Medical Forms

ILLNESS GUIDELINES
Health Services

Deciding when to keep your child home from school can be difficult. When a child is sick and needs to stay at
home, parents should contact the school and describe the illness and symptoms. If a medical provider makes
a specific diagnosis (such as strep throat, conjunctivitis, chicken pox, etc.), let school staff know.

There are several reasons to keep (exclude) sick children from school:
1. The child does not feel well enough to participate comfortably in usual activities, such as with extreme
signs of tiredness or fatigue, unexplained irritability or persistent crying.
2. The child requires more care than the school staff is able to provide without affecting the health and safety
of the other children.
3. The illness is on the list of symptoms or illness for which exclusion is recommended.
4. The child is not vaccinated due to medical or religious reasons and there is an outbreak in the school.

The following list gives guidelines and recommendations for exclusion from school due to illness. Children
with minor illness need not be excluded unless one or more of the following exists.

ILLNESS OR SYMPTOMS EXCLUSION IS NECESSARY

Chicken Pox

Yes – Until blisters have dried and crusted (usually 6
days).

Conjunctivitis (pink eye)
(pink or red eyes with thick mucous or pus
draining from the eye)

Yes – May return 24 hours after treatment begins. If
your health provider decides not to treat your child,
a note is needed.

Coughing
(severe, uncontrolled coughing or wheezing,
rapid or difficulty in breathing)

Yes – Medical attention may be necessary.
NOTE: Children with asthma may be cared for in
school with a written health care plan and
authorization for medication/treatment.

Coxsackie Virus
(Hand, foot and mouth disease)

No – May attend if able to participate in school
activities, unless the child has mouth sores and is
drooling.

Diarrhea
(frequent, loose or watery stools not caused by
diet or medication)

Yes – if child looks or acts ill; diarrhea with vomiting;
diarrhea that is not contained in the toilet.

Fever with behavior changes or illness
Fever is an elevation of body temperature above
normal.

Yes – when fever is elevated above 100.4° and is
accompanied by behavior changes or other
symptoms of illness, such as fatigue, rash, sore
throat, upper respiratory symptoms, vomiting,
diarrhea, etc. Must remain at home for at least 24
hours or until all symptoms subside medication free.
Fifth Disease No – child is no longer contagious once rash
illness appears.
Head Lice Yes – May return after treatment and removal of
all live lice and nits from hair.
Hepatitis A Yes – Until 1 week after onset of illness or
jaundice and when able to participate in school
activities.

Herpes

Yes – if area is oozing and cannot be covered, e.g.,
mouth sores. Otherwise, may return to school.

Impetigo/Staph/MRSA

Yes – May return 24 hours after treatment starts.
Wound must be covered with dressing taped on
all 4 sides.
Body Rash with fever Yes – Seek medical advice. Any rash that spreads
quickly, has open, weeping wounds and/or is not
healing should be evaluated. May return to school
when medical provider determines that illness is
not communicable.
Mild Cold Symptoms
(stuffy nose with clear drainage, sneezing,
mild cough)
No – May attend if well enough to participate in
school activities.
Upper Respiratory Complications
– large amount of thick nasal discharge
– extreme sleepiness
– ear pain
– fever (100° or above orally)
Yes – Seek medical advice. May return when
symptoms are improved.

Ringworm Yes – May return after treatment begins. Area
should be covered while in school for the first 48
hours of treatment.
Roseola No – Unless child cannot participate in usual
activities and has fever.
Scabies Yes – May return after treatment is started with
note from medical provider.
Strep Throat Yes – May return after 24 hours of antibiotic
treatment and no fever for 24 hours.
Vaccine Preventable Diseases
(mumps, measles, whooping cough)
Yes – Until judged not infectious by a medical
provider. Report all cases to Health Services
Coordinator.
Vomiting
(2 or more episodes in the past 24 hrs)
Yes – until vomiting resolves or health care
provider determines that cause is not
communicable.
Note: Observe for other signs of illness and for
dehydration.

Handout developed by The Children’s Hospital School Health Program, Denver, CO (303) 281-2790, 1995, revised 1999, 2001,
and 2003. Revised 2019, for use by St. Johns County School Health Services, St. Johns County, FL.

References – American Academy of Pediatrics, American Public Health Association, National Resource Center for Health and Safety in Child Care,
Caring for our Children: National Health and Safety Performance Standards, Second Edition, Elk Grove, IL 2002 – Centers for Disease Control and Prevention, ABC’s for Safe and Health Child Care. A Handbook for Child Care Providers. Atlanta, GA.
U.S. Department of Commerce; 1996 – Colorado Department of Public Health and Environment, Communicable Disease Epidemiology Program, Infectious Disease in Child
Care Settings; Guidelines for Child Care Providers, Denver, CO., December 2002 – Kendrick AS, Kaufman R., Messenger KP, Eds. Healthy Young Children: A Manual for Programs. Washington, D.C. National Association
for the Education of Young Children; 2002