Caring for Our Children (CFOC)

Chapter 7: Infectious Diseases

7.3 Respiratory Tract Infections

7.3.1 Group A Streptococcal (GAS) Infections Exclusion for Group A Streptococcal (GAS) Infections

Content in the STANDARD was modified on 8/9/2017 and 7/05/2022.

Children or staff with group A streptococcal (GAS) infection (strep throat or skin infection) should be temporarily excluded from the early care and education program until they have been treated with an appropriate antibiotic for 12 hours. Children may return once they are treated with an appropriate antibiotic and are able to fully participate in activities.1–2 Children or staff who have GAS skin infections do not need to be sent home early and should have the area washed with soap and water and covered with a bandage.3

Parents/guardians and staff exposed to a child with a GAS infection should be told of the exposure and watch for symptoms.3 Children and staff who develop symptoms should be examined by a health care provider.


Strep throat can occur in any age but is less common in children under three years old.3 Close contact in early care and education programs is a risk factor for spread for both children and adults.3 Children and adults who have been treated with appropriate antibiotics for 12 hours are not at risk for spreading this infection to others. Early diagnosis and treatment of a GAS infection in children and adults can help reduce the likelihood of complications of the infection and spreading the disease to others.

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS Inclusion/Exclusion/Dismissal of Ill Children Staff Exclusion for Illness Guidelines for Taking Children’s Temperatures Infectious Disease Outbreak Control Exclusion and Alternative Care for Children Who Are Ill Informing Caregivers/Teachers of Group A Streptococcal (GAS) Infection
  1. American Academy of Pediatrics. Section 3: Summaries of infectious disease, Group A streptococcal infections. In: Kimberlin DW, Barnett ED, Lynfield R, Sawyer MH, eds. Red Book: 2021 Report of the Committee on Infectious Diseases. Elk Grove Village, IL: American Academy of Pediatrics; 2021:706

  2. American Academy of Pediatrics. Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide. Aronson SS, Shope TR, eds. 5th ed. Itasca, IL: American Academy of Pediatrics; 2020

  3. Centers for Disease Control and Prevention. Group A streptococcal (GAS) disease. Pharyngitis (strep throat). Web site. Last reviewed November 1, 2018. Accessed March 1, 2022.


Content in the STANDARD was modified on 8/9/2017 and 7/05/2022.