Ask Dr. Marla: How sick is "too sick" to go to school?

By Dr. Marla Shapiro on February 19, 2013
How sick is “too sick” to go to school or daycare?


This is a very common question that parents ask me all the time! The most common illnesses kids get are typically infectious diseases. We want to be sure that they are not contagious or communicable to other children. If they are, then you would want to keep your child home. The American Academy of Pediatrics suggests you ask yourself these three questions:

  1. Does your child have a fever? 
  2. Is your child well enough to engage in class?  
  3. Do you think your child has a contagious illness such as the fl u or pinkeye? 

If you answer ‘yes’ to questions 1 or 3, then keep your child home. If you answer ‘no’ to number 2, then keep your child home. Even though a cough and cold can be infectious, a child with a mild common cold without a fever and who is reasonably comfortable can go to school. Otitis media (ear infection) is not contagious and children can go to school, as long as they are not in pain. The following conditions, however, mean your child should stay home:

Fever: An oral temperature higher than 38.6°C lets us know that the body is fi ghting off an infection of some sort.
Diarrhea: This is likely the result of gastroenteritis, which is contagious. That child should stay home and drink plenty of fluids.
Vomiting: For obvious reasons.
Respiratory infections: Illnesses such as the flu, bronchitis, bronchiolitis or pneumonia should keep a child at home.
Strep throat: Stay home for at least a full 24 hours after starting an antibiotic.
Pinkeye: Stay home until 24 hours after starting topical antibiotics.
Rash: Be sure it is not due to a virus or bacteria. Chickenpox, impetigo and scarlet fevers are examples of rashes that indicate the presence of an infectious disease and are contagious.

If your child is lethargic and has a behaviour change along with a headache, seek medical attention to make sure it is not a sign of a brain infection called meningitis. Headache and fever should also be looked at to rule out an infectious cause of the headache.

Got a health question? Submit it to Dr. Marla.

Originally published in ParentsCanada magazine, February/March 2013.

By Dr. Marla Shapiro| February 19, 2013

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