Absences from School Due to Illness
Communication between families and the school nurse is critical when it comes to identifying potential outbreaks of contagious illness in our schools. It is imperative that we all work as partners in promoting the health and wellness of our entire school community, which includes not only our students, but our staff members as well.
Please notify your child’s school nurse and keep them home from school with the following:
• Fever of 100.0 or above. Students should be fever-free without use of a fever-reducing medication for 24 hours before returning to school.
• Any skin rash suggestive of a communicable disease.
• Eye discomfort suggestive of a possible bacterial or viral infection that includes but is not limited to drainage, itching, and redness.
• Vomiting and/or diarrhea. Students should stay at home for 24 hours without repeated episodes of vomiting/diarrhea and should be able to tolerate fluids and solid food.
• Cough that is persistent and disruptive.
• Other nonspecific symptoms that have been associated with possible Covid-19 infection such as sore throat, muscle or body aches, nausea, headache, congestion, runny nose.
The following illnesses may require an assessment by a physician and possible exclusion from school.
Allergic Conjunctivitis. This condition more often involves both eyes simultaneously; itching is prevalent and the discharge is clear. There is usually some swelling of the eyelids and other allergy symptoms are present, such as sneezing, itchy and runny nose. Students do not need to be excluded from school.
Bacterial/Viral Conjunctivitis. Both conditions are very contagious and spread easily. The student can return to school 24 hours after an antibiotic has been started if symptoms have improved. It is difficult to differentiate viral vs. bacterial conjunctivitis. Therefore, treatment with prescription antibiotic eye drops is recommended for both conditions.
Chicken Pox (Varicella). Students are to be excluded for not less than five to seven days from onset of the disease and until all pox are crusted over and healing. There is no exclusion for contacts unless they are unvaccinated for varicella.
COVID-19. This novel virus made a pandemic presence in early 2020 and has caused significant illness and in some cases, death. The full control of this viral infection may not be realized until widespread immunity and immunization occur. Until that time, we must be vigilant and aware of any febrile or flu-like illness and subsequently test for Covid-19 infection. Nurses will follow public health guidelines in excluding student with possible Covid-19 infection from school for evaluation and possible quarantine and isolation.
Fever. Students with a temperature of 100 degrees or higher will be sent home from school. They must remain at home for at least 24 hours fever-free without use of a fever-reducing medication.
Fifth Disease (erythema infectiosum). This is a common and highly contagious childhood ailment that causes a distinctive “slapped-cheek” appearing rash of the face and a lacy red trash on the trunk and limbs. By the time the rash or joint pain appear students are no longer contagious and do not need to be excluded from school.
Hand, Foot, and Mouth. This is a viral infection caused by a strain of Coxsackie virus. Symptoms of this virus often include fever and flu-like symptoms. One or two days after the fever starts, students may get painful mouth sores (herpangina). These sores usually start as small red spots, often in the back of the mouth, that blister and can become painful. They can be on the soles of the feet, palms of hands or sores in the mouth. There is no specific medical treatment for Hand, Foot, and Mouth Disease. This disease spreads easily through person to person contact, airborne when an infected person coughs or sneezes, and when in contact with contaminated surfaces and objects. Students may return to school when they have been afebrile without fever reducing medication for 24 hours.
Impetigo. Impetigo is a highly contagious bacterial skin infection. Students should be excluded until treated for at least 24 hours.
Influenza A or B/Influenza-like illnesses. Students with influenza-like illness must remain at home for at least 24 hours after they are fever-free without the use of fever-reducing medications and other symptoms have improved. Symptoms of influenza include fever, cough, runny or stuffy nose, body aches, diarrhea, vomiting, and fatigue.
Measles/Mumps/Rubella. Students with these illnesses must stay at home from school for at least five days after onset of symptoms. There is no exclusion for contacts unless they are unvaccinated.
Molluscum Contagiosum. This condition is noted by the presence of a skin rash that has clear or flesh colored bumps and is caused by a virus. It can spread from one part of the body to another or from person to person. It is most often found on the trunk, arms, and face. Students may attend school and participate in sports; however, it is recommended to keep the exposed bumps covered to prevent the spread of molluscum.
Mononucleosis. The clinical diagnosis of infectious mononucleosis is suggested on the basis of the symptoms of fever, sore throat, swollen lymph glands, and the age of the patient. Laboratory tests are needed for confirmation. Serologic results for persons with infectious mononucleosis include an elevated white blood cell count, an increased percentage of certain atypical white blood cells, and a positive reaction to a “mono spot” test. Attendance at school and full activities is contingent on MD approval.
Pediculosis (Head Lice). While pediculosis is not considered an infectious disease, transmission from one individual to another can occur primarily through direct head to head contact or secondarily through the sharing of personal items such as hats, scarves, helmets, brushes, combs, or pillows. Students with live head lice should be treated at home and may return to class after appropriate treatment has begun. Students should be inspected by the school nurse upon return to school. Following treatment, students may remain in school if there are nits, but the family should continue with proper nit removal procedures. The school nurse should reinspect the student for presence of head lice 7-10 days following the initial treatment. Retreatment may be necessary. Parents should contact their child’s physician for recommendation of treatment and should keep in mind that other household members should be inspected for head lice and treated as needed. The school nurse provide instructions on dealing with treatment for students and family members with head lice.
Pertussis. This is a highly communicable, vaccine-preventable disease that lasts for many weeks and is typically manifested in children with paroxysmal spasms of severe coughing, whooping, and posttussive vomiting. Students are to be excluded from school until treatment with appropriate antibiotics for a minimum of 5 days.
Ringworm. Ringworm is a common infection of the skin/scalp and nails that is caused by several different kinds of fungus. It is characterized by a red ring of scaly skin that grows outward as the infection spreads. If there is ringworm on the scalp, the student needs to be treated with prescription, antifungal medication. If a suspected ringworm is found anywhere other than the scalp, cover the area with a band aid (student may stay in school if area is covered) and send to MD for diagnosis. MD note or proof of treatment is sufficient to return to school.
RSV. Respiratory syncytial virus is a common and contagious virus that causes infections of the respiratory tract. Students must remain at home for 7 days from onset of symptoms, as this is how long the virus can be “shed” and may be contagious. Students may return to school after seven days AND symptoms (coughing) have significantly improved and fever-free for 24 hours without fever-reducing medication.
Scabies. Students are to be excluded until control measures are instituted. Scabicides used to treat human scabies are available only with a prescription from a physician. No “over-thecounter” products have been tested and approved to treat human scabies. Proof of treatment is sufficient for return to school.
Strep Throat. Students diagnosed with strep throat are to be excluded from school until treated with one full day (24 hrs) of antibiotics.
Tuberculosis. Students are to be excluded while there is evidence that the condition is active. Exposures need not be excluded.
Varicella (chicken pox). Students are to be excluded for at least five to seven days from onset of the disease and until all pox are crusted over and healing. No exclusion for contacts unless they are unvaccinated.