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Nursery and School Policies for Conjunctivitis

Our public health team and the four east Kent Clinical Commissioning Groups would like to draw your attention to advice from Public Health England.

The four east Kent Clinical Commissioning Groups (Ashford, Canterbury and Coastal, South Kent Coast and Thanet) and Kent County Council’s public health team would like to draw your attention to advice from Public Health England for schools and nurseries about infectious diseases and also the CCGs back to school NHS toolkit

In particular, we would like to highlight advice on the management of conjunctivitis.

Conjunctivitis is an inflammation of the outer lining of the eye and eyelid causing an itchy red eye with a sticky or watery discharge. It can be caused by bacteria or viruses or due to an allergy.

The eye(s) becomes reddened and swollen and there may be a sticky yellow or green discharge. Eyes usually feel itchy and ‘gritty’.

Most cases of infective conjunctivitis are viral and self-limiting and will clear up without treatment within a few days. Those that are not viral are caused by a bacterial infection. Up to 65% of bacterial cases resolve without antibiotic treatment by day five. Antibiotic eye drops or ointment are therefore only occasionally required to treat severe cases. It is important to avoid the use of medicines unnecessarily, particularly antibiotics, as all medicines have the potential to cause side effects and overuse of antibiotics is contributing to the very serious issue of antimicrobial resistance.

To determine if treatment is necessary we recommend that parents seek advice from a pharmacist. Parents do not need to book an appointment to see a pharmacist. Pharmacists will be able to advise parents and where appropriate recommend treatment or if necessary refer on to the GP. Treatment for conjunctivitis can be purchased over the counter from pharmacies without the need for a prescription for children over the age of two. Please note that GPs will not prescribe simple medications that are available to buy over the counter for any patient, including children. Over the counter medication can be administered to a child in an educational establishment with parental consent. A doctor’s prescription is not required before administering such medicines to a child.

While advice from a pharmacist can be sought for children under the age of two, if treatment is deemed appropriate then they would need to be referred to their GP for a prescription.

It is not necessary to exclude a child or staff member from childcare or school if they have conjunctivitis. Cases can be managed by implementing some simple infection control measures:

  • Encourage children not to rub their eyes and to wash their hands frequently
  • Avoid sharing towels, flannels or pillows
  • Regular cleaning of items handled by children such as toys, pens etc.

However, you are advised to contact your local Public Health England Health Protection Team if an outbreak or cluster occurs. The Health Protection Team can be contacted by phone 9am to 5pm, Monday to Friday on 03442 253861 Option 1.

We would be very grateful if you could review your policy on conjunctivitis to ensure that children are not unnecessarily excluded from school or nursery and that antibiotic treatment is only used when deemed appropriate and necessary by a pharmacist or prescriber.

Dr Navin Kumta, Clinical Chair NHS Ashford CCG
Chair East Kent Clinical Assurance and Strategy Committee