Guidelines for Common School Age Concerns and Illness
The following are guidelines, always consult with your health care provider when symptoms arise and/or persist.
If your child has:
Fever, a temperature of 100.4 degrees or greater - remain home until fever free for 24 hours without the use of fever reducing medicine. Must have a physician's note and indicate a diagnosis.
Strep Throat or Scarlet Fever (must be treated with antibiotics x 12 hours and fever free) - please provide a note
Bacterial Conjunctivitis/Pink Eye - (must be treated with antibiotic eye drops x 24 hours) - doctor's clearance required.
Impetigo (must be treated with antibiotics x 24 hours), must keep area covered in school - doctor's clearance required.
Untreated active pediculosis (lice), see lice facts below
Severe cold symptoms – excessive sneezing, coughing, runny nose, nasal discharge, etc. and/or cannot concentrate in school - remain home, if not resolved within 24 hours, provide doctor's note.
Sore throat - remain home, if not resolved within 24 hours, provide doctor's note.
Nausea, Vomiting, or Diarrhea before and during school - remain home for 24 hour after symptoms resolve.
Rash or open lesions on any body part - remain home and provide a medical note with a diagnosis and when student may safely return to school.
Severe Earache, Toothache, or Headache - remain home until resolved.
Pain or limitation of movement from an injury - remain home and if not improved within 24 hours, seek medical evaluation and provide a doctor's note. Crutch use in school must have a physician note.
If diagnosed flu, RSV, COVID, or a virus, they MUST stay home and may return when:
Fever free for 24 hours without fever reducing medicine AND
Symptoms have resolved without a persistent cough
Common Childhood Concerns and Illnesses
COXSACKIE VIRUS (HAND, FOOT & MOUTH DISEASE)
This is a mild, but highly contagious viral infection common in young children. Hand-foot-and-mouth disease is characterized by ulcers/ sores in the mouth and a rash/blisters on the hands and feet. It spreads from person to person, usually through unwashed hands or contaminated surfaces. There is no specific treatment; treatment is aimed at fever control and good oral hydration. Students can return to school when any open blisters are healed and student is fever free for 24 hours.
CONJUNCTIVITIS
This is a viral or bacterial eye infection which can follow a common cold and presents with red, itchy eyes. An irritant in the eye or allergies can also be a causative factor. If the discharge becomes yellow and the eyelids are matted together after sleeping please consult your physician as your child may need treatment with antibiotic eye drops. Children with contacts should switch to glasses until symptoms resolve. Remember to wash pillow cases and towels in hot water, avoid touching/ rubbing eyes, and maintain good hand washing.
COVID-19 or MIS-C
If your child is showing symptoms of MIS-C such as fever, abdominal pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes, or feeling extra tired contact your doctor or urgent care right away. Please be aware that not all children will have all the same symptoms.
for further information about COVID-19.
FIFTH'S DISEASE (PARVOVIRUS B19)
It was named when it was added to a list of four other childhood diseases that cause rashes rubella, measles, scarlet fever, and Dukes. Fifth Disease is a viral infection transmitted in blood and in respiratory secretions from close exposure to an infected person. This viral illness, which affects all age groups, can occur at any time of the year, most frequently in late winter and early spring, although outbreaks may continue well into the summer.
Fifth Disease is characterized as a mild childhood illness that usually manifests itself in the classic facial rash (a slapped cheek appearance), as well as a lacy rash on the trunk and extremities. Often this rash reoccurs for several weeks following certain stimuli, such as changes in temperature and sunlight, and also from emotional stress. Before the rash, the patient usually has mild, flu-like symptoms and some children may have no symptoms at all. The incubation period is 4-14 days but may be as long as 20 days.
Students are contagious prior to the appearance of the rash. However, by the time the rash is evident; they are no longer contagious and may attend school.
FLU (INFLUENZA)
Influenza is a respiratory infection caused by influenza viruses. Symptoms can include fever, coughing, runny nose, sore throat, body aches, lethargy, headache, chills, fatigue and, on occasion, diarrhea and vomiting. Individuals experiencing these symptoms should seek medical attention.
A vaccine is available for high-risk individuals. The anti-Flu medications Tamiflu and Relenza are also effective if taken within the first 48 hours of becoming ill. As a general precaution, you should remember to speak to your children about proper hygiene.
It takes about two weeks after vaccination for antibodies to develop in the body that provide protection against influenza (flu) virus infection. That is why it's better to get vaccinated before the flu season really gets under way. CDC recommends people get vaccinated by the end of October, if possible. It is never too late to get a flu shot however.
Remember to:
Avoid close contact with people who are sick.
Stay Home from work/school & avoid public places if you know you are sick.
Cover your nose and mouth with a tissue when you sneeze or cough. (Discard used tissues)
Wash your hands with soap and water often.
Don't share food or drinks or any items of a personal nature.
Avoid touching your eyes, nose or mouth.
Sick day guidelines for further information about the Flu
HEAD LICE - (PEDICULOSIS)
Head lice are spread directly or indirectly from another person (either head to head or transferred via clothing and/or furniture, etc.) Lice are not discriminate; in fact they attach to clean hair faster.
