Guidance

Specific settings and populations: additional health protection considerations

Updated 21 February 2024

Early years or pre-school children (ages 0 to 5)

This section provides additional considerations for early years and pre-school settings. It should be used in conjunction with other sections of Health protection in children and young people settings, including education.

People in early years and child-minding settings should follow the advice set out in the main body of the guidance, for example:

• preventing and controlling infections
• management of specific diseases
• managing outbreaks and incidents
• supporting immunisation programmes

Hand and respiratory hygiene remain extremely important for this age group. Pre-school children need to understand why it is important to wash their hands and be taught how to wash, rinse and dry their hands correctly. Early years lesson plans on hand and respiratory hygiene are available. Adults should support children to follow the hand washing advice in the main guidance.

Some additional setting specific advice is provided that is particularly relevant to settings primarily attended by pre-school age children, such as nurseries and child minders.

Preventing and controlling infections

What you need to know

The early years environment can present additional cleaning challenges due to poor hand and respiratory hygiene of pre-school children, frequently touched surfaces, and the more common and frequent use or sharing of interactive items, toys and soft furnishings.

There are many areas in early years settings with a high risk of germs being present, for example toilets, nappy changing areas, food areas and kitchens. These germs can be transferred to people via objects such as toys and equipment, for example, once a toy has been touched with unclean hands.

In early years settings, parents or carers may have provided labelled milk, including breast milk, for storage and use at the setting. Just like other foods, milk can become contaminated with germs.

What you need to do

In addition to general cleaning guidance:

• ensure all toys carry a BS, BSI or CE mark and where possible buy toys and equipment that can be easily cleaned
• store toys in a clean container
• do not let children take toys into toilet areas
• store reusable equipment that has been cleaned but is not in use separately from used equipment and away from where equipment cleaning takes place

In addition to general food hygiene guidance, when preparing and storing formula milk foods for babies:

• follow the manufacturers’ instructions for making formula milk
• use freshly boiled water that you have allowed to cool
• if possible, where dried formula for reconstitution has been supplied, make up each feed before using it; alternatively, encourage parents or carers to provide readymade formula bought in tetri packs

In addition to general food hygiene guidance, when preparing and storing breast milk foods for babies:

• all breast milk should be labelled with the child’s name and date of expression
• use milk within 24 hours of it being expressed
• breast milk can be stored in the body of the fridge between 1°C and 4°C before use (not in the door where pasteurised drinking milk is often stored, as the temperature can vary considerably when opened)

When disposing of unused milk, you should:

• dispose of the remaining milk portion left after a feed
• rinse and wash bottles, teats, plastic spoons and other utensils thoroughly and return to parent or carer at the end of the day where appropriate

Supporting immunisation services

What you need to know

The National routine childhood immunisation programme has a direct positive impact on the health and wellbeing of children as well as communities. Children aged 0 to 5 require a number of critical vaccinations to give the best protection against a number of infectious diseases.

The schedule of immunisations is included in the Green Book. It is important to note that while vaccines should be given on time to provide protection against serious infections as early in life as possible, it is possible to catch up if an individual has missed a vaccine.

The immunisations provided to 0 to 5 years olds take place in GP surgeries or child health clinics, and not in settings. The only exception to this is the flu vaccine, which is provided through the schools-based immunisation programme to children from reception age.

As children in the early years may not yet be old enough to have received all their immunisations, it is important that staff are protected by being up to date with the routine immunisation schedule, including 2 doses of the MMR vaccine. This is covered in the immunisation guidance.

What you need to do

Encourage parents and carers to ensure their child is up to date with their immunisations. If concerned, encourage them to seek additional guidance from the health visitor or their GP. For more information, you may wish to point them towards NHS vaccinations and when to have them, which includes tips for parents or carers.

Allow individuals to take time off to receive immunisations.

Encourage staff to check their immunisation records and contact their GP practice if they are unsure or need to catch up. Where possible, provide time for staff to attend routine immunisation appointments.

Actions in the event of an outbreak or incident

What you need to know

Children and staff in early years settings are likely to have a higher level of close contact which will impact on the spread of infections.

Very few people with respiratory infections become seriously unwell. This is also true for people with long-term conditions. However, some children under 2, especially those born prematurely or with a heart condition, can be more seriously unwell from respiratory syncytial virus (RSV).

What you need to do

Reinforce basic infection prevention and control measures, recognising the increased risk individuals due to the higher level of close contact.

