NHMRC’s recommended minimum exclusion periods for early childhood education and care services, for all 55 conditions in Table 4.2 and the 5 symptom rules in Table 4.1. Use it to answer family and service questions, then check your state.
Support tool, not clinical advice. NHMRC states that the tables do not replace clinical assessment, management or judgement, and should be used with any medical management plan. They are minimums; a child may need longer to be well enough to return. Only for children without serious symptoms (if serious symptoms, call 000).
Key points
- Letters and clearance. Services are not required to follow doctors’ letters saying a child can return, and should not require “clearance” from a doctor (NHMRC, p.93).
- Contact the public health unit for a disease outbreak, or a case of a notifiable or concerning disease (NHMRC, p.79).
- State differences. Some states and territories have different or additional requirements. Victoria’s periods are set by regulation.
- Scope. Children up to school age, and care outside school hours.
By symptom (Table 4.1)
Diarrhoea or vomitingExcluded
Go home straight away? Yes: go home as soon as possible for any diarrhoea or vomiting.
- Exclude until there has not been any diarrhoea or vomiting for at least 24 hours.
- If it is confirmed to be norovirus, exclude until there has not been any diarrhoea or vomiting for at least 48 hours.
- Staff members with these symptoms should not handle food until they have not vomited or had diarrhoea for at least 48 hours (they can be assigned to other duties after at least 24 hours, or stay away from the service for at least 48 hours).
- Check if your state or territory has different requirements for gastroenteritis.
- Talk to your local public health unit for advice if there are several children and staff with diarrhoea or vomiting at the service.
NHMRC Table 4.1, p.77
Eye discharge (pus or severe wateriness)Excluded
Go home straight away? Yes: go home as soon as possible.
- Exclude until the discharge from the eyes has stopped (unless a doctor has diagnosed a non-infectious cause for the eye discharge).
NHMRC Table 4.1, p.77
Fever (temperature more than 38.0 °C)Excluded
Go home straight away? Yes: go home as soon as possible.
- Exclude until the temperature remains normal, unless the fever has a known non-infectious cause.
- If the child has gone home with a fever but their temperature is normal the next morning, they can return.
- If the child wakes in the morning with a fever, they should stay home until their temperature remains normal.
- A normal temperature is between 36.5 °C and 38.0 °C.
- If a doctor later diagnoses the cause of the fever, follow the exclusion guidance for that disease.
NHMRC Table 4.1, p.77
RashDepends
Go home straight away? No: stay at the service unless the rash develops rapidly or is combined with fever or other concerning symptoms.
- A rash on its own may not be a cause for concern, but rash is often combined with other symptoms.
- If the rash develops rapidly, or is combined with other concerning symptoms, exclude until the concerning symptoms have gone.
NHMRC Table 4.1, p.77
Respiratory symptoms (cough, runny or blocked nose, sore throat)Depends
Go home straight away? Yes, if the symptoms are severe or getting worse, or combined with concerning symptoms such as fever, rash, tiredness, pain or poor feeding.
- If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), monitor them and exclude them if they have: several respiratory symptoms at the same time; new symptoms that developed while at the service; severe respiratory symptoms; symptoms that are getting worse (more frequent or severe); or concerning symptoms as well (fever, rash, tiredness, pain, poor feeding).
- A person can often have an ongoing cough after recovering from a respiratory infection. If their other symptoms have gone and they feel well, they can return.
- Talk to your local public health unit for advice if there are several children and staff with respiratory symptoms at the service.
- Check if your state or territory has different requirements for respiratory symptoms.
NHMRC Table 4.1, p.78
By diagnosed condition (Table 4.2)
Skin
Chickenpox (varicella)Excluded
Person who is sick
- Exclude until all blisters have dried – this is usually at least 5 days after the rash first appeared in non-immunised children, and less in immunised children.
Contacts (no symptoms) Not excluded
- Staff or children who are immunocompromised are at high risk of developing severe disease if exposed.
- Talk to immunocompromised or pregnant staff about risk and recommend they seek medical advice.
- For any immunocompromised children, talk to the parents about the child’s potential risk of exposure and follow the child’s agreed action plan (see Plans for immunocompromised children).
