Infectious illnesses: Symptoms, spread and exclusion guidance (HS120)
This page provides information for Early Learning Services (ELS) to support decision-making about whether a person (child or adult) should be excluded from the facility. This guidance may also be applied in schools and workplaces.
Vaccine-preventable and/or on National Immunisation Schedule. Talk to your healthcare provider to find out more about immunisations.
During pregnancy, seek advice from your healthcare provider or GP regarding any risks to your unborn pēpi | baby if you get the illness and whether there are any vaccinations you can get to protect your unborn pēpi.
Symptoms
Fever, runny nose, cough and spots with a blister on top of each spot.
How it spreads
Breathing in infectious air particles from an infected person who has breathed out, sneezed or coughed. Contact with fluid from blisters.
Time between exposure and showing symptoms
10 to 21 days (usually 14 to 16 days)
Exclude sick person from early learning service, school, or work until
1 week from appearance of rash, or until all blisters have dried up and crusted.
More information
Chickenpox – KidsHealth New Zealand's Trusted Voice On Children's Health
Symptoms
Fever, headache, sore throat, painful red blisters in or around the mouth. 1 to 2 days later red blisters can appear on palms of hands, soles of feet or elsewhere on the body.
How it spreads
Breathing in infectious air particles from an infected person who has breathed out, sneezed or coughed. Contact with fluid from blisters.
Time between exposure and showing symptoms
3 to 5 days
Exclude sick person from early learning service, school, or work until
All blisters have dried up (usually within a few days). If blisters can be covered, and child is feeling well, they will not need to be excluded.
More information
Symptoms
Itchy scalp or scratch marks, especially behind ears. Lice (small flat insects) seen on the scalp, or their eggs (nits) on strands of hair.
How it spreads
Direct contact with an infested person’s hair, and less commonly by contact with contaminated surfaces and objects.
Time between exposure and showing symptoms
Not applicable
Exclude sick person from early learning service, school, or work until
No exclusion required. ELS/school should be informed. Treatment is recommended to kill eggs and lice.
Caregivers are encouraged to seek treatment advice.
More information
How to get rid of head lice – KidsHealth New Zealand's Trusted Voice On Children's Health
Symptoms
Red sores or blisters, which burst to leave crusty, golden-brown patches. This can be itchy.
How it spreads
Direct contact with an infected person's sores or their clothing, bedding or towels.
Time between exposure and showing symptoms
Approximately 10 days
Exclude sick person from early learning service, school, or work until
Sores have dried up or at least 24 hours after appropriate treatment has started and sores on exposed skin are covered.
Caregivers are encouraged to seek treatment advice.
More information
School sores in children – KidsHealth New Zealand's Trusted Voice On Children's Health
Notifiable disease. Public health service will be notified and will manage and support people with this disease.
Vaccine-preventable and/or on National Immunisation Schedule. Talk to your healthcare provider to find out more about immunisations.
During pregnancy, seek advice from your healthcare provider or GP regarding any risks to your unborn pēpi | baby if you get the illness and whether there are any vaccinations you can get to protect your unborn pēpi.
Symptoms
Fever, cough, runny nose and sore or red eyes. 3 to 5 days later a rash appears, starting on the face and neck, before spreading down the rest of the body. The rash is not usually itchy.
How it spreads
Breathing in infectious air particles from an infected person who has breathed out, sneezed or coughed. The virus can remain in the air for up to 2 hours.
Time between exposure and showing symptoms
7 to 21 days (usually 10 to 14 days)
Exclude sick person from early learning service, school, or work until
4 full days after appearance of a rash
A person is also infectious from 4 days before the appearance of a rash.
More information
Measles In Children – KidsHealth New Zealand's Trusted Voice On Children's Health
Symptoms
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.
How it spreads
Direct contact with an infected person's sores or their clothing, bedding or towels. Through infected water, such as a bath.
Time between exposure and showing symptoms
Usually 2 weeks but can be up to 6 months
Exclude sick person from early learning service, school, or work until
No exclusion required.
