Prevention and Control of Communicable Diseases - Missouri ...

SPECIFIC DISEASE EXCLUSION GUIDELINES FOR CHILDCARE
Roseola Until the fever is gone and other rash illnesses, especially measles, have
been ruled out.
Rotaviral Infection Until the child has been free of diarrhea for at least 24 hours.
Rubella (German
Measles)
July 2011
Until 7 days after the rash appears.
Exclude unvaccinated children and staff in which a case of rubella occurs
for at least 3 weeks after the onset of rash in the last reported person who
developed rubella.
Salmonellosis Until the child has been free of diarrhea for at least 24 hours. Children
who have Salmonella in their stools but who do not have symptoms do
not need to be excluded.
Exclude symptomatic staff with Salmonella from working in food service
or providing childcare. Other restrictions may apply; call your local
health department for guidance.
*If a case of Salmonella typhi is identified in a childcare center or school,
please consult with your local or state health department. Each situation
must be looked at individually to determine appropriate control measures
to implement.
Scabies Until 24 hours after treatment begins.
Shigellosis
Children and child care staff with diarrhea should be excluded from
childcare until they are well. The child care should be closed to new
admissions during outbreaks, and no transfer of exposed children to other
centers should be allowed. Shigellosis is transmitted easily and can be
severe, so all symptomatic persons (employees and children) should be
excluded from childcare setting in which Shigella infection has been
identified, until diarrhea has ceased for 24 hours, and one (1) stool culture
is free of Shigella spp. Stool specimens should not be obtained earlier
than 48 hours after discontinuation of antibiotics. Antimicrobial therapy
is effective in shortening the duration of diarrhea and eradicating
organisms from feces.
No one with Shigella should use swimming beaches, pools, water parks,
spas, or hot tubs until 1 week after diarrhea has stopped.
Food service employees infected with Shigella bacteria should be
excluded from working in food service. An employee may return to work
once they are free of the Shigella infection based on test results showing
2 consecutive negative stool cultures that are taken at least 24 hours after
diarrhea ceases, not earlier than 48 hours after discontinuation of
antibiotics, and at least 24 hours apart; or the food employee may be
reinstated once they have been asymptomatic for more than 7 calendar
days.
In the absence of laboratory verification, the excluded food handler may
return to work after symptoms of vomiting and/or diarrhea have resolved,
and more than 7 calendar days have passed since the food handler
became asymptomatic.
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