NHMRC Table 4.2, p.81
Cold sores (herpes simplex)Depends
Person who is sick
- Not excluded if the person can maintain hygiene practices to minimise the risk of transmission.
- If the person cannot maintain these practices (for example, because they are too young), exclude until the sores are dry.
- Cover sores with a dressing, if possible.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.81
Fifth disease (slapped cheek syndrome)Not excluded
Person who is sick
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.84
Hand, foot and mouth diseaseExcluded
Person who is sick
- Exclude until all blisters have dried.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.86
Head liceDepends
Person who is sick
- Not excluded, as long as effective treatment begins before the next attendance at the service.
- The child does not need to be sent home immediately if head lice are detected.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.86
Impetigo (school sores)Excluded
Person who is sick
- Exclude until antibiotic treatment has started.
- Cover any sores on exposed skin with a watertight dressing.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.87
Molluscum contagiosumNot excluded
Person who is sick
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.88
Ringworm, tinea and other fungal skin infectionsExcluded
Person who is sick
- Exclude until the day after starting appropriate antifungal treatment.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.85
Roseola (sixth disease)Not excluded
Person who is sick
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.89
Scabies and other mites causing skin diseaseExcluded
Person who is sick
- Exclude until the day after starting treatment.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.91
Shingles (zoster infection)Excluded
Person who is sick
- Exclude children until blisters have dried and crusted.
- Adults who can cover the blisters are not excluded (they are excluded if blisters cannot be covered).
Contacts (no symptoms) Ask PHU
- Talk to your public health unit for advice about pregnant women and anyone who is immunocompromised.
NHMRC Table 4.2, p.91
Staph infection (Staphylococcus aureus)Excluded
Person who is sick
- Exclude until the person has received antibiotic treatment for at least 24 hours and feels well.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.91
Thrush (candidiasis)Not excluded
Person who is sick
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.91
WartsNot excluded
Person who is sick
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.92
WormsNot excluded
Person who is sick
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.92
Eyes and ears
ConjunctivitisExcluded
Person who is sick
- Exclude until discharge from the eyes has stopped.
- Not excluded if a doctor has diagnosed non-infectious conjunctivitis.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.82
Ear infectionDepends
Person who is sick
- Not excluded unless associated with other concerning symptoms.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.84
Trachoma (eye infection)Excluded
Person who is sick
- Exclude until antibiotic treatment has started.
- Talk to your local public health unit for advice.
Contacts (no symptoms) Ask PHU
- Talk to your public health unit for advice.
NHMRC Table 4.2, p.91
Stomach and gut
Campylobacter infectionExcluded
Person who is sick
- Exclude until there has not been any diarrhoea or vomiting for at least 24 hours.
- Staff members with these symptoms should not handle food until they have not vomited or had diarrhoea for at least 48 hours (they can be assigned to other duties after at least 24 hours, or stay away from the service for at least 48 hours).
- Talk to your local public health unit for advice if there are several children and staff with diarrhoea or vomiting at the service.
- Check if your state or territory has different requirements for gastroenteritis.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.80
CryptosporidiosisExcluded
Person who is sick
- Exclude until there has not been any diarrhoea or vomiting for at least 24 hours.
- Staff members with these symptoms should not handle food until they have not vomited or had diarrhoea for at least 48 hours (they can be assigned to other duties after at least 24 hours, or stay away from the service for at least 48 hours).
- Talk to your local public health unit for advice if there are several children and staff with diarrhoea or vomiting at the service.
- Check if your state or territory has different requirements for gastroenteritis.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.84
Giardia infection (giardiasis)Excluded
Person who is sick
- Exclude until there has not been any diarrhoea or vomiting for at least 24 hours.
- Staff members with these symptoms should not handle food until they have not vomited or had diarrhoea for at least 48 hours (they can be assigned to other duties after at least 24 hours, or stay away from the service for at least 48 hours).
- Talk to your local public health unit for advice if there are several children and staff with diarrhoea or vomiting at the service.
- Check if your state or territory has different requirements for gastroenteritis.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.85
Hepatitis AExcluded
Person who is sick
- Exclude until at least 7 days after jaundice starts, or if there is no jaundice, until at least 2 weeks after onset of other symptoms.
- Talk to your public health unit for advice.
Contacts (no symptoms) Not excluded
- Talk to your public health unit for advice.
