Contributor Dr. Elise Herman
As kids head back to school and are together in classrooms again, parents know their child may pick up some illnesses. There are times when it is appropriate to keep sick children home, both for their own recovery as well as protecting fellow students and school staff. Students should be showing signs of improvement before returning to the classroom. Below are helpful guidelines for different illnesses your child may encounter as we move into fall and winter.
Fever: In general, kids should stay home if they have a fever over 100.4 degrees Fahrenheit. They may return to school if it has been about 24 hours without a fever (and no fever-reducing medications like Tylenol or Ibuprofen given).
Colds, RSV (Respiratory Syncytial Virus), COVID, and Influenza: if cough and congestion are mild and there is no fever, kids may stay in school. If they have a fever, follow the above guidelines. If your child has a more persistent cough or is very fatigued, keep them home until they are improving. When they return to school, kids should wear a mask for up to 5 days after becoming sick to protect others.
Gastroenteritis (Vomiting and Diarrhea): Kids should stay home if stools are very watery and hard to control (this may depend on the age of your child). If it has been hours since the last vomiting episode and the child is now keeping down liquids and solids, they may return to school.
Strep Throat: Children diagnosed with strep throat may return to school if it has been 12-24 hours since starting antibiotics and they are feeling better. Make sure they are drinking and eating adequately, too.
Pinkeye (conjunctivitis): If eye discharge is thin and watery with pink eyes, this infection is most likely due to a virus and no treatment is needed. This should resolve on its own within 5-7 days and your child may stay in school (be sure to review good hygiene to prevent spread). If eye discharge is thick, green/ yellow and eyes are very red, call your child’s provider since antibiotic drops or ointment may be appropriate if the cause is bacterial. Kids can return to school about 24 hours after starting this treatment.
Chickenpox (varicella): Chickenpox is less common now with effective vaccination, but if it occurs, all sores should be dry and crusted before returning to school.
Impetigo: This common skin infection may be treated with topical antibiotic cream or oral antibiotics. Kids can be in school once treatment has been started.
Hand, Foot, and Mouth Disease: This viral illness causes painful sores in the mouth and small blisters on the palms and soles. There often is fever and a body rash, too. Children should stay home till they are drinking and eating well and fever-free x 24 hours; the rash does not need to have resolved since that can take 1-2 weeks.
Lice, scabies, and ringworm (tinea): These infections are very common in school-age kids, and children may return to class after treatment is begun. Kids do not need to be ‘nit-free’ to be in school.
Make sure your child is up to date on vaccines to prevent common and potentially dangerous illnesses, including COVID-19 and influenza. Remind your child about handwashing and good hygiene– and be a good role model with this! Call your child’s healthcare provider if you have concerns about your child’s illness and return to school. Policies about returning to class may differ between school districts; many school districts post their policy online. Your child’s school nurse is an excellent source of information if you still have questions.
Resource
https://www.cdc.gov/orr/school-preparedness/infection-prevention/when-sick.html
more about The contributor
Dr. Elise Herman
Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.