Intense head scratching is usually the first indication of infestation. Use a magnifying glass to look for tiny red bite marks on the scalp or neck, or sesame seed-sized lice eggs, called nits; attached with a sticky substance to strands of hair. (If it looks like dandruff but will not flake off, it is most likely a nit.) If you are uncertain, consult with your school nurse and/or health care provider.
Treatment:
It is tedious, however, if done properly, it will not become a chronic family health issue. Consult your physician regarding the appropriate treatment. It is strongly recommended to treat the entire family to prevent oversight of early infestations.
Purchase a nit comb for careful removal of all nits. The hair should be combed daily for 2 weeks to ensure success.
Thoroughly vacuum, hot-water wash, dry clean, or seal in a plastic bag for 2 weeks everything that could have come in contact with the infected person's head. (Do not forget the furniture, bedding, car, book bag, etc.)
Re-treat the hair and scalp a second time under physician recommendation, 7-10 days after the first treatment. Continue daily monitoring for nits until your family is nit/lice free.
Avoid family remedies. Treatments with kerosene, Vaseline, etc do not work. Instead of halting the progression, they have caused serious burns and daunting tasks respectively. After treatment and thorough combing, your child can return to school to be checked by the school nurse for active lice.
Remember to call your physician for proper treatment and then come to the nurse's office for evaluation.
MONONUCLEOSIS (MONO)
Infectious Mononucleosis is a viral disease caused by the Epstein-Barr virus. The virus is spread by person-to-person contact via saliva. Symptoms include fever, sore throat, swollen glands and fatigue. Sometimes, the liver and spleen are affected. The symptoms appear four to six weeks after exposure and may last several weeks. No treatment other than rest is needed in the majority of the cases. Avoid activities involving the transfer of body fluids until asymptomatic.
MEASLES
Measles is a serious respiratory disease that causes a rash and fever. It is very contagious. You can catch it just by being in a room where someone with measles coughed or sneezed.
Symptoms usually appear about 10 to 12 days after a person is exposed to measles. The first symptoms are usually:
High fever
Cough
Runny nose
Red watery eyes
Rash
Small red spots, some of which are slightly raised.
Spots and bumps in tight clusters give the skin a splotchy red appearance.
Usually appears 2 to 4 days after the fever begins and lasts 5 to 6 days.
Begins at the hairline, moves to the face and neck, down the body and then to the arms and legs.
March 2024 Please view information from New York State: MEASLES UPDATE
MOLLUSCUM
Molluscum contagiosum is an infection caused by a poxvirus (molluscum contagiosum virus). The result of the infection is usually a benign, mild skin disease characterized by lesions (growths) that may appear anywhere on the body. They are small, raised, and usually white, pink, or flesh-colored with a dimple or pit in the center. They often have a pearly appearance. They’re usually smooth and firm. In most people, the lesions range from about the size of a pinhead to as large as a pencil eraser (2 to 5 millimeters in diameter). They may become itchy, sore, red, and/or swollen. Only a healthcare professional can diagnose molluscum contagiosum.
Mollusca may occur anywhere on the body including the face, neck, arms, legs, abdomen, and genital area, alone or in groups. The lesions are rarely found on the palms of the hands or the soles of the feet.
The virus that causes molluscum spreads from direct person-to-person physical contact and through contaminated fomites. Fomites are inanimate objects that can become contaminated with virus; in the instance of molluscum contagiosum this can include linens such as clothing and towels, bathing sponges, pool equipment, and toys.
Since the virus lives only in the top layer of skin, once the lesions are gone the virus is gone and you cannot spread it to others.
Lesions must be covered by clothing, any lesions not covered by clothing should be covered with a watertight bandage changed daily by the parent.
Check with your physician for treatment.
MUMPS
Mumps is a disease caused by a virus. You can catch mumps through the air from an infected person's cough or sneeze. You can also get it by direct contact with an infected surface. The virus usually makes you feel sick and causes a salivary gland between your jaw and ear to swell. Other body tissues can become infected too.
After exposure to mumps, symptoms may appear in 16 to 18 days. But, it can take 12 to 25 days after exposure. A person with mumps can pass it to others from 2 to 3 days before the swelling starts until five days after the swelling begins. Please consult your physician if any symptoms.
The symptoms are usually:
Low-grade fever
Headache
Muscle aches
Stiff neck
Fatigue
Loss of appetite
Earache aggravated by chewing
Swelling and tenderness of one or more of the salivary glands (side of face chipmunk like)
Some people have just mild symptoms, or no symptoms.
Students with 2 MMR immunizations should be immune but always refer to your physician.
NOROVIRUS
Norovirus is a very contagious virus that causes vomiting, stomach cramps, and diarrhea. Anyone can get infected and sick with norovirus. You can get norovirus from: Having direct contact with an infected person.