NHMRC Table 4.2, p.86
Hepatitis EExcluded
Person who is sick
- Exclude until at least 7 days after jaundice starts, or if there is no jaundice, until at least 2 weeks after onset of other symptoms.
Contacts (no symptoms) Not excluded
- Talk to your public health unit for advice.
NHMRC Table 4.2, p.86
Norovirus infectionExcluded
Person who is sick
- Exclude until there has not been any diarrhoea or vomiting for at least 48 hours.
- Talk to your local public health unit for advice if there are several children and staff with diarrhoea or vomiting at the service.
- Check if your state or territory has different requirements for gastroenteritis.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.88
Rotavirus infectionExcluded
Person who is sick
- Exclude until there has not been any diarrhoea or vomiting for at least 24 hours.
- Staff members with these symptoms should not handle food until they have not vomited or had diarrhoea for at least 48 hours (they can be assigned to other duties after at least 24 hours, or stay away from the service for at least 48 hours).
- Talk to your local public health unit for advice if there are several children and staff with diarrhoea or vomiting at the service.
- Check if your state or territory has different requirements for gastroenteritis.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.89
Salmonella infection (salmonellosis)Excluded
Person who is sick
- Exclude until there has not been any diarrhoea or vomiting for at least 24 hours.
- Staff members with these symptoms should not handle food until they have not vomited or had diarrhoea for at least 48 hours (they can be assigned to other duties after at least 24 hours, or stay away from the service for at least 48 hours).
- Talk to your local public health unit for advice if there are several children and staff with diarrhoea or vomiting at the service.
- Check if your state or territory has different requirements for gastroenteritis.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.90
Shigella infection (shigellosis)Excluded
Person who is sick
- Exclude until there has not been any diarrhoea or vomiting for at least 24 hours.
- Staff members with these symptoms should not handle food until they have not vomited or had diarrhoea for at least 48 hours (they can be assigned to other duties after at least 24 hours, or stay away from the service for at least 48 hours).
- Talk to your local public health unit for advice if there are several children and staff with diarrhoea or vomiting at the service.
- Check if your state or territory has different requirements for gastroenteritis.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.91
Typhoid and paratyphoid feverExcluded
Person who is sick
- Exclude until cleared by the local public health unit.
Contacts (no symptoms) Not excluded
- Talk to your public health unit for advice.
NHMRC Table 4.2, p.92
Breathing
AsthmaNot excluded
Person who is sick
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.79
BronchiolitisDepends
Person who is sick
- If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), monitor them and exclude them if they have: several respiratory symptoms at the same time; new symptoms that developed while at the service; severe respiratory symptoms; symptoms that are getting worse (more frequent or severe); or concerning symptoms as well (fever, rash, tiredness, pain, poor feeding).
- A person can often have an ongoing cough after recovering from a respiratory infection. If their other symptoms have gone and they feel well, they can return.
- Talk to your local public health unit for advice if there are several children and staff with respiratory symptoms at the service.
- Check if your state or territory has different requirements for respiratory symptoms.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.79
BronchitisDepends
Person who is sick
- If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), monitor them and exclude them if they have: several respiratory symptoms at the same time; new symptoms that developed while at the service; severe respiratory symptoms; symptoms that are getting worse (more frequent or severe); or concerning symptoms as well (fever, rash, tiredness, pain, poor feeding).
- A person can often have an ongoing cough after recovering from a respiratory infection. If their other symptoms have gone and they feel well, they can return.
- Talk to your local public health unit for advice if there are several children and staff with respiratory symptoms at the service.
- Check if your state or territory has different requirements for respiratory symptoms.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.80
COVID-19Depends
Person who is sick
- If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), monitor them and exclude them if they have: several respiratory symptoms at the same time; new symptoms that developed while at the service; severe respiratory symptoms; symptoms that are getting worse (more frequent or severe); or concerning symptoms as well (fever, rash, tiredness, pain, poor feeding).
- A person can often have an ongoing cough after recovering from a respiratory infection. If their other symptoms have gone and they feel well, they can return.
- Talk to your local public health unit for advice if there are several children and staff with respiratory symptoms at the service.
- Check if your state or territory has different requirements for respiratory symptoms.
Contacts (no symptoms) Not excluded
- Refer to state or territory advice.
