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|Quick reference medical handouts used
by Pediatric offices
When to send your child back to school
|Should you send your child to school or keep them
home is a question facing many parents at the breakfast table when their usually
exuberant, hungry child sits listlessly ignoring their food. Since it is
important to provide as healthy a school environment as possible for all
students and staff, here are some guidelines to help parents struggling with his
Cat scratch disease
|This illness is usually spread
by bacteria from the cat’s saliva into a child’s open skin and not
by person to person contact. Therefore, the child may attend school.
|As long as there is no fever
or discomfort, a child with a cold may go to school as long as they are
not too uncomfortable to function in school. Instruct the youngster on
the proper use of tissues for coughing, sneezing, and nose blowing. They
should also be taught good hand washing techniques, since research has
shown that more colds are spread via contaminated hands than by infected
droplets in the air. Alcohol wipes can be used to reduce spread from
hands or contaminated objects (toys, etc.)
child may return to school once all the chicken pox lesions are crusted
over. Since the child was contagious up to two days before the rash
started, most of their classmates were already exposed.
|Loose stools have many causes;
a child should not attend school until the bowel movements have normal
consistency. This reduces the chance of leakage or contaminating the
child’s hands. Certainly, youngsters still in diapers who have watery
loose stools that cannot be contained in the diaper should stay home. In
addition, youngsters with diarrhea that contains blood or mucus should
be kept home until their physician evaluates them. Children with Escherichia
coli 0157:H7 or Shigella infections should be kept home until
diarrhea resolves and two stool cultures are negative for the organisms.
|Never ignore an earache. Keep
your child home and contact your physician. If there is ear discharge,
even without pain, notify the doctor, as this generally means a ruptured
eardrum ( a draining ear is not contagious).
|The first question to answer
here is “what is fever?” Most experts agree that any temperature
below 100.8 degrees is normal (for babies under four months of age, any
temperature demands medical attention). Temperature should be normal for
24 hours before sending a child to school. For example, if a youngster
has a fever 100.8 degrees or higher during the night, he or she should
probably not attend school in the morning, even if the temperature is
normal. Temperatures are lower in the morning and the fever may occur
again in the afternoon. Temperature is
also influenced by activity, diet, and environment. Fever in
itself is not contagious. Its presence simply means that parents should
look at their youngster more closely for other signs or symptoms.
|By the time the lacey red or "slapped cheek" rash is
visible, the affected child is no longer infectious.
Therefore, they can return to school and exclusion from class is
|This illness is non-serious,
but is especially uncomfortable. While exclusion from school is not
necessary, the child should be kept at home if they have an elevated
temperature or the mouth sores make them too uncomfortable to attend
|Head lice pass from child to
child on clothing, bed linens, combs, brushes, and hats, but the louse
does not jump from one child to another. The child may return to school
when the treatment is completed. Often, the child is then examined by
the school nurse or designated personnel for signs of an active
infection. Although medical experts feel a child should not be denied school attendance because of the presence of nits, it nay be the policy of your child's school system, private school, or day care center, that the youngster be nit free.
child with Hepatitis A should remain home for one week after the start
of the illness. Most school districts require a physician's note before a child with either Hepatitis A, B, or C, is permitted back in class. Some children with hepatitis can be asymptomatic and still be contagious.
with impetigo requiring antibiotics may return to school 24 hours after
they have begin taking the antibiotics, While many infectious disease experts do not believe the impetigo sores need to be covered, most school systems and day care centers do require the lesions be covered.
