Landmark ruling on the Isle of Wight case: An opinion Free article: Children, school and part-time work Free article: Employability skills and Ofsted Free article: A-Z of codes - Applying the codes in practice Free article: The common inspection framework Personal development, behaviour and welfare A-Z of Codes 5: Codes M, N, O, P and R Free article: Infection control in schools Free article: Prosecution or penalty notice: Which is the correct response? Free article: Managing difficult conversations Free article: Parental engagement: working with hard-to-reach families Free article: A-Z of codes 1: marks for 'present' Free article: The use of penalty notices: the pros and cons Free article: Incentivising attendance - what really works Free article: Practical tips for transforming lateness into punctuality Free article: Best practice case study: Waldegrave School

Landmark ruling on the Isle of Wight case: An opinion

Ben Whitney gives his take on the recent Supreme Court ruling.

Free article: Children, school and part-time work

Ben Whitney enters the debate on the role of children in the workplace and discusses what help and regulation should exist to support them.

Free article: Employability skills and Ofsted

Under the new inspection framework, schools will be inspected on pupils' economic well-being – and that includes attendance rates. 

Free article: A-Z of codes - Applying the codes in practice

To conclude this series of reference guides, Ben Whitney reflects on some of the issues it has raised, both in correspondence and through questions by participants at Forum attendance conferences.

Free article: The common inspection framework Personal development, behaviour and welfare

A new common inspection framework is now in effect, and pupil attendance can be reviewed in terms of personal development, behaviour and welfare.

A-Z of Codes 5: Codes M, N, O, P and R

Continuing his series of handy reference guides, Ben Whitney explores each of the recommended Codes in detail, including:

Free article: Infection control in schools

Infections that cause diarrhoea, vomiting, common colds and flu are responsible for the loss of thousands of school days each year. Martin Hodgson gives guidance on what you need to…

Free article: Prosecution or penalty notice: Which is the correct response?

Ben Whitney looks at the circumstances that might dictate how schools and local authorities respond to cases of persistent absence.

Free article: Managing difficult conversations

Some conversations -whether with pupils, their parents or colleagues - are always going to be uncomfortable. In this article, Louise Wingrove looks at managing difficult subjects with care and confidence.

Free article: Parental engagement: working with hard-to-reach families

In this article, Professor Ken Reid explores some of the many options for families to play a larger part in school life, with potential benefits for both the children and…

Free article: A-Z of codes 1: marks for 'present'

In this series of handy reference guides, Ben Whitney explores each of the recommended Codes in detail.

Free article: The use of penalty notices: the pros and cons

Professor Ken Reid examines the use of penalty notices (PNs) since the Children Act 2006, including some discussion on recent developments in Wales and the issue of regional variations in…

Free article: Incentivising attendance - what really works

David Birch outlines the importance of reward systems as a means of improving attendance in schools. Read on to find out about the merits of commercial schemes and the essential…

Free article: Practical tips for transforming lateness into punctuality

Steve Baker provides some practical advice on how to tackle persistent lateness and develop school-wide policies to encourage, develop and maintain punctuality.

Free article: Best practice case study: Waldegrave School

Our reporter Helen Clark finds out how one outstanding school has just achieved its best-ever attendance figures.

Free article: Infection control in schools

Published: Friday, 21 November 2014

Infections that cause diarrhoea, vomiting, common colds and flu are responsible for the loss of thousands of school days each year. Martin Hodgson gives guidance on what you need to know and how best to respond to an infectious outbreak.

Summary

  • Schools are an ideal environment for the spread of infectious diseases because so many people share the premises every day.
  • There is a broad plan of action that schools can follow to prevent the spread of diseases.
  • Staff, pupils and their parents should be informed of the standard incubatory periods for infectious diseases.

Public Health England (PHE) has published updated guidance on infection control for schools (http://bit.ly/ZhTfgs). The updated guidance gives advice on the prevention of infections and provides recommended periods for children to be excluded from school if infected.

Infectious diseases

Infectious diseases are those that can be passed from person to person. They are caused by micro-organisms, such as bacteria or viruses, which typically gain access to the body by being passed on by touch, by being eaten, by being breathed into the air – for example, when someone coughs or sneezes – or through bodily fluids, such as blood. Once in the body, a person's immune system will try to fight the infection and they may go through an incubation period before any symptoms emerge.

