When can a child go back to school or day care after being ill?

The following is adapted from the 2000 Red Book ( American Academy of Pediatrics, Report of the Committee on Infectious Diseases) page 108, "Recommendations for Inclusion or Exclusion". Note that the policies of individual schools or day cares may be more stringent.

Children need not be excluded from the childcare setting for minor illness except for the following illnesses:

  • Illness that prevents the child from participating comfortably in program activities.
  • Illness that results in a greater need for care than the staff can provide without compromising the health and safety of other children.
  • The child has any of the following conditions: fever, lethargy, irritability, persistent crying, difficult breathing, and/or other manifestations of possible severe illness.
  • Diarrhea or stools that contain blood or mucus.
  • E. coli 0157:H7 infection, until diarrhea resolves and two stool cultures are negative.
  • Vomiting two or more times in the previous 24 hours, unless the vomiting is determined to be caused by a non-communicable condition and the child is not in danger of dehydration.
  • Mouth sores associated with drooling, unless the child's physician or local health department authority states that the child is noninfectious.
  • Rash with fever or behavior change, until a physician has determined the illness is not communicable
  • Purulent conjunctivitis (defined as pink or red conjunctiva) with white or yellow eye discharge, often with matted eyelids after sleep and eye pain or redness of the eyelids or skin surrounding the eye? Until examined by the physician and approved for re-admission, with treatment.
  • Tuberculosis, until the health department states that the child is non-infectious.
  • Impetigo, until 24 hours after treatment has been initiated.
  • Streptococcal pharyngitis (strep throat), until 24 hours after treatment has been initiated.
  • Head lice, until after the first treatment (most schools have a "no nits" policy).
  • Scabies, until after treatment has been completed.
  • Varicella, until all lesions have dried and crusted (usually 6 days).
  • Pertussis, until 5 days of the appropriate antibiotic therapy has been completed.
  • Mumps, until 9 days after onset of salivary gland swelling.
  • Measles, until 5 days after onset of rash.
  • Hepatitis A virus infection, until 1 week after onset of jaundice or illness (if no jaundice occurred).

For further information on childcare visit the CDC website: www.cdc.gov/ncidod/hip/abc/abc.htm

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