For respiratory infections, note that these are common among people in winter months and so, those who have mild symptoms such as a runny nose, sore throat, or mild cough but are otherwise well, should be allowed to remain in the setting.

Follow the managing outbreaks and incidents and managing specific infectious diseases guidance. Information is included to help you decide if your local health protection team (HPT) needs to be informed. If they do, ensure that you make them aware of the ages of children in the setting, as younger babies and children may be at increased risk.

Further resources on actions in the event of an outbreak or incident

E-learning course on preventing and managing infections in childcare and pre-school settings available from FutureLearn.

Interactive lesson plans for ages 3 to 5 on hand, respiratory and oral hygiene.

Special educational needs, additional support needs and disabilities

This section provides additional considerations for settings working with people with special educational needs (SEN), additional support needs (ASN) or disabilities (SEND).

It is important to note that special educational needs are not the same as clinical vulnerability. Most people with SEN, ASN or disabilities will not require any additional health protection measures. Where an individual does have clinical vulnerabilities in a SEND setting, staff should seek advice from the individual’s clinical team.

However, there are some considerations that can be specific to some SEND settings in order to minimise the risk of transmission of infection.

Close personal care such as lifting and manual handling support may be more common in special educational needs settings. Extensive guidance is available from the Health and Safety Executive (HSE) on Supporting children and young people with disabilities, special educational needs, and additional support needs.

Where personal protective equipment (PPE) is indicated, full access to the required PPE and delivery and recording of appropriate training are required. This is covered in the preventing and controlling infections section of the general guidance.

Preventing and controlling infections

What you need to know

The SEND environment can present additional cleaning challenges due to the very frequently touched surfaces, and the more common use of interactive items, and soft furnishings.

There are many areas in settings with a high risk of germs being present, for example toilets, nappy changing areas, food areas and kitchens. These germs can be transferred to people via objects such as equipment, for example, once lifting equipment has been touched with unclean hands.

What you need to do

All play, learning and lifting equipment must be safe for use and well maintained to reduce the risk of spreading harmful germs.

Where possible buy play and lifting equipment that can be easily cleaned.

Do not let individuals take learning equipment into toilet areas.

Equipment must be cleaned:

• between uses
• after any bodily fluid contamination
• at regular intervals as part of an equipment cleaning schedule
• before and after servicing and repair

Reusable equipment that has been cleaned but is not in use should be stored separately from used equipment and away from where equipment cleaning takes place.

Supporting immunisation services

What you need to know

It is extremely important for people with SEN, ASN and disabilities to still follow the routine immunisation schedule set out in the Green Book, unless advised not to by their clinical team. Some people with SEND may find vaccination sessions particularly stressful, but this should not prevent immunisation from taking place. Immunisation remains a critical intervention to protect them from certain diseases.

Staff who are providing close personal care may face increased transmission risks. Therefore, it is important for them to be up to date with the routine immunisation schedule. It is also recommended that staff who are involved in the care of individuals with a severe learning disability should receive the hepatitis B vaccine, if recommended through an occupational health risk assessment.

Further information is provided in the Supporting immunisation programmes section.

What you need to do

Encourage parents and carers to ensure their child or young person is up to date with their immunisations. If concerned, encourage them to seek additional guidance from the health visitor or their GP. Students of higher education should be encouraged to seek additional guidance from their student health services.

For more information, you may wish to point them towards NHS vaccinations and when to have them and if appropriate, communications tools for people with learning disabilities.

Allow individuals to take time off to receive immunisations.

Encourage staff to check their immunisation records and contact their GP practice if they are unsure or need to catch up. Where possible, provide time for staff to attend routine immunisation appointments.

If you have staff working with people with a severe learning disability, conduct an occupational risk assessment and, if required, pay for the hepatitis B vaccine. This is the responsibility of the employer.

Actions in the event of an outbreak or incident

What you need to know

Close personal care naturally requires close contact between children, young people and staff and increases transmission risks where infections are present.

When managing a specific infectious disease, refer to the guidance on exclusions. Given the importance of therapy services for some individuals with SEND, it is important that exclusion due to the individual having a specific disease is only carried out where recommended and for the minimum time suggested.

What you need to do

Reinforce basic infection prevention and control measures, recognising the increased risk of individuals due to the higher level of close contact.

If you are concerned about an individual with clinical vulnerability due to an outbreak, seek advice from that individual’s clinical team.