More information
Molluscum contagiosum in children – KidsHealth New Zealand's Trusted Voice On Children's Health
Symptoms
Flat, itchy, scaly spots or rash on the skin with a raised red border that spreads outwards in a circle.
How it spreads
Direct contact with an infected person's rash or their clothing, bedding or towels.
Time between exposure and showing symptoms
4 to 14 days
Exclude sick person from early learning service, school, or work until
No exclusion required. Swimming and skin contact should be avoided until treated with antifungal product.
Caregivers are encouraged to seek treatment advice.
More information
Ringworm – KidsHealth New Zealand's Trusted Voice On Children's Health
Notifiable disease. Public health service will be notified and will manage and support people with this disease.
Vaccine-preventable and/or on National Immunisation Schedule. Talk to your healthcare provider to find out more about immunisations.
During pregnancy, seek advice from your healthcare provider or GP regarding any risks to your unborn pēpi | baby if you get the illness and whether there are any vaccinations you can get to protect your unborn pēpi.
Symptoms
Fever, swollen neck glands or sore throat. Runny nose, sneezing, cough, sore, red eyes, sore joints. Red or spotty rash on the face, neck and body.
How it spreads
Breathing in infectious air particles from an infected person who has breathed out, sneezed or coughed.
Time between exposure and showing symptoms
14 to 23 days (usually 16 to 18 days)
Exclude sick person from early learning service, school, or work until
7 days after the appearance of a rash and feeling well
More information
Symptoms
Itchy rash mostly affecting the arms, legs and trunk (from the neck down to the pelvis).
How it spreads
Direct contact with an infected person's rash or their clothing, bedding or towels.
Time between exposure and showing symptoms
3 to 6 weeks (can be 1 to 4 days if had scabies before)
Exclude sick person from early learning service, school, or work until
24 hours after the first treatment
Caregivers are encouraged to seek treatment advice.
More information
Scabies in children – KidsHealth New Zealand's Trusted Voice On Children's Health
During pregnancy, seek advice from your healthcare provider or GP regarding any risks to your unborn pēpi | baby if you get the illness and whether there are any vaccinations you can get to protect your unborn pēpi.
Symptoms
Fever, headache, runny nose, sore throat followed a few days later by a bright red rash on cheeks and a pink lace-like rash on the body.
How it spreads
Breathing in infectious air particles from an infected person who has breathed out, sneezed or coughed.
Time between exposure and showing symptoms
4 to 20 days (usually 16 days)
Exclude sick person from early learning service, school, or work until
Feeling well. If they have a rash but are otherwise feeling well, they do not need to be excluded.
More information
Slapped cheek disease (Fifth Disease) – KidsHealth New Zealand's Trusted Voice On Children's Health
Notifiable disease. Public health service will be notified and will manage and support people with this disease.
Do not go swimming in a pool if you have diarrhoea (runny poos). You need to wait until it has been at least 2 weeks since the last time you had diarrhoea.
Symptoms
Stomach pain, fever, nausea, diarrhoea and/or vomiting.
Giardia may also cause bloating, flatulence and weight loss.
How it spreads
Consuming contaminated drinking water, raw milk, food, or undercooked food.
Exposure to contaminated environmental surfaces and water sources (for example, rivers).
Contact with an infected person’s or animal’s faeces (poo).
Time between exposure and showing symptoms
Campylobacter: 1 to 10 days
Cryptosporidium: 1 to 12 days
Giardia: 3 to 25 days
Salmonella: 6 hours to 3 days
Exclude sick person from early learning service, school, or work until
48 hours after a person last had diarrhoea or vomiting
More information
Notifiable disease. Public health service will be notified and will manage and support people with this disease.
Vaccine-preventable and/or on National Immunisation Schedule. Talk to your healthcare provider to find out more about immunisations.
Do not go swimming in a pool if you have diarrhoea (runny poos). You need to wait until it has been at least 2 weeks since the last time you had diarrhoea.
Symptoms
Fever, fatigue, nausea, stomach pain, general sickness with jaundice (yellow skin) appearing a few days later.
Children may have no symptoms or other symptoms such as diarrhoea, cough, runny nose, joint pain.
