School Health Issues

When must I keep my child home from school or day care?

According to the American Academy of Pediatrics children should be excluded from the childcare setting for the following:

• Illness that prevents the child from participating comfortably in program activities.
• Illness that results in a need for care that is greater than the staff can provide without compromising the health and safety of other children.
• Any of the following conditions suggesting possible severe illness: fever, lethargy, irritability, persistent crying, difficult breathing, or other manifestations of possible severe illness.
• Diarrhea or stools that contain blood or mucus.
• Shiga toxin-producing Escherichia coli, including E coli 0157:H7, or Shigella infections, until diarrhea resolves and results of 2 stool cultures are negative for these organisms.
• Vomiting 2 or more times during the previous 24 hours, unless the vomiting is determined to be caused by a noncommunicable condition and the child is not in danger of dehydration.
• Mouth sores associated with drooling, unless the child's physician has determined the illness is not a communicable disease.
• Purulent conjunctivitis (defined as pink o 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 a physician and approved for readmission.
• Tuberculosis, until the child's physician or local health department authority states that the child is noninfectious.
• Impetigo, until 24 hours after treatment has been initiated.
• Streptococcal pharyngitis, until 24 hours after treatment has been initiated.
• Head lice (pediculosis), until after the first treatment.
• Scabies, until after treatment has been given.
• Varicella, until all lesions have dried and crusted (usually 6 days after onset of rash.
• Pertussis, until 5 days of appropriate antimicrobial therapy (which is to be given for a total of 14 days) have been completed.
• Mumps, until 9 days after onset of parotid gland swelling.
• Measles, until 4 days after onset of rash.
• Hepatitis A virus (HAV) infection, until 1 week after onset of illness or jaundice (if symptoms are mild).

Which illnesses and conditions do not necessitate exclusion from school or day care?

Most minor illnesses do not constitute a reason for excluding a child from childcare. According to the American Academy of Pediatrics children with the following conditions do not necessitate exclusion:

• Nonpurulent conjunctivitis (defined as pink conjunctiva with a clear, watery eye discharge without fever, eye pain, or eyelid redness)
• Rash without fever and without behavioral change
• Parvovirus B19 infection in an immunocompetent host
• Cytomegalovirus CMV) infection
• Chronic hepatitis B virus (HBV) infection
• Human immunodeficiency virus (HIV) infection
• For additional information: www.health.state.ny.us/.