Follow the managing outbreaks and incidents and managing specific infectious diseases guidance. Information is included to help you decide if your local health protection team (HPT) needs to be informed. If they do, ensure that you make them aware of any people within the affected group who are at higher risk from severe disease.

Further resources

Guidance is available from HSE on Supporting pupils with disabilities, special educational needs, and additional support needs.

Guidance is available from the Department for Education (DfE) on Supporting pupils at school with medical conditions.

Guidance is available from DfE on Ensuring a good education for children who cannot attend school because of health needs.

Residential settings

Residential settings are settings where a group of people live together and have commonly shared areas including kitchens, bathrooms or sleeping arrangements. This section provides additional guidance to settings who provide residential care to children and young people and includes settings such as boarding schools, halls of residence, and children’s homes.

We recognise that there are further differences for residential children’s homes and secure settings. Therefore, this should be taken in conjunction with other sector-specific policy and guidance. The guidance is also applicable to residential educational trips and visits.

In settings where education and living arrangements are provided together, a wider range of potential health protection issues should be planned for. What is specific to these settings is the increased risk of any infection spreading quickly through this confined and close network of people, and also the increased risk of transmission of more serious disease due to the closeness of contact.

Those responsible for managing these settings should familiarise themselves with this guidance and prepare plans for managing cases and clusters of common illnesses including: diarrhoea and vomiting, respiratory infection and meningococcal disease.

Boarding schools in particular can bring together groups of children and young people from international countries, increasing the risk of infectious diseases less common to the UK than in other countries. Boarding schools and their medical staff should stay alert to the possibility of unusual presentations.

Infection prevention and control

What you need to do

Ensure appropriate parental consent, or assessment of a child or young person’s competence to consent, for public health measures should be documented well before they are required. These can include vaccination, prophylaxis or isolation or exclusion from activities. More detail is available from Children and young people: consent to treatment (NHS).

Provide additional advice on the increased risk of shared towels, toothbrushes, razors and other higher risk vectors to people living in a residential setting.

Pillows and mattresses should have a protective cover, and these should be checked regularly. For settings with young people who are sexually active, consider the risk of sexually transmitted infections and include approaches to reduce the risk of transmission. Contact your local sexual health clinic for resources.

Supporting immunisation services

What you need to do

Encourage children and young people and parents or carers to provide consent for routine immunisation.

Support residents to keep up to date with their routine immunisation schedule.

Vaccination records should be stored for each resident, and any missing vaccinations should be offered to residents or staff.

Time away from work or school should be made available to attend vaccination appointments.

Where staff are providing care for individuals with severe learning disabilities or challenging behaviour within the setting, conduct an occupational risk assessment to identify whether staff require the hepatitis B vaccine. In such circumstances, it is the responsibility of the employer to conduct an occupational health risk assessment and pay for the vaccine if it is required.

Action in the event of an outbreak or incident

What you need to do

Follow the actions in managing outbreaks and incidents section to determine whether the UKHSA HPT needs to be informed.

Due to shared living arrangements, it is more likely that residential settings may be asked to identify household contacts during investigation of, for example, meningococcal disease.

A household contact is usually defined as those living and/or sleeping in the same household, for example individuals in the same dormitory or those sharing a kitchen or bathroom. Individuals may also be asked to identify close contacts, such as boyfriends or girlfriends.

If isolation is advised, it can be more challenging for residential settings and may require careful risk assessment in order to maintain appropriate staffing levels.

Health protection teams (HPTs) can support case by case risk assessments of how to achieve separation (cohorting) of cases, contacts and others. This includes staff as well as residents.

Communication during outbreaks or incidents is vital in residential settings and a communications plan should be prepared. This may require tailored communications to individuals, parents/ carers, and staff, and you may need to seek advice from the HPT regarding who is appropriate to communicate, warn, and inform in certain circumstances.

Further resources

DfE Boarding schools National minimum standards (2015 to 2022).

DfE Residential special schools: national minimum standards.

Your local UKHSA health protection team will follow this guidance on disease management in closed settings:

• Suspected acute viral respiratory infections: managing outbreaks in schools
• Managing clusters of pneumococcal disease in closed settings
• Section 10.2 of Guidance for public health management of meningococcal disease in the UK covers management of clusters in an educational or residential settings
• Some relevant advice on what to expect when dealing with a cluster of meningococcal cases is found in Guidance on the prevention and management of Meningococcal meningitis and septicaemia in higher education institutions

Travel health

At some point during their studies, many students will travel abroad. This section has been compiled using advice from the National Travel Health Network and Centre (NaTHNaC) and highlights key issues to consider when planning travel.

