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Conjunctivitis Whats Your Policy ?


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Do you exclude children with conjunctivitis ?


I collected one of my charges from nursery earlier ths week and noticed immediatley he wasnt "right"

There was no comment from the nursey teacher but he looked very sad and had red eyes.I questioned him gently and he said there was nothing wrong and he was nt sad.

Concerned I rang mum but there was no answer so i left a message

We popped along to the shops on the way home where we bumped into dad,I explained my concerns and he informed me his eyes had been worse the day before but he d appeared better that morning so he d been taken to nursery

Mum later rang (mum and dad are separated) and said she d taken him to the pharmasist the previous day and they did nt think it was conjunctivitis and said just to bathe the eyes .


dad picked him up early that day as they decided to take him to the doctors ,and he did nt come to me for the next 2 days although on the second day he was back at nursery .

I spoke to dad at school and he said it was conjunctivitis that they just had to bathe the eyes and practise good hygiene but had been told that there was no need to exclude him from nursery .

I questioned this knowing it is so contagious saying that as a childminder i did nt take children with it as it spread so easily.

He returned to me later saying he had spoken to one of the other mums saying that her child also had it and she d been told the same .

I suggested thats why maybe several children in nursery had it as it spreads like wildfire and 3 and 4 year olds are nt especially good at not wiping their eyes if they re sore !!!


What does anyone else do ?

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Just found this on a scottish website-



Exclusion is unnecessary, unless there is a lot of

pus being produced in which case children should be excluded until three

days of treatment have been completed.


not sure if I should have written that - but here's the link to the webpage just be be the safe side!




We usually send children home and say they can return once treament has started - we haven't been challenged about this approach yet. But we're a pre-school...........I imagine it's alot more difficult for childminders.

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There are three types of conjunctivitis, each with a different cause.

* irritant conjunctivitis

* allergic conjunctivitis

* infective conjunctivitis

only infective conjunctivitis is infectious and requires the child to be kept off school

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I to recently had a similiar situation with a child that attends my setting but if you look at the HPA guidance on infection control in schools and other childcare settings it actually states " the recommended period to be kept away from school,nursery or childminders- none" I was shocked by this as I thought that this can be spread easily.




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Our school and therefore nursery policy is that the child can return once treatment has been administered. Treatment is now available over the counter and there is no requirement for the child to see a Doctor.

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We have the same policy at our Nursery - if badly weeping and red then the child has to be taken to GP or pharmacy for treatment - once treatment has been administered and eyes less infected and weepy they can return ( can be later same day or next day.) If there is no sign of redness in the eyes and the pus is minimal then it's just monitored at Nursery and parents informed. :o

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We have just received a letter about this from Lincolnshire NHS:


Dear Colleagues


RE: Conjunctivitis


I have been asked to provide some advice notes for circulation to day-nurseries and schools regarding conjunctivitis. This is to specifically include recommendations concerning treatment and exclusion from the day nursery or school setting. I have therefore listed some facts for your information.


What is conjunctivitis?

Conjunctivitis means inflammation of the eye.


How does conjunctivitis present?

The eye appears red and may feel 'gritty', with a watery or yellow discharge.


What causes conjunctivitis?

Conjunctivitis may be caused by a number of things for example bacteria, viruses, a tiny piece of debris in the eye such as grit or occasionally allergy to a particular substance.


How long does conjunctivitis last?

The incubation period can be anything from 3 to 29 days depending on the bacteria or the virus, and the infection may lasting for 2-3 weeks. Many individuals have no more than redness of the eyes and a slight discharge for a few days.


What is the treatment?

Sometimes it will not be clear whether the infection is bacterial or viral. The GP may take swabs.

• Bacterial Conjunctivitis may require antibiotic eye drops and/or ointment from the GP. Care should be taken to follow instructions on the pack or advice from the GP.

• Viral conjunctivitis is not helped by antibiotics and will clear up on its own, without treatment, probably taking between 5 and14 days.


Exclusion from school or nursery?

Exclusion of cases from school/nursery is not necessary. However, sometimes discomfort of Conjunctivitis can make the affected person feel generally unwell and “miserable”. Young children especially may suffer more than adults, so should be kept off school until they feel better.


Exclusion may be necessary if an outbreak occurs. If outbreak is suspected further advice should be sought from your governing body and notified or cascaded as set down in your establishment’s plan.


How may the spread of conjunctivitis be prevented?

• Good standards of hand washing and drying

• Personal hygienic care and appropriate treatment of the affected eye – including separate towels, face cloths and so on.

• Avoid sharing any clothing or equipment that may come into contact with the eye including toys



I hope that this helps with the care of and advice about individuals presenting at the day-nursery or school with conjunctivitis.











Janine Rayfield

Nurse Consultant Public Protection

District Immunisation Coordinator

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Our school policy is once the child has the eyes drops/cream in they can come back before we broke up for easter in the nursery we had 6 cases of it within a week!

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Hello all

I am reading with interest this thread on conjunctivitis- our school policy is also once been treated it is ok for the child to be in. However, if the child is feeling generally miserable and 'not their usual self' then we phone for the carer to come and collect.

It is even more interesting that we have had about half a dozen cases in the last week of term- is there a common theme/pattern throughout the nation!

I too was surprised that it was ok for the child to be in the setting due to it's high contagious rate- the advise used to be to keep them off. Given that young children are not the best ones at keeping their hands to themselves then maybe this is why there are so many cases at the moment. Maybe the policy of sending them back should be reviewed if outbreaks keep occurring?

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We always excluded children until treatment was completed so were surprised when one parent returned from doctor's having been told exclusion isn't necessary unless you have an outbreak of several cases - parent knew this wasn't our normal policy so asked doctor for copy of the information and brought it in for us!

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There is a particularly high incidence of conjunctivitis around at the moment - it appears to be connected in a lot of cases with a severe cold virus which is going around in our area so it's mainly viral conjunctivitis and the GPs just recommend bething with boiled cooled water and a teaspoon of salt. This is because the eyedrops tend to only deal with bacterial infections and are quite difficult to administer to small children. Often if there is a cluster in a setting it's not cross contamination from child to child - its just the poor handwashing and general 'rubbing' of mucus etc into their own eyes that causes the infection. :o

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Thanks for all of your replies ,I ve been reading them with interest.There doesnt seem a clear cut answer ,but I still think I will continue to exclude until the child has been at least treated .as a childminder my big concern was not only it spreading to the other children in my care -some of them very young ,but that if I get it am I supposed to stay off work,would the parents be as happy to leave their childrern with me and if I m not available no work = no pay!!

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  • 3 weeks later...
Its worth getting a copy of this poster and guidance as it's got info on all the common infections





Thanks for the link to poster, have a copy now.

Edited by Guest
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  • 2 weeks later...

Reading this with interest (a few days late) as our policy (if red and inflamed, send home) has just been challenged by a parent. The HPA poster shown in the link is a new version of one we have. The one we have says no exclusion once better, whereas the new poster says no exclusion unless there is a cluster of cases. The problem is, of course, that if you don't exclude, you are likely to get a cluster of cases and it can be pretty horrible!


I wish when I went on a wild goose chase after the old HPA poster last year (and in the end had to download and print, which is tricky for A3!), that the officials had thought to say that the reason there were no hard copies was that they were up-dating it and changing the advice!!!!

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