Diseases passed from person to person by physical contact are often described as contagious or communicable diseases. In some diseases, once the symptoms have disappeared, the person may remain infectious for a period and still capable of passing the micro-organism on to other people. In such cases it is important that staff do not return to work, or pupils return to school, before it is safe to do so.

Schools are an ideal environment for the spread of infectious diseases because so many people share the premises every day. In addition, difficulties in maintaining high standards of hygiene amongst children are well known. Good infection control measures are therefore essential to protect both children and staff if high levels of staff and pupil sickness are to be avoided.

Those most at risk are the very young and the elderly, and those who are immuno-compromised. Immuno-compromised individuals may have a condition, or are receiving a treatment that suppresses their normal immune response, which leaves them vulnerable to infection. This includes those being treated for leukaemia or other cancers, or those on high doses of steroids. Information about such treatments or conditions should be included in a pupil's healthcare plan and appropriate actions agreed with parents.

Preventing infections

While infectious diseases cannot be eliminated entirely, there is much that a school can do to prevent diseases being spread. The updated PHE advice, Guidance on infection control in schools and other childcare settings, lists key actions as:

  • routine immunisation
  • high standards of personal hygiene, particularly hand-washing
  • maintaining a clean environment.

Cleaning

An effective cleaning regime should be in place whereby the school is kept in a clean and hygienic condition. Dirt and grime provide a breeding ground for bacteria, and many infectious organisms can exist on uncleaned surfaces.

Cleaning of premises and equipment should be frequent and thorough. Special attention should be paid to kitchens, dining rooms, washrooms, changing areas and medical rooms.

Cleaning standards should be closely monitored, and good practice should be followed. For example, colour-coded equipment should be used to ensure that the same items are not used in areas such as kitchens and toilets.

Spillages and waste disposal

Any spillage of bodily fluids, or body waste such as blood, faeces and urine, should be cleaned up as quickly as possible and with caution. Staff should assume that spillages are infectious and should wear appropriate personal protective equipment, such as disposable gloves.

A suitable cleaning product should be used that combines both a detergent and a disinfectant to kill any micro-organisms. The manufacturer's instructions should be followed and precautions taken in compliance with the Control of Substances Hazardous to Health Regulations 2002 (COSHH).

Mops should not be used for cleaning up blood and bodily fluid spillages. Disposable paper towels are a far safer option. Used towels should be discarded as clinical waste.

A made-up spillage kit should be available for blood spills. This should contain disposable aprons, gloves, clinical waste bags, paper towels, disinfectant cleaning products and instructions for use.

Infectious waste should be segregated from ordinary waste, placed in clinical waste bags and stored securely until collected by a specialist waste contractor. As well as waste from spillages, potentially infectious waste includes items such as soiled dressings.

Hand hygiene

Hand hygiene is the single most important way of reducing infection and preventing its spread. Hands should be washed after using the toilet, after blowing the nose, coughing or sneezing, and before eating or handling food.

Public health experts recommend the use of liquid soap, hot water and paper towels. Bar soaps and fabric roller-towels can quickly become soiled and damp, and can harbour micro-organisms themselves.

Hand-cleaning notices can be posted by sinks to remind both staff and pupils to wash their hands after using the toilet, and all opportunities should be taken to teach the importance of hand hygiene to pupils.

Information and exclusion

Children who are ill with an infectious disease should not be in school.

Staff, pupils and parents should be informed of the standard incubatory periods for infectious diseases and of the importance of preventing the further spread of infection by excluding infected pupils from school.

Those showing symptoms of an infectious disease should be advised as to the recommended minimum exclusion periods. These may vary from one area to another according to advice from local authorities (LAs), but the PHE guidance gives typical examples for common diseases. These include:

  • Diarrhoea and/or vomiting – 48 hours from last episode of diarrhoea or vomiting
  • E.coli O157 VTEC/Typhoid (enteric fever)/shigella (dysentery) – should be excluded for 48 hours from the last episode of diarrhoea, with further exclusion required for some children
  • Flu (influenza) – until recovered
  • Whooping cough (pertussis) – five days from starting antibiotic treatment, or 21 days from onset of illness if no antibiotic treatment
  • Head lice – none
  • Meningococcal meningitis/septicaemia – until recovered
  • Viral meningitis – none
  • Threadworms – none
  • Tonsillitis – none
  • German measles (rubella) – four days from onset of rash
  • Scabies – after first treatment.