Some GP practices and pharmacists will provide travel health advice and will usually administer any vaccines that are necessary. Any queries that your local practice cannot answer may be directed to a specialist travel clinic.

More details can be found from:

• Travel Health Pro, which provides travel health advice from NaTHNaC
• foreign travel advice, which provides travel information for individual countries

Any ongoing health conditions should be discussed with their general practitioner as specific advice may be needed to help manage these while overseas.

Regulations about whether medications can be taken overseas depend on the destination. Individuals travelling abroad should check with that country’s embassy or another reliable source.

Individuals should also be advised to consider an appropriate travel insurance (for their travel needs).

Immunisation

A number of vaccine preventable diseases are common in foreign countries. Many of these diseases, such as hepatitis A, typhoid fever, rabies and some types of meningitis are potentially serious and are not part of the routine childhood immunisation schedule. It is therefore important that students are advised to have all the recommended vaccines for their destination.

Some vaccinations are a mandatory requirement for entering a country. For example, pilgrims to the Hajj must have certain vaccines, including MenACWY, in order to obtain the required visa. Other countries have their own requirements for specific immunisations.

Travellers should see their GP or a specialist travel clinic at least 6 weeks before the departure date. It is helpful to take information about all destinations and any records of personal immunisation history to the appointment. NHS.UK has further information on travel vaccinations.

Sexual health and contraception while travelling

Unprotected sexual intercourse (sex without a condom) can lead to STIs. Examples include (but are not limited to) HIV, hepatitis B, chlamydia trachomatis and gonorrhoea.

In the UK, it is possible to access urgent treatment following unprotected sex with a partner who might be infected with HIV. This is called post-exposure prophylaxis. Please note, that this service is not available universally in other countries.

Individuals travelling abroad should take necessary precautions to protect themselves. If they think they might be sexually active, while abroad, then barrier protection (use of condom) is a must. In addition to having access to condoms, they should also consider carrying contraceptives with them, as these are difficult to obtain while abroad. Similarly, not all countries have easy access to the morning-after pill and individuals travelling abroad should be advised to consider their personal contraceptive needs during travel and discuss them with their GP or a local sexual health clinic prior to travel.

Insect bites

Insect bites can transmit infections to humans. The type of infection varies according to the type of insect and the country where the exposure occurs. Examples include (but are not limited to) malaria, dengue fever, yellow fever (all transmitted by mosquito bites) and Lyme disease (transmitted by tick bites).

These can have serious or even life-threatening complications.

Avoiding insect bites

It is important to find out about the local risk of insect- borne diseases before visiting a country and if possible, avoid visiting particularly infested areas (especially from dusk till dawn). Wear loose clothing with long-sleeves and long trousers during the times when mosquitoes are most active, usually from dusk till dawn. If in a tick infested area, it is especially important to wear covered shoes, long trousers, and socks. The socks should be tucked into the trousers to prevent ticks crawling up the leg.

Bed nets

When visiting areas infested with mosquitoes, sleeping under a bed net can help to reduce the risk of mosquito bites. The most effective type of net is treated with an insecticide. These nets often need to be retreated every 6 months and should also be checked for holes which can allow mosquitoes to pass through.

Insect repellents

Repellents containing diethyltoluamide (DEET) are recommended for use on exposed areas of skin. As with all topical medications, care should be taken to avoid eyes, lips and broken skin. Repellents should be reapplied after swimming or heavy sweating.

Malaria prophylaxis

Malaria is a serious infection that causes large numbers of deaths and serious illness in some countries. It is a parasitic infection transmitted to humans through the bite of infected mosquitoes.

Everyone needs malaria prophylaxis if they are travelling to an ‘at-risk’ area. Even if the traveller has lived before in the country, any protection they might have developed while there disappears quickly. Some malaria prophylaxes must be started 2 weeks before travel, so it is important to seek travel advice early.

Country specific information

Check foreign travel advice and the NaTHNaC website for the risk of diseases in different countries. The NaTHNaC website or your local travel clinic will be able to provide personal advice on what precautions to take.