How it spreads
Consuming contaminated food, or drink. Contact with an infected person’s faeces (poo).
Time between exposure and showing symptoms
15 to 50 days (usually 28 to 30 days)
Exclude sick person from early learning service, school, or work until
7 days after the start of jaundice (yellow eyes or skin) and/or other symptoms
More information
Vaccine-preventable and/or on National Immunisation Schedule. Talk to your healthcare provider to find out more about immunisations.
Do not go swimming in a pool if you have diarrhoea (runny poos). You need to wait until it has been at least 2 weeks since the last time you had diarrhoea.
Symptoms
Stomach pain, fever, nausea, diarrhoea and/or vomiting.
How it spreads
Consuming contaminated food or drink.
Exposure to contaminated environmental surfaces and water sources (for example, rivers).
Contact with an infected person’s faeces (poo).
Time between exposure and showing symptoms
Norovirus: 10 to 72 hours
Rotavirus: 24 to 74 hours
Exclude sick person from early learning service, school, or work until
48 hours after a person last had diarrhoea or vomiting
More information
Notifiable disease. Public health service will be notified and will manage and support people with this disease.
Do not go swimming in a pool if you have diarrhoea (runny poos). You need to wait until it has been at least 2 weeks since the last time you had diarrhoea.
Symptoms
Bloody diarrhoea, stomach pain.
Can lead to serious complications requiring immediate medical attention.
How it spreads
Consuming contaminated drinking water, raw milk, food, or undercooked food.
Exposure to contaminated environmental surfaces and water sources (for example, rivers).
Contact with an infected person’s or animal’s faeces (poo).
Time between exposure and showing symptoms
2 to 10 days
Exclude sick person from early learning service, school, or work until
48 hours after a person last had diarrhoea or vomiting
More information
Notifiable disease. Public health service will be notified and will manage and support people with this disease.
Do not go swimming in a pool if you have diarrhoea (runny poos). You need to wait until it has been at least 2 weeks since the last time you had diarrhoea.
Symptoms
Diarrhoea (may be bloody), fever, nausea, stomach cramps, vomiting.
How it spreads
Consuming contaminated food or drinking water.
Exposure to contaminated environmental surfaces.
Contact with an infected person’s faeces (poo).
Time between exposure and showing symptoms
12 hours to 7 days (usually 1 to 3 days)
Exclude sick person from early learning service, school, or work until
48 hours after a person last had diarrhoea or vomiting
More information
Flu (Influenza)
Vaccine-preventable and/or on National Immunisation Schedule. Talk to your healthcare provider to find out more about immunisations.
Other illnesses similar to influenza
RSV (respiratory syncytial virus)
Vaccine-preventable and/or on National Immunisation Schedule. Talk to your healthcare provider to find out more about immunisations.
Colds (upper respiratory tract infection)
COVID-19
Notifiable disease. Public Health Service may provide support.
Vaccine-preventable and/or on National Immunisation Schedule. Talk to your healthcare provider to find out more about immunisations.
During pregnancy, seek advice from your healthcare provider or GP regarding any risks to your unborn pēpi | baby if you get the illness and whether there are any vaccinations you can get to protect your unborn pēpi.
Symptoms
Cough, sore throat, headache, tiredness.
Cold symptoms are gradual and commonly include runny nose and sneezing.
Flu is usually more severe, and the symptoms may last longer. Flu symptoms are sudden and commonly include fever and muscle aches.
How it spreads
Breathing in infectious air particles from an infected person who has breathed out, sneezed or coughed.
Time between exposure and showing symptoms
Flu: 1 to 4 days
RSV: 2 to 8 days
Cold: 1 to 3 days
COVID-19: 1 to 14 days (usually 2 to 5 days)
Exclude sick person from early learning service, school, or work until
No fever for 24 hours, no need for medicine to reduce fever for 24 hours and none or only mild symptoms (that is, mild cough, headache, runny or blocked nose).
More information
Flu in children – KidsHealth New Zealand's Trusted Voice On Children's Health
Colds in children – KidsHealth New Zealand's Trusted Voice On Children's Health
Notifiable disease. Public health service will be notified and will manage and support people with this disease.
