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

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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

  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.

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