Systematic review on the incubation and infectiousness/shedding period of communicable diseases in children

Evidence assessment

European Centre for Disease Prevention and Control. Systematic review on the incubation and infectiousness/shedding period of communicable diseases in children. Stockholm: ECDC; 2016.

​Illnesses caused by infectious diseases are common in children in schools or other childcare settings. Currently there is no common EU approach to the control of communicable diseases in schools or other childcare settings, and existing information is uncertain.

Executive summary

ECDC undertook a systematic review that looked into the incubation period and period of infectiousness/duration of shedding for 30 of the most common infectious diseases in children. It also looked into the exclusion period for children in schools and other childcare settings. The findings may provide evidence essential for public health action, such as the minimum school leave period for an infected child/teenager. Evidence from the scientific literature can also provide the basis for a guidance on the exclusion-making process and for other control strategies to prevent the spread of the most frequent infectious diseases in schools and other childcare settings. 

The review covered selected infections in children aged 1 month to 18 years. The outcomes were subdivided in the following disease groups:

  • Vaccine preventable diseases (measles; meningococcal disease; mumps; pertussis; rubella; varicella);
  • Food and waterborne diseases (enterovirus infections; viral gastroenteritis by adenovirus, astrovirus, noro-/calici-/sapovirus, rotavirus; hepatitis A; campylobacteriosis; Escherichia coli infections; Salmonella infections (non-typhoid, typhoid, paratyphoid); shigellosis; giardiasis):
  • Airborne diseases (influenza; infectious mononucleosis; respiratory syncytial virus infections; streptococcal infections (scarlet fever, streptococcal pharyngitis, impetigo);
  • Other transmissible diseases of interest in paediatrics (roseola infantum, erythema infectiosum, staphylococcal impetigo, hospital colonisation by resistant pathogens and MRSA infections).

Publication data

Related diseases


Measles is an acute, highly contagious viral disease capable of causing epidemics. Infectivity is close to 100% in susceptible individuals and in the pre-vaccine era measles would affect nearly every individual during childhood.

Meningococcal disease

Meningococcal disease is caused by Neisseria meningitidis, a bacterium with human carriers as the only reservoir. It is carried in the nose, where it can remain for long periods without producing symptoms.


Mumps is an acute illness caused by the mumps virus. It is characterised by fever and swelling of one or more salivary glands (mumps is the only cause of epidemic infectious parotitis).

Rubella (German measles)

Rubella is a mild febrile rash illness caused by rubella virus. It is transmitted from person to person via droplets (the virus is present in throat secretions). It affects mainly, but not only, children and when pregnant women are infected, it may result in malformation of the foetus. Humans are the only reservoir of infection.

Varicella (chickenpox)

Varicella (chickenpox) is caused by the varicella-zoster virus (VZV), which also causes shingles. The virus spreads through the body into the skin causing rashes to appear.

Seasonal influenza

Seasonal influenza is a preventable infectious disease with mostly respiratory symptoms. It is caused by influenza virus and is easily transmitted, predominantly via the droplet and contact routes and by indirect spread from respiratory secretions on hands etc.


Enteroviruses are a group of viruses that cause a number of infectious illnesses which are usually mild. However if they infect the central nervous system, they can cause serious illness. The two most common ones are echovirus and coxsackievirus, but there are several others.

Rotavirus infection

Rotavirus infection is an acute infectious disease mainly affecting children. The main symptoms are fever, vomiting and diarrhoea and many affected children suffer from extensive fluid loss in need of medical attention. The incubation period is 1-2 days.

Hepatitis A

Hepatitis A is an acute infectious disease of the liver caused by the hepatitis A virus, a small, non-enveloped hepatotropic virus classified in the genus Hepatovirus within the family Picornaviridae.


Campylobacteriosis is a diarrhoeal disease caused by Campylobacter bacteria, found in animals such as poultry, cattle, pigs, wild birds and wild mammals


Enteric infections due to Salmonella bacteria are generally referred to by the term ‘salmonellosis’ when they are due to Salmonella species other than Salmonella typhi and Salmonella paratyphi.

All ECDC systematic reviews

Prevalence of post COVID-19 condition symptoms: a systematic review and meta-analysis of cohort study data, stratified by recruitment setting

Evidence assessment - 31 Oct 2022

The primary aim of this systematic review and meta-analysis was to estimate the prevalence of symptoms of post COVID-19 condition, stratified by recruitment setting (community, hospital and Intensive Care Unit (ICU)) as a proxy for disease severity.

Systematic review on the diagnosis, treatment, care and prevention of tuberculosis in prison settings

Evidence assessment - 30 May 2017

The objective of this report is to systematically review data on the diagnosis, treatment, care and prevention of tuberculosis in prison settings, with a focus on the countries of the European Union and the European Economic Area.

Systematic review on hepatitis B and C prevalence in the EU/EEA

Evidence assessment - 10 Nov 2016

ECDC conducted a systematic review of the literature published between 2005–2015, with the aim to estimate the prevalence of hepatitis B and C in the general population and specific population subgroups in the EU/EEA Member States. This review is an update of an earlier review covering the period 2000–2009.