During pregnancy, seek advice from your healthcare provider or GP regarding any risks to your unborn pēpi | baby if you get the illness and whether there are any vaccinations you can get to protect your unborn pēpi.
Vaccine-preventable and/or on National Immunisation Schedule. Talk to your healthcare provider to find out more about immunisations.
Symptoms
Runny nose, persistent mild cough followed by coughing fits; may result in vomiting, breathlessness, or a 'whoop' sound when gasping for breath between coughs.
How it spreads
Breathing in infectious air particles from an infected person who has breathed out, sneezed or coughed.
Time between exposure and showing symptoms
5 to 21 days (usually 7 to 10 days)
Exclude sick person from early learning service, school, or work until
3 weeks after cough started (if no antibiotics taken)
2 to 5 days after starting antibiotics (timeframe depends on type of antibiotics taken)
More information
Whooping cough in children – KidsHealth New Zealand's Trusted Voice On Children's Health
Symptoms
Sore throat (especially when swallowing), headache, vomiting.
An untreated strep sore throat can lead to rheumatic fever.
Rheumatic fever - Health New Zealand | Te Whatu Ora
How it spreads
Breathing in infectious air particles from an infected person who has breathed out, sneezed or coughed.
Direct contact and sharing drinking bottles, cutlery and so on, with an infected person.
Time between exposure and showing symptoms
1 to 3 days
Exclude sick person from early learning service, school, or work until
Feeling well and/or 24 hours after antibiotic treatment has started.
Caregivers are encouraged to seek treatment advice.
More information
Symptoms
Irritation (itchy, gritty, burning or mild soreness) and redness of eye. Sticky and swollen eyelids.
How it spreads
Direct contact with discharge from the eyes or with items contaminated by the discharge.
Time between exposure and showing symptoms
2 to 10 days (usually 3 to 4 days)
Exclude sick person from early learning service, school, or work until
Eyes are not sticky or weeping.
More information
Conjunctivitis in children – KidsHealth New Zealand's Trusted Voice On Children's Health
Notifiable disease. Public health service will be notified and will manage and support people with this disease.
Vaccine-preventable and/or on National Immunisation Schedule. Talk to your healthcare provider to find out more about immunisations.
Symptoms
Fever, headache, generally unwell, vomiting, sometimes a rash. Symptoms can get rapidly worse.
Urgent treatment required
Urgent treatment in hospital is required as this is a life-threatening condition.
How it spreads
Close or prolonged contact with an infected person’s mucus (snot) or saliva.
Time between exposure and showing symptoms
2 to 10 days (usually 3 to 4 days)
Exclude sick person from early learning service, school, or work until
Feeling well following discharge from hospital. Person is no longer infectious 24 hours after antibiotic treatment has started.
More information
Meningococcal disease – KidsHealth New Zealand's Trusted Voice On Children's Health
Notifiable disease. Public health service will be notified and will manage and support people with this disease.
Vaccine-preventable and/or on National Immunisation Schedule. Talk to your healthcare provider to find out more about immunisations.
Symptoms
Swelling of the glands around the face and neck, pain in jaw, fever, headache.
How it spreads
Breathing in infectious air particles from an infected person who has breathed out, sneezed or coughed.
Direct contact with tissues, toys or surfaces contaminated with an infected person’s mucus (snot) or saliva.
Time between exposure and showing symptoms
12 to 25 days (usually 16 to 18 days)
Exclude sick person from early learning service, school, or work until
5 days after facial swelling develops
More information
Mumps – KidsHealth New Zealand's Trusted Voice On Children's Health
Symptoms
Itchy bottom, often worse at night. Not sleeping well, irritable and not wanting to eat as much.
How it spreads
Swallowing the eggs that stick to fingers and get under fingernails when scratching.
Time between exposure and showing symptoms
1 to 2 months
Exclude sick person from early learning service, school, or work until
No exclusion required
More information
Threadworms in children – KidsHealth New Zealand's Trusted Voice On Children's Health