Illness, Infectious Disease Rules, and When Children Must Stay Home
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Parent Support and Information.
Keeping Children Healthy in Early Childhood Services
Early childhood services have an important responsibility to protect the health of all children and adults on their premises. This includes knowing which infectious diseases require a child or adult to stay away from the service. If a person is suspected of having, or is confirmed to have, an infectious disease, they must not enter the service or come into contact with others.
Services must also have a safe, supervised space where a child can wait comfortably (an isolation area) if they become unwell during the day, until a parent or caregiver is able to collect them.
Not all illnesses require exclusion. Common, mild illnesses – such as a simple cold – are not listed on the infectious diseases chart and do not require a child to be isolated or sent home unless their condition prevents them from participating comfortably in the programme.
What Parents and Caregivers Can Do
- Keep your emergency contact details up to date, including who can collect your child if you’re unavailable or unable to get to the service promptly (for example, within an hour).
- Talk with teachers or your home‑based educator if you have any concerns about your child’s health.
- Let staff know if your child has had medication overnight or before arriving. This helps them monitor your child in case symptoms worsen.
- Keep your child home for at least 48 hours after vomiting or diarrhoea has stopped.
- Seek advice from your GP or healthcare provider if you are unsure whether your child is well enough to attend.
Under Regulation 57 of the Education (Early Childhood Services) Regulations, services must exclude a child from contact with others if there are reasonable grounds to believe they have an infectious or contagious disease. The infectious diseases chart (see below) outlines how long children should stay away for each illness.
When There Is Disagreement About Attendance
Parents and caregivers know their child best and can often tell when their child is well enough to participate in the day’s activities. It is reasonable and a sign of care for a service to contact you if your child shows signs of illness, so you can decide whether to check on them or take them home.
However, disagreements can sometimes arise. Services may face roll‑management pressures, or staff may not be fully familiar with the service’s illness policy or exclusion rules. In these situations, a parent may be asked to collect a child even when the illness does not require exclusion.
If there is uncertainty or disagreement about whether a child should stay away, the Public Health Service’s guidance on exclusion times is the standard reference.
If your GP or healthcare provider advises keeping your child home longer than the minimum exclusion period, you may choose to follow their recommendation. Healthcare providers can consult with the Public Health Service.
ECE Service Policy and Procedures
Your service should have an Illness and Infectious Diseases Policy – you can ask to see this. It is a good idea to know the policy so you know what to expect.
Early childhood services are required to take all reasonable steps to protect children from coming into contact with anyone who may have an infectious disease. While no service can completely prevent the spread of illness, especially in group settings where children naturally play closely together, they must do everything practicable to minimise the risk.
To keep children as safe and healthy as possible, each service must be able to:
- Recognise early signs of illness
- Understand what actions to take when a child or adult may be infectious
- Know how long a person is infectious and when they can safely return
- Understand how different diseases spread and the practical measures that can be taken in the early childhood setting to reduce the risk, such as ensuring fresh air flow in all rooms and ensuring children don’t share cups and eating utensils.
The Office of Early Childhood Education (OECE) provides clear policy guidance and a template that services can adapt to suit their community: Illness and Infectious Diseases Policy and Procedures.
We’ve also included a simplified version of the OECE’s Illness and Infectious Diseases Chart (see below), which outlines common infectious conditions and their recommended exclusion times.
Chart Showing Infectious Diseases and Conditions likely to be Passed on to Children, Symptoms, and Exclusion Times
| DISEASE or CONDITION **Vaccine-preventable and/or on the National Immunisation Schedule | EARLY SYMPTOMS | MINIMUM EXCLUSION PERIOD FROM ATTENDING ECE SERVICE |
| Campylobacter (Notifiable disease – Public Health) | Stomach pain, fever, nausea, diarrhoea and/or vomiting. | Until well and for 48 hours after last episode of diarrhoea or vomiting. |
| Chicken Pox ** | Fever and spots with a blister on top of each spot. | 1 week from appearance of rash, or until all blisters have dried. |
| Conjunctivitis (Pink eye) | Irritation and redness of eye. Sometimes there is a discharge. | Exclude until eyes are not sticky or weeping. |
| Cryptosporidium (Notifiable disease – Public Health) | Stomach pain, fever, nausea, diarrhoea and/or vomiting. | Until well and for48 hours after last episode of diarrhoea or vomiting. Do not use public pool for 2 weeks after symptoms have stopped. |