Food, water and travellers’ diarrhoea

In some countries, drinking from the local water supply may lead to transmission of water-borne diseases such as cholera, hepatitis A and travellers’ diarrhoea. Additionally, certain foods may be contaminated with infectious organisms. These illnesses can be debilitating and often include symptoms of diarrhoea and vomiting.

If there are any concerns about the safety of the local water supply, it is advisable to drink bottled water. Additionally, avoid drinks with ice made from tap water.

Food should be eaten freshly prepared and still hot. Do not eat unwashed fruits and vegetables or undercooked fish and shellfish.

Try to avoid food exposed to insects such as flies as these may transmit infections. Exercise caution regarding ice cream sold at small kiosks where refrigeration may be inconsistent.

If symptoms of diarrhoea and vomiting develop, then medical advice should be sought locally in the first instance.

Avoid dehydration by drinking plenty of fluids while symptomatic (ideally bottled water instead of carbonated drinks or fruit juices).

Further information on food and water hygiene is available from Travel Health Pro.

Sun protection

Sunlight includes both ultraviolet A (UVA) and ultraviolet B (UVB) radiation, which can both contribute to sunburn, skin ageing and the development of skin cancer. Excessive exposure to sunlight can also cause eye problems, including inflammation of the surface of the eye and, in the long term, cataracts.

Excessive exposure can be avoided by:

• staying in shaded areas, especially during the hours with greatest sunlight (between 10am and 3pm)
• wearing clothes to protect skin and sunglasses to protect eyes
• wearing a hat
• using sunscreens that protect against UVA and UVB radiation and reapplying regularly

Further information on sunscreen and sun safety is available from NHS.UK

Outdoor learning, including forest schools and educational visits

This section presents additional considerations for settings who are taking children and young people off site, including to farms and zoos, or providing education in outdoor environments, such as forest schools.

Education and childcare settings can benefit hugely from trips and outdoor learning activities. Educational time spent learning outdoors provides clear public health benefits. Some additional specific considerations for infection prevention and control can minimise the risk to health from infectious disease during these activities.

Activities such as farm and countryside visits, or bringing animals into education and childcare settings, can expose children, young people and adults to a range of potentially harmful germs including E. coli O157. All animal droppings should be considered infectious. Healthy animals often show no signs of carrying germs, which are part of the normal environment at farms, stables, zoos and so on.

Any educational visits off site should be subject to risk assessments as normal and reflect any public health advice or in-country advice for an international destination.

General guidance on educational visits is available from DfE and is supported by specialist advice from the Outdoor Education Advisory Panel (OEAP). Further advice is available in DfE’s Keeping children safe in out of school settings: code of practice.

The OEAP provides guidance including actions to manage the risk of disease during a variety of visits. This guidance is also relevant if animals are brought into the setting.

For international educational visits, you should refer to foreign travel advice and the guidance on international travel before booking and travelling to make sure that the group meets any entry and in country requirements especially in relation to vaccinations. Additional information can be obtained from TravelHealthPro.

Water-based activities

What you need to know

There is a risk of infection associated with any water-based activity on rivers, canals and freshwater docks, and also with the collection of specimens from ditches, streams and ponds.

Further details on health considerations and actions to take before, during and after the activity can be found in the OEAP guidance.

What you need to do

Ensure parents and carers know that if their child or young person becomes ill following participation in outdoor or water-based activities, the treating doctor should be made aware of the child or young person’s participation in these activities.

Do not allow babies or children to swim in public swimming pools or participate in school swimming lessons until 2 weeks after diarrhoea and vomiting has stopped.

Farms and zoos

What you need to know

There are a number of diseases that can be passed on to children, young people and staff from infected farm animals such as Shiga Toxin-producing Escherichia Coli (STEC) (including E. coli 0157), campylobacter, salmonella and cryptosporidium. These can cause serious illness, particularly in young children. People can become infected through direct contact with animals, contact with an environment containing animal faeces or consuming contaminated food or drink.

Hands must be washed after contact with animals and when leaving the site. Many of these harmful germs need to be swallowed before they cause infection. Individuals that do not wash their hands thoroughly may swallow the germs when sucking their fingers or biting their nails.

Individuals can also be infected despite not actually touching the animals. For example, E. coli O157 has been found on shoes and pushchairs after agricultural shows. Care should be taken when removing shoes or handling pushchairs to avoid contact with any potentially contaminated substances. Other sources of risk include manure, fields previously used for grazing, and dung on rural roads and paths (E. coli O157 can survive for some months in the environment).