|The child may return to school
once cleared by their physician. Despite many myths to the contrary, the
virus that causes “mono” has an extremely low communicability
Absence from school varies among teenagers with mono and depends on how
much energy they have to attend class. For example, some teens may
tolerate attending school full time, while others may need to be off for
|Child may return to school
four days after the onset of the rash. Since most kids are required to
be immunized against measles, a child who has been diagnosed with this
condition probably has another reason for the rash and is therefore not
a child has a condition necessitating they return to school while still
on antibiotics, parents should check with the school regarding
Trained school personnel (most schools don't have nurses) will administer medication only to those students who have a signed authorization form on file at the school. Most require that all
medication must be in the original container. Prescription medications need only the parent's signature since the physician's prescription is the labeled pharmacy container. Over-the-counter medications require both the parent's and physician's signatures. Both signatures are also required if the student is carrying and self-administering their own medication. Parents should be encouraged to work with their physician to schedule medication administration before and after school, if possible.
|Child should remain home until
9 days after the beginning of parotid gland swelling. Since most kids
are required to be immunized against mumps, a child who has been
diagnosed with this condition probably has another reason for the
swelling and is therefore not contagious.
|If the child is old enough to
be responsible about hand washing (usually school age), exclusion from
school or activities is not necessary. If the youngster is a toddler or
pre-schooler, it is probably best to keep them at home for a couple of
days until either the condition clears on its own or a physician has
looked at it and states it is not contagious. Unfortunately, how long a
child is excluded from daycare or school is often dictated more by the
day care’s individual policy than by sound medical science.
|A child with this parasitic
condition need not be excluded from school, but good hand washing,
particularly after using the restroom, should be required. Since
pinworms exit at night, the child is most contagious in the morning, so
good hand washing at school first thing is a good idea.
||A rash is usually a sign of a
viral illness. It may also be a reaction to a medication or chemical
(plant, detergents). If your child has an unusual rash or it is
associated with a fever, it is probably best to keep your child at home
until you have had a chance to discuss the condition with your
youngster’s physician. Most
viral rashes are not contagious, so parents should use their own common
sense. For example, if your child has an allergic rash and is taking an
antihistamine to prevent itching, it might be a good idea to keep the
youngster home since these medications tend to make kids sleepy.
||The Committee on Infectious
Diseases of the American Academy of Pediatrics has stated that children
receiving treatment for ringworm may attend school. Haircuts, shaving of
the head, or wearing a cap during treatment are not necessary (parents should check with their child's school or day care center, since many require the lesions to be covered).
impractical to keep children out of school for the 4-8 weeks it takes to
completely eradicate the infection.
||Students with any rash and
fever should not return to school until their fever is gone. It is
believed that children are contagious from a few days before the fever
until onset of the rash.
|Scarlet Fever and Strep
||A child diagnosed with strep
throat may return to school 24 hours after the youngster has been on
with tuberculosis infection or disease can attend school or childcare if
they are receiving therapy. Most schools require a letter from the child’s
physician indicating that the youngster is no longer contagious.
||If a child vomits during the
night, it is probably not a good idea to send them to school or day care
in the morning. What he or she needs is rest and either a liquid or soft
|Child should remain home until
they have been on antibiotics (erythromycin) for five days. Since most
kids are required to be immunized against whooping cough, a child who
has been diagnosed with this condition may actually have another reason
for the cough and is therefore not contagious.
Signs indicating that your child is in the early stages of a health problem may
include changes in behavior, mood, activity, and loss of appetite. Parents
should always let their instincts be their guide. If you are uncertain about
sending your child to school on any given day, it is probably best to keep the
youngster home and observe him or her for further symptoms. It is always a good
idea for parents to check with their child's school nurse or daycare center to
find out their individual policies on illness. These policies differ and could
affect your decision as a parent. One final word: it is a
good idea for everyone to wash their hands routinely, especially if they have a communicable disease, in order to keep themselves healthier as well as those around them.
Prepared with the help and
assistance of Diana H. Dameron, BSN, MPH, Supervisor, School Health Services,
Pinellas County Schools, Florida, and Jack Hutto, M.D., chief, Infectious Disease
Department, All Childrens Hospital St Petersburg, Florida.
As a reminder, this information should not be relied on as
medical advice and is not intended to replace the advice of your childs pediatrician.
Please read our full disclaimer.