Health Services

Staying home when sick can lower the risk of spreading infections. Under routine circumstances, some illness spread among school communities is expected. In general, children with improving symptoms should be able to participate in school.

If a child’s needs while sick with an infectious illness would interfere with school staff’s ability to teach and care for other students, the child should stay home. Schools must balance the risk of infectious disease spread with educational, social, and mental health needs of children when determining when students should stay home.

Schools, parents, and caregivers often do not know what specific illness a child may have; rather, children present with symptoms. If someone has the following symptoms, they should stay home because their illness could affect their ability to participate in school and there is concern that they might spread an infection to staff and students.

When to stay home from school: 

• Fever, including a fever with a new rash.
• Vomiting more than twice in the preceding 24 hours.
• Diarrhea that causes ‘accidents’, is bloody, or results in greater than two bowel movements above what the child normally experiences in a 24-hour period.
• Skin sores that are draining fluid on an uncovered part of the body and are unable to be covered with a bandage.
• Respiratory virus symptoms that are worsening or not improving and not better explained by another cause such as seasonal allergies.

The above list describes symptoms of common illnesses experienced in school-aged children and can also apply to school staff. Schools should develop policies for common illnesses, such as strep throat and hand-foot-mouth disease, that are informed by CDC pathogen-specific guidance, with assistance from school health teams and other professionals with expertise in infectious disease management and spread. Teams can include people with child-health and infection-prevention expertise, such as school nurses, pediatricians, and health department advisors. When developing illness-specific policies, schools can reference resources from school health experts (for example, the American Academy of Pediatrics , the National Association of School Nurses, and the School-Based Health Alliance) who provide several resources that may be useful. Schools can also refer to state and local health department school health resources.

When a person can return to school depends on the nature of the illness. In general, a child returning to school should be well enough to participate in school (e.g., can adequately manage improving cough and congestion on own, not overly fatigued), and care of the returning child should not interfere with the school staff’s ability to teach or care for other students. Students and staff returning to school following an illness may still be contagious, but are likely to be less contagious as symptoms improve, depending on factors like duration and severity of illness. Parents and caregivers should consult their child’s health care providers with specific questions about their child’s condition or recovery.

When to return to school: 

• The child has not had a fever (and is not using fever-reducing medicine) for at least 24 hours.
• Fever with a new rash has been evaluated by a healthcare provider and fever has resolved.
• Uncovered skin sores are crusting, and the child is under treatment from a provider.
• Vomiting has resolved overnight and the child can hold down food / liquids in the morning.
• Diarrhea has improved, the child is no longer having accidents or is having bowel movements no more than 2 above normal per 24-hour period for the child. Bloody diarrhea should be evaluated by a healthcare provider prior to return.
• Respiratory virus symptoms are getting better overall for at least 24 hours. Students and staff returning after a respiratory illness can consider additional actions to reduce spread.