are several different viruses which affect the liver, primarily hepatitis A, B, C, D and E.
The main difference between the viruses is how they are spread; the way they cause liver damage and the effects they have on health. In the UK, hepatitis B infection is not a common viral infection in young children and young people.
Hepatitis B can cause an acute or a chronic illness. An acute illness is one that gets better quickly, usually within weeks or at most a few months.
A chronic illness lasts much longer, sometimes waxing and waning. Chronic hepatitis B is when it lasts longer than 6 months.
Symptoms can vary and may include general fatigue, nausea and vomiting, loss of appetite, fever and dark urine. Older children and adults may develop jaundice (a yellowing of the eyes and skin).
Many people never have any symptoms, but they can pass on the infection. The incubation period (the delay between infection and the appearance of symptoms) can be between 4 weeks and 6 months.
It is spread is by contact with infected blood and body fluids entering the bloodstream through broken skin or mucous membranes (eyes, mouth and nose), for example through a bite which breaks the skin or if the skin is pierced by a contaminated object.
The virus can also be passed on via tattooing or from medical and dental treatment if equipment is not adequately sterilised.
All blood and body fluids should be considered potentially infectious, and spills should be cleaned wearing protective clothing and using a spillage kit.
Exclusion is not required.
What you need to do
Do not exclude individuals with chronic hepatitis B infection or restrict their activities.
Contact your UKHSA HPT for more advice if required.
People with acute hepatitis B will typically be too ill to attend their education or childcare setting. Follow their doctor's advice regarding when they can return.
Clean kitchen and toilet areas regularly (for more details, see cleaning).
Wear PPE when handling or cleaning blood, urine, loose stools and vomit.
Take a standard approach to cleaning all spillages of blood and body fluids, managing all as potentially infectious (for more details, see Safe management of blood and bodily fluids).
Always complete the accident book with details of injuries or adverse events.
Educate young people on safe sex to protect them from hepatitis infection (and other sexually transmitted infections) through sexual contact. A lesson plan is available to support this.
Hepatitis C
Hepatitis C is not a common infection in children.
Hepatitis C virus (HCV) is a blood borne virus affecting the liver. Symptoms of hepatitis C infection can often be vague and include loss of appetite, fatigue, nausea and abdominal pain. Jaundice (yellowing of the skin and eyes) occurs less commonly than in hepatitis B infection. Up to 80% of those infected may be carriers of the virus and can pass it on to others.
HCV is present in blood and other body fluids. It is spread in the same way as hepatitis B virus. Hepatitis C, like hepatitis B, cannot be spread through casual contact.
Exclusion is not required.
What you need to do
Do not exclude individuals with chronic hepatitis C infection or restrict their activities.
Contact your UKHSA HPT for more advice if required.
Wear the appropriate protective clothing including gloves when cleaning up blood, urine, loose stools and vomit.
Always complete the accident book with details of injuries or adverse events.
Encourage children, young people and staff to implement good hand hygiene practices.
Take a standard approach to cleaning all spillages of blood and body fluids, managing all as potentially infectious (for more details, see Safe management of blood and bodily fluids).
Ensure personal hygiene items such as toothbrushes, nail cutters, razor and nail scissors are not shared.
Ensure the setting has appropriate sanitary item disposal containers and contracts in place.
Educate young people on safe sex to protect them from hepatitis infection (and other sexually transmitted infections) through sexual contact. A lesson plan is available to support this.
Impetigo
Impetigo is a bacterial skin infection which mainly affects infants and young children. It is very infectious and appears most commonly as reddish sores on the face. It may be a primary infection or a complication of an existing skin condition such as eczema, scabies or insect bites.
The sores can develop anywhere on the body but tend to occur as reddish sores on the face, especially around the nose and mouth and on hands and feet. After about a week, the sores burst and leave golden brown crusts. It can sometimes be painful and itchy. The incubation period is between 4 to 10 days.
Impetigo can easily spread to other parts of the affected person's body or to other people such as through direct physical contact, or by sharing towels, flannels or eating and drinking utensils.
Note that symptoms may present differently dependent on the skin tone. This guidance is not intended to act as a diagnostic tool. If concerned, refer to a clinician and follow appropriate and proportionate measures in the meantime.
Exclusion is recommended.
What you need to do
Exclude the individual from education or childcare setting until all lesions (sores or blisters) are crusted over or until 48 hours after commencing antibiotic treatment.
You do not need to contact your HPT.
Encourage children, young people and staff to implement good hand hygiene practices.
Encourage children, young people and staff to avoid touching or scratching the sores, or letting others touch them.
Do not allow towels, flannels and eating and drinking utensils to be shared by others.
Ensure that toys and play equipment are thoroughly cleaned daily. Non-washable soft toys should be wiped or washed with a detergent using warm water and dried thoroughly (for more details, see cleaning).
Influenza
Influenza, commonly known as flu, is caused by a virus, usually influenza A or B. It spreads easily in crowded populations and in enclosed spaces. Flu viruses are always changing so this winter's flu strains will be slightly different from previous winters.
Flu can affect anyone but if people have a long-term health condition the effects of flu can make it worse even if the health condition is well managed and they normally feel well.
Conditions which may increase your risk of serious influenza illness are detailed in the Green Book.
Influenza is a respiratory illness and commonly has a sudden onset. Symptoms include headache, high temperature, cough, sore throat, aching muscles and joints and fatigue.
Cases can be infectious one day before to 3 to 5 days after symptoms appear. Importantly, children may sometimes present differently with flu – for example, without fever but with diarrhoea.
By breathing in droplets coughed out into the air by infected people or by the droplets landing on mucous membranes. Transmission may also occur by direct or indirect contact with respiratory secretions for example via soiled tissues, surfaces.
The risk of infection can be minimised through vaccination. For further details see the section on supporting immunisation programmes and/or UK national immunisation schedule. For details of school years eligible for flu vaccination, please see the annual programme letter.
Exclusion is recommended.
What you need to do
Exclude individuals with symptoms of the flu, until they have recovered. However, do not exclude individuals with only mild symptoms of a respiratory illness, such as a runny nose, sore throat, or mild cough, but who are otherwise well.
You do not need to contact your HPT.
Encourage those in eligible groups to have the flu vaccine.
Encourage children, young people and staff to implement good hand hygiene practices.
Encourage children, young people and staff to implement good respiratory hygiene practices.
Measles
Measles is a highly infectious viral infection. Symptoms include a runny nose; cough; conjunctivitis (sore, itchy, watery, red and sticky eyes); high fever and small white spots (Koplik spots) inside the cheeks. Around day 3 of the illness, a rash of flat red or brown blotches appear, beginning on the face, behind the ears and spreading over the body. The incubation period is between 10 to 12 days but can vary from 7 to 21 days.
Measles is highly infectious and transmitted via airborne or droplet spread, or direct contact with nasal or throat secretions of infected persons. Cases are infectious from 4 days before onset of rash to 4 days after, where the date of the rash onset is day 0.
The MMR (measles, mumps and rubella) vaccine is the safest and most effective way to protect against measles. People need 2 doses of MMR to be protected against measles, mumps and rubella.
During coronavirus (COVID-19), there has been a significant drop in children getting vaccinated with MMR and other childhood vaccines. Measles is highly infectious so even a small decline in MMR vaccine uptake can lead to significant increases in cases.
Note that symp...
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