PERTUSSIS(WHOOPING COUGH)
This is a highly contagious bacterial infection that can cause an uncontrollable, violent cough lasting several weeks or months. It has been called the 100 day cough. It is spread from person to person by direct contact with mucus or droplets from the nose and throat of infected persons. Initially symptoms resemble a common cold, sneezing, runny nose, low grade fever and a mild cough. Within two weeks the cough becomes more severe with episodes of numerous rapid coughs followed by a high pitched whoop. These episodes may occur for 1 to 2 months and are more frequent at night. INDIVIDUALS WHO ARE IMMUNIZED MAY ALSO CONTRACT PERTUSSIS. Immunity decreases after 5-10 years from the last pertussis vaccine dose.
A person with whooping cough can pass it to others as soon as they get cold-like symptoms and up to 3 weeks after they start coughing. If the infected person takes an appropriate antibiotic, they will not spread the germ after 5 full days of treatment. Treatment with the appropriate antibiotics, such as Zithromax, will shorten the time a person can spread pertussis to 5 days. Students who are positive with Bordetella pertussis (not para pertussis) may not return to school until they are without fever and have completed the 5 day course of antibiotics. When a person is positive , all of the household members must be tested because of the close contact and must complete the 5 days of antibiotics regardless. For those with close contact exposure (family member), a 5 day course of antibiotic treatment must be completed and the student must stay home until there is proof of a negative test or completes the 5 day course of antibiotics. Please notify your school nurse for further details. Those with potential exposure should monitor for symptoms for 21 days after the last day of exposure/ contact.
MYCOPLASMA PNEUMONIA (Walking pneumonia)
Mycoplasma infection is respiratory illness caused by Mycoplasma pneumoniae, a microscopic organism related to bacteria.Anyone can get the disease, but it most often affects older children and young adults.Mycoplasma is spread through contact with droplets from the nose and throat of infected people especially when they cough and sneeze. Transmission is thought to require prolonged close contact with an infected person. Spread in families, schools and institutions occurs slowly. The contagious period is probably fewer than 10 days and occasionally longer. Mycoplasma infection is usually diagnosed on the basis of typical symptoms and a chest x-ray. Blood tests may be done. Always consult your physician for signs and symptoms.
The symptoms are usually:
Fever
Cough
Bronchitis
sore throat, headache and tiredness
RINGWORM
A fungal infection of the skin which can be found on the trunk, face, scalp, limbs, feet, toe nails and genital areas. Transmission can occur by direct skin-to-skin contact with infected people or pets, or indirectly by contact with items such as shower stalls or floors. Ringworm of the scalp usually begins with a small pimple which becomes larger in size with scaly patches. Ringworm of the nails usually causes thick, discolored, brittle nails. Ringworm of the skin appears as a flat, spreading ring-shaped areas with a reddish outer ring.
If Ringworm is suspected, contact your physician for the appropriate fungicidal treatment. The student may return to school after treatment has begun.
RSV
Respiratory syncytial (sin-SISH-uhl) virus, or RSV, is a common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be serious, especially for infants and older adults. RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) in children younger than 1 year of age in the United States.
People infected with RSV usually show symptoms within 4 to 6 days after getting infected. Symptoms of RSV infection usually include Runny nose, Decrease in appetite, Coughing, Sneezing, Fever, Wheezing
These symptoms usually appear in stages and not all at once. In very young infants with RSV, the only symptoms may be irritability, decreased activity, and breathing difficulties.Almost all children will have had an RSV infection by their second birthday per CDC.
If RSV is suspected please see your physician for testing. Students can return when fever free for 24 hours and they have an improving cough without a wheeze. See sick Day Guidelines for mask wearing recommendaton upon return.
STREP THROAT
The most common clinical illness produced by streptococcal infection is pharyngitis (sore throat) or tonsillitis (inflamed tonsils). The affected individual may also complain of an upset stomach, headache or general malaise. Fever is not always present during the onset of symptoms. In some cases, an individual may experience very mild symptoms or be asymptomatic. In rare cases, as the Streptococcal infection progresses, an individual may also develop a rash.
Streptococcal infection is almost always transmitted by close contact with respiratory secretions. The incubation period is 2 to 5 days after exposure. Streptococcal infection can be distinguished from a viral infection by having your physician obtain a throat culture.
Children with streptococcal infection should not return to school until at least 12 hours of antibiotic therapy, and until they have no fever or the above mentioned symptoms.
VARICELLA (CHICKEN POX)
Chicken Pox is a viral disease characterized by fever and a raised, pustular rash. The rash occurs in clusters with a mild fever and sometimes-mild complaints of tiredness and mild respiratory symptoms. The rash originates on the trunk and spreads to the arms and legs.
Chicken Pox is transmitted by direct contact with the lesions, or by contaminated air-borne droplets. A child with Chicken Pox may transmit the disease to susceptible children one day prior to the eruption of the rash and until all lesions have become dry and crusted. The incubation is usually 10 - 20 days after exposure, with the highest incidence occurring on the 14th day. Children with uncomplicated Chicken Pox may return to school when all lesions are dry and crusted.
Unfortunately, even children who have been immunized against Chicken Pox may develop the disease. A small percentage of children do not develop immunity after receiving the immunization and remain susceptible. Please contact your physician if your child appears to have chicken pox.