Further guidance on Preventing or controlling ill health from animal contact at visitor attractions or open farms is available from Health and Safety Executive (HSE).

What you need to do

All staff and adults on the trip should refer to and follow the Access to Farms Code of Practice before, during and after the visit.

Prepare for the trip by:

• identifying petting zoos and country parks which have suitable facilities for children and young people to wash their hands (washing with soap and water is always best), ideally those that conform to the Industry Code of Practice
• identifying whether the adults attending the trip need more resources or training to help them manage the risks
• reminding children and young people of the rules and precautions to take upon arrival

During the trip, wash hands thoroughly with soap and water immediately, and supervise younger children to ensure hands are washed effectively at key moments that can break the chain of infection, such as:

• after direct contact with animals
• after touching fences, gates, cages, soil, tools and animal bedding, as these can be contaminated with germs
• before eating or drinking
• when leaving sites with animals
• after removing shoes or wellington boots
• after touching shoes, pushchairs and so on that have been used on a site with animals

Hand sanitiser should not be used a substitute for handwashing with soap and water.

During the trip, ensure children, young people and staff follow the following precautions:

• avoid contact with animals which appear to be ill
• avoid contact with manure and dung
• only eating or drinking in designated eating areas which are separate from the animal areas
• only eating food brought with them or food for human consumption bought on the premises
• not touching or eating any food that has fallen to the floor or any food for animal consumption
• avoid kissing animals, only touching animals with their hands and washing immediately afterwards
• avoid putting hands in their mouth during the visit, until they have washed their hands thoroughly

After the trip, staff supervising young children should:

• clean the group’s shoes, pushchairs and so on, to avoid contaminating cars, toys, nursery floors, or other surfaces, washing hands afterwards
• change outdoor shoes before entering environments where children are crawling

In order to protect their own health and that of their unborn child, those who are, or may be, pregnant should be advised to avoid close contact with livestock animals that are giving birth.

The above guidance also applies if animals are brought into the education or childcare setting. You should check beforehand that animals have been healthy. You should not allow animals that have recently been ill into your setting.

Forest schools

What you need to know

Sanitation facilities are required to ensure people can access outdoor learning provision while minimising the risk to health from infectious diseases.

What you need to do

Where no running water is available, provide sufficient mobile handwashing stations, with liquid soap, water, and disposable towels. The use of the same bowl or basin of water for multiple people to wash their hands should not be used. Hand sanitiser should not be used as a replacement for handwashing with soap and running water.

When planning toilet provision, above all, it is important to protect the privacy and dignity of individuals. Where possible, use conventional standard flush toilets. If these are not available and there are no public toilets nearby, consider alternatives such as compost toilets, chemical and portable toilets and wild toileting.

Additional infection prevention and control measures include the following.

Fixed compost toilets

Fixed compost toilets will only work if you have systems in place to manage the waste processing from start to finish. Check whether secondary processing of accumulated solids is required and where this would be sited, including how the final compost is stored and used.

Ensure neither children nor visitors can access human waste compost during any stage.

PPE must be worn by whoever works with the compost and risk assessments must be carried out.

Portable toilets

It is important to consider who disposes the contents, when and how, ensuring they have the necessary PPE, and neither children nor visitors can come into contact with the human waste.

Wild toileting

This is not advisable as the main provision, but it may be necessary from time to time. Make sure you have an agreed approach based upon the advice of the landowner and environmental health officer.

Action in the event of an outbreak or incident

Cases and outbreaks should be dealt with in line with usual practices.

Follow the actions in managing outbreaks and incidents section to determine whether the UKHSA HPT needs to be informed, with additional attention paid to potential environmental exposures in the outdoor setting, particularly where a number of cases are reported in the same class or group.

If the HPT does need to be informed, ensure that you make them aware of any recent trips, visits or exposure in the week prior to the outbreak.

Some allergic reactions, for example sneezing and rashes could be misinterpreted as an infectious illness and there must be an awareness of both to ensure correct management.

Resources

Health and safety on educational visits

OEAP national guidance

Access to Farms: code of practice (includes a teacher’s guide)

Preventing or controlling ill health from animal contact at visitor attractions or open farms

Keeping children safe in out-of-school settings: code of practice

EBug Lesson KS2: Animal and farm hygiene

My world outdoors

Out to Play – creating outdoor play experiences for children: practical guidance

Scottish Advisory Panel for Outdoor Education