About 50 childcare centres within the Hunter New England health care district are battling viral gastroenteritis outbreaks, with public health officials warning people with symptoms to stay home until 48 hours after symptoms have passed.
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"It is as bad a season as we've seen in a long time," Hunter New England Health's Dr David Durrheim said.
"Usually it peaks in the winter months, but this year we were doing such a good job with social distancing, and a lot of centres were closed, that unfortunately we have seen a shift in the timing. We have had nearly 70 childcare centres affected, and that's similar to some of the worst viral gastro seasons we have seen recently."
Symptoms of viral gastroenteritis include nausea, vomiting, diarrhoea, fever, abdominal pain, headache and muscle aches.
Hand-washing, cleaning surfaces with bleach, and wearing gloves and masks when cleaning up any spills and vomit, could help prevent the spread of the virus.
"It is quite hard to maintain good hygiene in childcare centres," Dr Durrheim said.
"Children's behaviour means they find it very difficult to keep a distance from each other, and it is incredibly infectious.
"If you get an outbreak - particularly with vomiting in a confined area - it can actually be breathed in. It is not only from touching surfaces
"In those sorts of settings, the spread can be really quite explosive."
Dr Durrheim said anyone experiencing symptoms should avoid preparing food, should not visit aged care centres or hospitals, and be "absolutely meticulous" with hand hygiene.
"It is really important anybody who has gastro - any child, or any worker - not go to work or into a childcare centre until at least 48 hours after the symptoms have ceased," he said.
"Once it's in a family setting it's quite easy for the virus to spread."
The main treatment for viral gastroenteritis is to rest and drink plenty of fluids. Most people recover without complications, but gastroenteritis can be serious for infants, people with suppressed immune systems and the elderly.
NSW Health is reminding childcare centres to reinforce basic hygiene measures, such as regular hand washing (paying particular attention to hand washing after attending to nappy changes), cleaning all hard surfaces and providing education to help prevent the spread of infections. Staff should also wear gloves and a mask when cleaning up bodily fluids, including vomit, when symptoms commence at the centre. Disinfect surfaces with a freshly made sodium hypochlorite solution.