NHMRC Table 4.2, p.83
Common coldDepends
Person who is sick
- If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), monitor them and exclude them if they have: several respiratory symptoms at the same time; new symptoms that developed while at the service; severe respiratory symptoms; symptoms that are getting worse (more frequent or severe); or concerning symptoms as well (fever, rash, tiredness, pain, poor feeding).
- A person can often have an ongoing cough after recovering from a respiratory infection. If their other symptoms have gone and they feel well, they can return.
- Talk to your local public health unit for advice if there are several children and staff with respiratory symptoms at the service.
- Check if your state or territory has different requirements for respiratory symptoms.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.82
CroupDepends
Person who is sick
- If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), monitor them and exclude them if they have: several respiratory symptoms at the same time; new symptoms that developed while at the service; severe respiratory symptoms; symptoms that are getting worse (more frequent or severe); or concerning symptoms as well (fever, rash, tiredness, pain, poor feeding).
- A person can often have an ongoing cough after recovering from a respiratory infection. If their other symptoms have gone and they feel well, they can return.
- Talk to your local public health unit for advice if there are several children and staff with respiratory symptoms at the service.
- Check if your state or territory has different requirements for respiratory symptoms.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.83
Flu (influenza)Depends
Person who is sick
- If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), monitor them and exclude them if they have: several respiratory symptoms at the same time; new symptoms that developed while at the service; severe respiratory symptoms; symptoms that are getting worse (more frequent or severe); or concerning symptoms as well (fever, rash, tiredness, pain, poor feeding).
- A person can often have an ongoing cough after recovering from a respiratory infection. If their other symptoms have gone and they feel well, they can return.
- Talk to your local public health unit for advice if there are several children and staff with respiratory symptoms at the service.
- Check if your state or territory has different requirements for respiratory symptoms.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.85
Human metapneumovirusDepends
Person who is sick
- If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), monitor them and exclude them if they have: several respiratory symptoms at the same time; new symptoms that developed while at the service; severe respiratory symptoms; symptoms that are getting worse (more frequent or severe); or concerning symptoms as well (fever, rash, tiredness, pain, poor feeding).
- A person can often have an ongoing cough after recovering from a respiratory infection. If their other symptoms have gone and they feel well, they can return.
- Talk to your local public health unit for advice if there are several children and staff with respiratory symptoms at the service.
- Check if your state or territory has different requirements for respiratory symptoms.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.87
PneumoniaDepends
Person who is sick
- If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), monitor them and exclude them if they have: several respiratory symptoms at the same time; new symptoms that developed while at the service; severe respiratory symptoms; symptoms that are getting worse (more frequent or severe); or concerning symptoms as well (fever, rash, tiredness, pain, poor feeding).
- A person can often have an ongoing cough after recovering from a respiratory infection. If their other symptoms have gone and they feel well, they can return.
- Talk to your local public health unit for advice if there are several children and staff with respiratory symptoms at the service.
- Check if your state or territory has different requirements for respiratory symptoms.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.89
RSV (respiratory syncytial virus)Depends
Person who is sick
- If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), monitor them and exclude them if they have: several respiratory symptoms at the same time; new symptoms that developed while at the service; severe respiratory symptoms; symptoms that are getting worse (more frequent or severe); or concerning symptoms as well (fever, rash, tiredness, pain, poor feeding).
- A person can often have an ongoing cough after recovering from a respiratory infection. If their other symptoms have gone and they feel well, they can return.
- Talk to your local public health unit for advice if there are several children and staff with respiratory symptoms at the service.
- Check if your state or territory has different requirements for respiratory symptoms.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.90
Streptococcal sore throatExcluded
Person who is sick
- Exclude until the person has received antibiotic treatment for at least 24 hours and feels well.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.91
Tuberculosis (TB)Ask PHU
Person who is sick
- Talk to your local public health unit for advice about exclusion.
Contacts (no symptoms) Ask PHU
- Talk to your public health unit for advice about screening, antibiotics and TB clinics.
NHMRC Table 4.2, p.92
Whooping cough (pertussis)Excluded
Person who is sick
- Exclude until at least 5 days after starting appropriate antibiotic treatment, or for at least 21 days from the onset of coughing if the person does not receive antibiotics.