Staff should immediately inform the headteacher if they have concerns about a pupil. The headteacher should comply with LA policies, where applicable, and work with the pupil's parents to have the pupil seen by a GP.

Where necessary, schools should seek advice from the local Consultant in Communicable Disease Control (CCDC).

Immunisation

People can be protected from many infectious diseases, such as measles, mumps, rubella and chickenpox, by being immunised.

Both pupils and staff should be encouraged to be up to date with the immunisations recommended for them. The immunisation status of staff should be checked through an occupational health check before starting employment. Pupils will have been offered various vaccinations through the childhood immunisation scheme, and their compliance with this should be checked at school entry. Missed vaccinations for pupils should be addressed with their parents and followed up by the school nurse.

The childhood vaccination programme is subject to change. Schools and parents can find the latest news on the NHS Choices website. In 2013 there was a major MMR vaccination catch-up initiative in a number of schools, following concerns about rising numbers of measles cases.

Food-borne infections

School catering or kitchen staff who work around open food while suffering from certain infections (mainly from bacteria and viruses) can contaminate food and may spread infection. If a member of the school meal service develops the symptoms of any communicable disease or infection, they should inform their line manager and be excluded from food handling until symptom-free and fit to return to work.

Common food-poisoning organisms causing gastrointestinal infections include salmonella, campylobactor and E.coli.

Blood-borne infections

Blood-borne infections are those that can be spread through contamination by blood and other body fluids. Examples are HIV, hepatitis B, hepatitis C and viral hemorrhagic fevers.

Common routes of transmission include so-called 'sharps' accidents, where someone is injured by a contaminated syringe needle, intravenous drug use, or bites.

To avoid sharps injuries, any used needles should be discarded in specialist 'sharps' bins. In the event of a sharps injury, or a bite wound, staff should contact their GP or occupational health, or go immediately to A&E.

Action to take during an outbreak

An outbreak is said to occur where two or more children suffer from the same disease at the same time.

If an outbreak of infectious disease is suspected, schools should contact their local health protection unit immediately. They should comply with advice and guidance given and cooperate fully with the CCDC, who may require information about ill pupils health records, associations and movements.

Schools should ensure that all staff and parents are made aware of the outbreak but should coordinate any public announcements with the communicable disease team. Making public announcements about potentially serious illnesses without causing undue alarm is a sensitive task, and schools should ensure that a public health professional takes responsibility for managing the situation. Local CCDCs are used to handling such situations and dealing with the public concerns that usually accompany them.

In extreme cases a school may be closed temporarily, although this is very rare.

During an outbreak, increased environmental cleaning may be appropriate. Headteachers should arrange for toilets and facilities to be cleaned more often to reduce the risk of transmission of the infection via environmental contamination – e.g. a focus on the cleaning of toilet seats, toilet flushes and door handles in the event of diarrhoea or vomiting, etc.

In some cases, schools and children may be an 'early warning' for the community spread of an infection or an epidemic, and public health professionals will want to work closely with schools to collect data and build awareness.

Notifiable diseases

It is a statutory requirement that doctors report a notifiable disease to the proper officer of the LA, usually the CCDC. In addition, schools may be required, via locally agreed arrangements, to inform their local PHE centre.

Notifiable diseases include German measles, measles, scarlet fever, diptheria, hepatitis, typhoid, whooping cough, mumps, meningococcal meningitis and viral meningitis.

Infection control policies

All schools should have a policy on infection control, which should be read by all staff. The policy should include education and training of employees in infection prevention and control issues, including outbreaks of infection, and protocols for hand-washing.

Pregnant women

According to PHE guidelines, if a pregnant woman develops a rash or is in direct contact with someone with a potentially infectious rash, this should be investigated by a doctor.

Specific risks include:

  • chickenpox – which can affect the pregnancy if a woman has not already had the infection
  • German measles (rubella)
  • slapped cheek disease (parvovirus B19)
  • measles – during pregnancy this can result in early delivery or even loss of the baby.

Further Information

  • Guidance on infection control in schools and other childcare settings is available from the GOV.UK website (http://bit.ly/ZhTfgs).

Toolkit

Use the following items in the Toolkit to help you put the ideas in this article into practice:

About the author

Martin Hodgson MSc, PGCEA has worked in adult education for most of his career and has been a governor of a large technology college for nearly 10 years. His special interests are premises management and health and safety.

First published on this website in December 2014.

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