An ‘outbreak’ is classed as the sudden appearance of an infectious disease at a higher rate than usually expected. In a childcare setting, this would include 2 or more people experiencing similar symptoms or coming down with a proven infection after common exposure (such as visiting a farm). An outbreak is also classed as a single case of a serious and notifiable infection, such as measles.

Prevention is better than cure

Prevention is the first step in making sure that you minimise the frequency of outbreaks at your setting in the future. Immunisation is a safe and effective way of preventing these infections, so as a routine part of your admission process you should check that children are registered with their local GP and ensure their immunisations are up-to-date.

Each child’s immunisation status for the following should be noted on their admission form:

Age routinely vaccinated Vaccine given
2 months Diptheria/Tetanus/Whooping cough/ Polio

Haemophilus influenzae type b (Hib)

Pneumococcal conjugate vaccine (PCV)


3 months Diptheria/Tetanus/Whooping cough /Polio

Haemophilus influenzae type b (Hib)

Meningitis C (Men C)


4 months Diptheria/Tetanus/Whooping cough /Polio

Haemophilus influenzae type b (Hib)

Meningitis C (Men C)

Pneumococcal conjugate vaccine (PCV)

Between 12 and 13 months Haemophilus influenzae type b (Hib)

Meningitis C (Men C)

Measles, mumps and rubella (MMR)

Pneumococcal conjugate vaccine (PCV)

3 years and 4 months (or soon after) Diptheria/Tetanus/Whooping cough /Polio

Measles, mumps and rubella (MMR)

Signpost parents to the right advice

If you feel uncomfortable advising parents about immunisation and they’d like to know more about the benefits and side effects of these, encourage them to book an appointment with their GP. Alternatively, you can direct them to resources on the NHS website for more detailed information and the latest advice.

Check staff immunisation records

As well as your children being up-to-date with their immunisations, it’s also important for you to check all your staff are currently immunised. For example, staff members aged 16-25 should have had two doses of MMR and those working with children with learning difficulties may need a Hepatitis B vaccination if they’re at regular risk of being bitten.

Practice good hygiene

It goes without saying that having a good hygiene practice at your setting can help prevent and control the spread infections, especially those that cause diarrhoea and vomiting. Using personal protective equipment (PPE) including aprons and gloves whilst changing nappies reduces the risk of contamination and spread of infection.

Have rigorous policies and procedures in place

You should have a strict written policy in place for managing outbreaks at your setting.  It’s worthwhile going over this with parents as soon as their child is admitted and letting them know about exclusion periods for certain diseases (and how these apply to staff and other adults). You’ll also need to think about what procedure you’ll follow to notify relevant authorities - such as the Health Protection Agency (HPA) and Ofsted - if an outbreak occurs.

Notify the relevant authorities 

The HPA recommends that you telephone a local CCDC (consultant in communicable disease control) promptly to report any notifiable disease or infection. They can provide you with help and advice on what to do. If they suspect an outbreak of food poisoning, an Environmental Health Officer (EHO) may be asked to investigate. If either the CCDC or EHO consider that there is a need for extra cleaning or other precautions to be put in place, they’ll also discuss this with you.

Notifiable diseases and infections

Acute encephalitis Hepatitis A/B/C Meningococcal septicaemia Rubella (German measles) Viral haemorrhagic fever


Acute poliomyelitis HIV/Aids Mumps Scarlet fever Viral hepatitis


Anthrax Leprosy Ophthalmia neonatorum Smallpox Whooping cough



Cholera Leptospirosis Paratyphoid fever Tetanus Yellow fever


Diptheria Malaria Plague Tuberculosis  


Dysentery Measles Rabies Typhoid fever  


Food poisoning Meningitis Relapsing fever Typhus fever





Keep emergency records up-to-date

Make sure you regularly update your emergency contact details for parents and note any changes to the health conditions of your children. If you have nursery management software like Abacus, parents can check their child’s personal details via a linked online platform called Parent Portal and notify you of any changes immediately.

Top tips

  • Do ensure you have contingency arrangements in place for when parents can’t be contacted to collect their sick child
  • Do display HCA posters at your setting which give information on typical exclusion periods
  • Don’t allow parents to pressure you into caring for a child who is showing symptoms of infection
  • Don’t put children at risk by allowing staff to carry on working if they’re showing signs of infection

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