Contacts (no symptoms) Ask PHU
- Talk to your public health unit for advice about excluding non-immunised contacts.
- Talk to immunocompromised or pregnant staff about risk and recommend they seek medical advice.
NHMRC Table 4.2, p.92
Serious infections
Hib (Haemophilus influenzae type b)Excluded
Person who is sick
- Exclude until the person has received antibiotic treatment for at least 4 days.
Contacts (no symptoms) Not excluded
- Talk to your public health unit for advice.
NHMRC Table 4.2, p.86
MeaslesExcluded
Person who is sick
- Exclude for at least 4 days after the rash appeared.
Contacts (no symptoms) Depends
- Immunised contacts are not excluded.
- For non-immunised contacts, talk to your public health unit for advice.
- Talk to immunocompromised or pregnant staff about risk and recommend they seek medical advice.
- Exclude all immunocompromised children until 14 days after the rash appears in the last case at the service.
NHMRC Table 4.2, p.87
Meningitis (viral)Excluded
Person who is sick
- Exclude until person is well.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.87
Meningococcal infectionExcluded
Person who is sick
- Exclude until the person has completed antibiotic treatment.
Contacts (no symptoms) Not excluded
- Talk to your public health unit for advice about antibiotics and/or vaccination for people who were in the same room as the case.
NHMRC Table 4.2, p.88
MumpsExcluded
Person who is sick
- Exclude for at least 9 days or until swelling goes down (whichever is sooner).
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.88
Pneumococcal diseaseExcluded
Person who is sick
- Exclude until person has received antibiotic treatment for at least 24 hours and feels well.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.88
Rubella (German measles)Excluded
Person who is sick
- Exclude until the person has fully recovered or for at least 4 days after the rash appears.
Contacts (no symptoms) Not excluded
- Talk to immunocompromised or pregnant staff about risk and recommend they seek medical advice.
NHMRC Table 4.2, p.90
Other
Cytomegalovirus (CMV) infectionNot excluded
Person who is sick
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.84
Glandular feverNot excluded
Person who is sick
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.85
HIVNot excluded
Person who is sick
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.86
Hepatitis BNot excluded
Person who is sick
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.86
Hepatitis CNot excluded
Person who is sick
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.86
Mosquito-borne diseases (such as Ross River, dengue, malaria)Not excluded
Person who is sick
- Not excluded.
- Talk to your public health unit for advice.
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.88
ToxoplasmosisNot excluded
Person who is sick
Contacts (no symptoms) Not excluded
NHMRC Table 4.2, p.91
State and territory documents
Questions
Should I write a clearance letter before a child returns?
NHMRC says services are not required to follow letters from doctors stating that a child can return, and should not require 'clearance' from a doctor. The service decides, using the guidelines and its own policy. Public health units can help if there is doubt.
Do contacts need to be excluded?
Mostly no. NHMRC recommends excluding contacts only for specific diagnosed conditions, and for several (for example measles in non-immunised contacts, shingles or whooping cough) it advises talking to the public health unit. People who develop symptoms follow the guidance for the person who is sick.
Why do some state posters differ from NHMRC?
NHMRC states that some states and territories have different or additional requirements, and Victoria's periods are set by regulation. Queensland's Time out poster, for example, gives different periods for some conditions, including mumps, rubella and flu-like illness. Always check the state document.
What do I tell a family about flu or COVID-19?
NHMRC handles flu, COVID-19, RSV and other respiratory infections by symptoms: monitor, and exclude if there are several respiratory symptoms at once, new symptoms, severe or worsening symptoms, or concerning symptoms such as fever, rash, tiredness, pain or poor feeding. For COVID-19 contacts it says to refer to state or territory advice.
Related
Patient version (searchable) · Safety netting · Catch-up vaccination
Source and licence
Source: National Health and Medical Research Council. Staying healthy: Preventing infectious diseases in early childhood education and care services, 6th edition (2024), Tables 4.1 and 4.2, pages 77–92 © Commonwealth of Australia 2024, licensed under CC BY 4.0. Adapted by AskMyGP: wording shortened and reorganised; the meaning of each recommendation is unchanged. NHMRC has not reviewed or endorsed this page. Read the original at NHMRC.
General information for clinicians, not clinical advice.