| Giardia (Notifiable disease – Public Health) | Stomach pain, fever, nausea, diarrhoea and/or vomiting. | Until well and for 48 hours after the last episode of diarrhoea or vomiting. |
| Hand, foot, and mouth disease | Fever, flu-like symptoms – rash on soles and palms and in the mouth. | Exclude until blisters have dried. If blisters can be covered, and child feeling well, no need to exclude. |
| Head lice (Nits) | Itchy scalp, especially behind ears. Occasionally scalp infections that require treatment may develop. | None, but ECE service should be informed. Treatment recommended to kill eggs and lice. |
| Hepatitis A (Notifiable disease – Public Health) | Nausea, stomach pains, with jaundice appearing a few days later. Children may have no symptoms or other symptoms such as diarrhoea, cough, runny nose, joint pain. | 7 days after the start of jaundice and/or other symptoms. |
| Influenza and Influenza-like illness including RSV and COVID 19 (COVID 19 is a notifiable disease)** | Sudden onset of fever with cough, sore throat, muscular aches, and a headache. | No fever for 24 hours – until well. |
| Measles (Notifiable disease – Public Health) ** | Runny nose and eyes, cough, and fever, followed a few days later by a rash. | 5 days after the appearance of rash. |
| Meningococcal Meningitis (Notifiable disease – Public Health) ** | Generally unwell, fever, headache, vomiting, sometimes a rash. Urgent treatment is required. | Until well enough to return. |
| Molluscum Contagiosum | Groups of small, hard, skin-coloured, raised spots on the skin. Can appear anywhere but often in the armpit, behind the knee, or in the groin. | No exclusion required |
| Mumps (Notifiable disease – Public Health) ** | Pain in jaw, swelling around face and neck, fever, headache. | Exclude until 5 days after facial swelling develops, or until well. |
| Norovirus | Stomach pain, fever, nausea, diarrhoea and/or vomiting. | Until well and for 48 hours after the last episode of diarrhoea or vomiting. |
| Ringworm | Flat, ring-shaped rash. | None, but swimming and skin contact should be avoided until treatment. |
| Rotavirus ** | Nausea, diarrhoea and/or vomiting. | Until well and for 48 hours after the last episode of diarrhoea or vomiting. |
| Rubella (German Measles) (Notifiable disease – Public Health) ** | Fever, swollen neck glands and a rash on the face, scalp, and body. | 7 days from appearance of rash and until well. |
| Salmonella (Notifiable disease – Public Health) | Stomach pain, fever, nausea, diarrhoea and/or vomiting. | Until well and for 48 hours after the last episode of diarrhoea or vomiting. Discuss exclusion of cases and contacts with public health service. |
| Scabies | Itchy rash. | Exclude until 24 hours after appropriate treatment. |
| School sores (Impetigo) | Blisters on the body which burst and turn into scabby sores. | Until sores have dried up or 24 hours after antibiotic treatment has started. |
| Shigella (Notifiable disease – Public Health) | Diarrhoea (may be bloody), fever, stomach pain. | Discuss exclusion of cases and their contacts with public health service. |
| Slapped cheek (Human parvovirus infection) | Fever, headache, runny nose, sore throat followed a few days later by bright red rash on cheeks and a pink lace-like rash on the body. | Unnecessary unless unwell. |
| Streptococcal sore throat | Headache, vomiting, sore throat. An untreated sore throat could lead to Rheumatic fever. | Exclude until well and/or has received antibiotic treatment for at least 24 hours. |
| Threadworm (pin worm) | Itchy bottom, often worse at night. Not sleeping well, irritable and not wanting to eat as much. | No exclusion required. Over-the-counter medicine available. |
| VTEC/STEC Verocytotoxin-or shiga toxin-producing E.coli (Notifiable disease – Public Health) | High incidence of bloody diarrhoea, stomach pain. High rate of hospitalisation. | 48 hours after person last had diarrhoea or vomiting |
| Whooping cough (Pertussis) (Notifiable disease – Public Health) ** | Runny nose, persistent cough followed by “whoop”, vomiting or breathlessness. | Five days from commencing antibiotic treatment. Or 21 days from onset of illness or until no more coughing if no antibiotic treatment. |
Failing to meet minimum standards
The Ministry of Education needs to know:
- If you are concerned children’s needs are not being met.
- If you are concerned a service is not meeting a minimum legal requirement.
READ MORE: How to make a complaint and your options.
CAUTION: This page and the information here is provided as part of the My ECE Guide to Early Childhood Service Regulations and Licensing Criteria for Parents (The Guide). The Guide does not purport to be a full and accurate interpretation of all statutory provisions relating to early childhood education services. While best efforts have been used in preparing this guide, no representations or warranties of any kind are made and My ECE assumes no liabilities of any kind with respect to the accuracy or completeness of the content. Please note that the Government and Ministry of Education may change, update, or alter any of the requirements at any time. Please help to keep the information on this page up to date by letting us know of changes that need to be made.
Thank you! Kia pai te rā
Reference:
My ECE Guide to Early Childhood Service Regulations and Licensing Criteria for Parents. Prepared by Dr Sarah Alexander and Warwick Marshall.
