Deciding when to exclude sick children from school and when to return them back can be difficult for many parents

These are the most important causes of sick child missing school

1 - Cold or Cough

• Runny Nose
• Scratchy / irritated throat
• Coughing
• Sneezing
• Watery eyes

If child has a fever with behavior change, looks or acts very ill, severe or uncontrolled cough, rapid or difficulty breathing, wheezing

Once exclusion criteria have been resolved

• Frequent loose or watery stools compared to child’s normal pattern
• Abdominal cramps

When to exclude ?

If child has 2 or more episodes of diarrhea in a 24 hour period, blood or mucus is in the stool, abnormal color of the stool for child, no urine output in 8 hours, skin or eyes are yellow (Jaundice), fever with behavior change, looks or acts very ill

Once child has been diarrhea free for 24 hours, or cleared by a health professional for bloody diarrhea.

3 - Eye Irritation Mucus in the eye

• Pink color instead of white of eye

If child has bacterial infection (as determined by his/her physician)

Once on medication at least24 hours.

4 - Fever

When to exclude?

• Temperature above 38 and the child feels ill and acts ill

Once fever free for 24 hours and able to participate.

• If child has chickenpox, scabies, impetigo, ringworm or headlice they should be excluded.
• If they have pinworm, allergic or irritant reactions and eczema they do not need to be excluded unless it appears infected or the itching interferes with learning.

• Once seen and cleared by a health professional, on medication at least 24 hours if indicated.
• Headlice: Follow policy of school or daycare center.
• Chicken pox: Pox needs to be dried and scabbed over

• Earache
• Headache
• Mouth Pain
• Sore Throat
• Stomach Ache

• Earache & Headache: If unable to participate or care would decrease staff’s ability to teach and care for other children.
• Mouth Pain or Tooth Ache: If child has mouth sores, tooth pain, drooling or difficulty swallowing.
• Sore Throat: If child is unable to swallow, has excessive drooling, fever with behavioral changes.
• Stomachache: If child is uncomfortable, pain lasts more than two hours, has been injured, bloody or black stool, no urine output for 8 hours, diarrhea, vomiting, fever with behavioral changes, looks or acts very ill.

• Once pain has resolved, child able to participate.
• With strep throat your child may return to school after 24 hours on antibiotics.

Vomiting two or more times in the last 24 hours, recent history of head injury, looks or acts very ill, vomit that appears bloody or green.

Until vomiting resolves for at least 24 hours or a healthcare provider decides it is not contagious

This article is based on (Managing infectious disease in children and school American Academy of pediatrics , 2005)