Sick Kids
When to Send them to School or Daycare

by Ann Douglas

It can be a tough call. Technically your child is sick, but seems to feel well enough for school. What should you do? Ann Douglas, author of The Unofficial Guide to Childcare, offers some guidelines.

Chickenpox	Red Measles
Common Cold	Pediculosis (Head Lice)
Conjunctivitis (Pink Eye)	Pertussis (Whooping Cough)
Ear Infections	Rubella
Fever	Scarlet Fever
Gastroenteritis (i.e., campylobacter, E. coli, Shigella, Yersinia, viral)	Strep Throat
Impetigo

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Chickenpox

Symptoms: Fever and headche; rash within 24 hours. Itching for four days. Blisters appear in crops over three to four days, turning to crusty scabs. Symptoms appear 11 to 21 days after exposure

Transmission: Spread through the air and by direct contact with blister fluid, saliva, phlegm, or articles freshly soiled by the sick child

Infectious period: Up to five days before the onset of the rash and not more than five days after the spots appear

When infected child can return to school or daycare: When all lesions are dry (at least five days after the first crop of lesions appeared)

When siblings can return to school or daycare: Should only be attending school or daycare if they have already had the chickenpox

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Common Cold

Symptoms: Runny nose, sore throat, cough, decreased appetite

Transmission: Spread through the air and via contaminated hands and objects

Infectious period: From one day before to seven days after onset of symptoms

When infected child can return to school or daycare: Child can attend school or daycare unless too ill to take part in activities

When siblings can return to school or daycare: No need for siblings to stay home

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Conjunctivitis (Pink Eye)

Symptoms: Red swollen eye(s); then thick, yellow discharge and crusting. Eyes itch and smart; no pain. Symptoms appear 24 to 72 hours after exposure

Transmission: Spread by touching the eye or through contact with articles soiled with discharge or phlegm.

Infectious period: Contagious until treated

When infected child can return to school or daycare: When whites of eyes are clear and crusting is gone

When siblings can return to school or daycare: No need for siblings to stay home unless they are infected

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Ear Infections

Symptoms: Earache; irritability, fever and cold symptoms

Transmission: Not infectious

Infectious period: Not infectious

When infected child can return to school or daycare: No need for child to stay home unless he/she is not feeling well enough to go.

When siblings can return to school or daycare: No need for siblings to stay home

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Fever

Symptoms: Temperature over 101°F or 38.5°C. A child with a temperature of 104°F or 40°C and higher will look and feel sick.

Transmission: Not infectious

Infectious period: Not infectious

When infected child can return to school or daycare: Keep child from school or daycare until he/she is feeling well enough to return.

When siblings can return to school or daycare: No need for siblings to stay home

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Gastroenteritis

Symptoms: Poor appetite, vomiting, stomach cramps, watery or bloody diarrhea. Symptoms usually appear 25 to 72 hours after exposure.

Transmission: Spread through contact with stool or through contaminated food, milk or water. Also spread by people with poor hygiene habits.

Infectious period: Contagious while symptoms are present.

When infected child can return to school or daycare: When diarrha stops and stool tests are negative.

When siblings can return to school or daycare: No need for siblings to stay home unless they are also infected

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Impetigo

Symptoms: Blisters, then honey-colored crusts on red base; often located around mouth, nose and diaper area. Symptoms take four to ten days to appear.

Transmission: Spread through contact with sores. Infection can be spread to other parts of the body by the child's fingers.

Infectious period: Contagious until sores are dry.

When infected child can return to school or daycare: When sores are dry

When siblings can return to school or daycare: No need for siblings to stay home unless they are also infected

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Red Measles

Symptoms: Fever, cough, red eyes,runny nose, red spots in mouth, swollen neck glands. Blotchy red rash spreads from face to neck to body over three days. Symptoms appear seven to eighteen days after exposure, with rash appearing on or about the fourteenth day.

Transmission: Spread through direct or airborne contact with saliva, phlegm, or articles soiled by the sick child.

Infectious period: Contagious from four days before to four days after rash appears.

When infected child can return to school or daycare: Child can return to school or daycare anytime after the fourth day after the rash starts, if he/she feels well enough.

When siblings can return to school or daycare: Siblings may continue to attend school or daycare as long as they are immunized or immune. If they have not been immunized, they may need a measles vaccine or immune globulin.

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Pediculosis (Head Lice)

Symptoms: Itchy scalp. Live lice are tiny wingless insects that crawl into the hair. Nits are tiny egg-shaped deposits which are firmly attached to the hair. Symptoms appear eight to ten days after exposure.

Transmission: Spread by direct head to head contact or by sharing clothing, hats, combs and brushes

Infectious period: Contagious until treated and nits are gone

When infected child can return to school or daycare: After treatment

When siblings can return to school or daycare: Siblings may continue to got to school or daycare as long as they are not infected.

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Pertussis (Whooping Cough)

Symptoms: Cold-like symptoms with irritating cough. Coughing is prolonged and severe, and it may be characterized by a high-pitched whoop or crowing. Symptoms appear seven to ten days after exposure.

Transmission: Spread through direct or airborne contact with saliva or phlegm, or articles soiled by the sick child

Infectious period: Contagious for up to three weeks after start of cough or up to five days after antibiotics are started

When infected child can return to school or daycare: After at least five days of antibiotic treatment, assuming child feels well

When siblings can return to school or daycare: Siblings may continue to attend school or daycare as long as they are immunized or immune. If they have not been immunized, they may need a booster shot and antibiotic.

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Rubella

Symptoms: Mild fever, headache, cough, red eyes, runny nose. Swollen glands at back of neck. May not feel ill. Rash consists of mottled or raised sopts spreading from face to neck to body over 12 to 24 hours. Symptoms appear 14 to 23 days after exposure.

Transmission: Spread through direct contact with phlegm, saliva, or articles soiled by the sick child. People without symptoms can spread the infection.

Infectious period: Contagious from seven days before to four days after rash appears.

When infected child can return to school or daycare: Child should stay home for seven days after rash appears and should avoid contact with nonimmune pregnant women.

When siblings can return to school or daycare: Siblings may continue to attend school or daycare as long as they are uninfected and have been immunized against the disease.

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Scarlet Fever

Symptoms: Sore throat and fever; fine red rash which feels like sandpaper and fades on pressure. Most often appears on neck, chest, folds of armpits, elbow, groin and inner parts of thighs. Symptoms appear one to three days after exposure.

Transmission: Spread through direct contact with phlegm, saliva or articles soiled by the sick child. Limited spread through the air. People without symptoms can spread the infection.

Infectious period: Contagious for 10 to 21 days after exposure or 24 to 48 hours after antibiotics have been started.

When infected child can return to school or daycare: Child can return to school 48 hours after the start of antibiotics if he/she is feeling well.

When siblings can return to school or daycare: Siblings may continue to attend school as long as they are not infected.

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Strep Throat

Symptoms: Fever, sore throat

Transmission: Spread person to person

Infectious period: Contagious until 24 hours after the start of treatment.

When infected child can return to school or daycare: Child can return to school 24 hours after the start of treatment.

When siblings can return to school or daycare: Siblings may continue to attend school as long as they are not infected.

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Links, information and more for you

Buy this book by Ann Douglas
The author's site
Directory of health articles
Directory of all articles

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About the author: Ann Douglas is the author of The Unofficial Guide to Childcare, from which this is excerpted. Ann is frequently quoted in the media on a range of parenting-related topics, and has appeared as a guest on a number of television and radio shows. She and her husband Neil have four children under the age of ten.