How Sick Is Too Sick? When To Keep Your Child At Home

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    There are three reasons to keep sick children at home:

    1. The child does not feel well enough to participate comfortably in usual activities, (such as; extreme signs of tiredness, unexplained irritability or persistent crying)
    2. The child requires more care than program staff is able to provide, without effecting the health and safety of the other children.
    3. The illness is on the list of symptoms or illness for which exclusion is recommended.

    Children with the following symptoms or illness should be kept (excluded) from school:

    Symptoms

    Child Must Be at Home?

    Diarrhea

    Frequent, Loose Or Watery Stools Compared To Child’s Normal Pattern; Not Caused By Diet Or Medication

    Yes – if child looks or acts ill; if child has diarrhea with fever and behavior change; if child has diarrhea with vomiting; if child has diarrhea that is not contained in the diaper or the toilet

    Fever With Behavior Changes Or Illness

    Note: An Unexplained Temperature Of 100°f Or Above Is Significant In Infants 4 Months Of Age Or Younger And Requires Immediate Medical Attention

    Yes – When Fever Is Accompanied By Behavior Changes Or Other Symptoms Of Illness, Such As Rash, Sore Throat, Vomiting, Etc.

    COUGHING severe, uncontrolled coughing or wheezing, rapid or difficulty breathing

    Note: Children With Asthma May Be Cared For In School With A Written Health Care Plan And Authorization For Medication/treatment

    Yes –For At Least 24 Hours After There Is No Longer A Fever, Without The Use Of Fever-reducing Medicine

    Mild Respiratory Or Cold Symptoms

    Stuffy Nose With Clear Drainage, Sneezing, Mild Cough

    Yes –Medical Attention Is Necessary

    Rash With Fever

    Note: Body Rash Without Fever Or Behavior Changes Usually Does Not Require Exclusion From School, Seek Medical Advice

    Yes –May Attend If Able To Participate In School Activities

    Rash With Fever

    Note: Body Rash Without Fever Or Behavior Changes Usually Does Not Require Exclusion From School, Seek Medical Advice

    Yes –Until Vomiting Resolves Or A Health Care Provider Decides It Is Not Contagious. Observe For Other Signs Of Illness And For Dehydration.

    Parent/Guardian Signatures:
    Date:

    Illness

    Child Must Be At Home?

    Diarrhea

    Yes – Until Blisters Have Dried And Crusted (Usually 6 Days). If Blisters Occur After Vaccination, Refer To Health Dept Guidelines.

    Conjunctivitis (Pink Eye)

    Yes – Until 24 Hours After Treatment Starts. If Untreated, A Note Is Needed From A Healthcare Provider.

    Croup (See Coughing)

    Seek Medical Advice.

    Fifth’s Disease

    No – Child Is No Longer Contagious Once Rash Appears.

    Hand, Foot, And Mouth Disease

    No – May Attend If Able To Participate In Activities, Unless The Child Has Mouth Sores And Is Drooling.

    Head Lice Or Scabies

    May Return After Treatment Starts.

    Head Lice Or Scabies

    May Return After Treatment Starts.

    Head Lice Or Scabies

    May Return After Treatment Starts.

    Hepatitis A

    Yes – Until 1 Week After Onset Of Illness Or Jaundice And When Able To Participate In Usual Activities.

    Herpes

    Yes –If Area Is Oozing And Cannot Be Covered (E.G., Mouth Sores).

    Impetigo

    Yes –For 24 Hours After Treatment Starts.

    Ringworm

    May Return After Treatment Starts; Keep Area Covered For The First 48 Hours Of Treatment.

    Roseola

    Yes –Seek Medical Advice.

    RSV (Respiratory Syncytial Virus)

    RSV (Respiratory Syncytial Virus)

    Return After Treatment Starts.

    Strep Throat

    Yes – For 24 Hours After Treatment And When The Child Can Participate In Usual Activities.

    Vaccine-Preventable Diseases

    Yes – Until Determined Not Infectious By A Healthcare Provider.

    Yeast Infections

    No –May Attend If Able To Participate In School Activities.

    References:
    • American Academy of Pediatrics, American Public Health Association, National Resource Center for Health and Safety in Child Care, Caring for Our Children: National Health and Safety Performance Standards, Second Edition, Elk Grove Village, IL 2002
    • American Academy of Pediatrics, Managing Infectious Diseases in Child Care and Schools, Elk Grove Village, IL 2005
    • Colorado Department of Public Health and Environment, Communicable Disease Epidemiology Program, Infectious Disease in Child Care Settings: Guidelines for Child Care Providers, Denver, CO., December 2002 http://www.cdc.gov/ Aurora, CO 303.281.2790 Revised 2009 2
    • retrieved August 2009