Too Sick to go to School?



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Throwing up, diarrhea, anything requiring surgery – those are easy calls. But how bad does a runny nose or a cough need to be to warrant a sick day? Or a rash? Or lice? Most things, with the exception of lice (but not for the reason you think) aren’t nearly as cut and dry as we might like them to be.

“It would be so easy if every time children got something, they just stayed home,” says Dr. Sharon Carson, a paediatrician in Burlington, Ontario. However, the reality is that most bugs are most contagious before any symptoms appear. So, we should be asking ourselves whether, at school, our child would receive the level of care they need in order not to get worse. Here’s a good tip: it’s more often the fever, not the sniffles or the cough, that should tip the scales in favour of a home day.

Stay-at-home parents will tend to keep their child home when it’s a marginal decision. It’s a harder call when both parents work and loss of pay or work obligations are a factor.



HOW LONG IS LONG ENOUGH?

If your child has…          You’re going to be home for a little while…         



CHICKEN POX                Wait until all the vesicles have crusted over. It usually takes about a week.



HAND, FOOT                  This is a viral illness of infants and children. There is a risk of dehydration.
AND MOUTH                  The fever alone would keep them out of school. It’s very contagious,
                                      so they should stay out until the legions are crusted over.

CROUP                           Keep them out the next day, but they could go back 24 hours after a croup episode.

RINGWORM                   Should be treated with an antifungal before the child returns to school.



SYMPTOM: Fever
COMMENT: Fever is something we are most at risk of underestimating, or overestimating, and often both at the same time.
WHEN TO GO: The fever is less than 38.3ºC (101ºF)
WHEN TO STAY: If it’s more than 38.3ºC (101ºF)

DR. CARSON SAYS: “If you are concerned about your child’s behaviour – meaning they are irritable, you can’t console them, they aren’t drinking –they should stay home.”

SYMPTOM: Sniffles, runny nose – your basic cold

COMMENT: Colds are common. For kids entering daycare, you can expect 10 to 12 over the course of the winter.

WHEN TO GO: The symptoms are mild, no fever, and aren’t too disruptive.

WHEN TO STAY: If there is also a fever.

DR. CARSON SAYS: “If the cold is preventing the child from remaining hydrated, then they should stay home.”



SYMPTOM: Sore throat

COMMENT: Could be anything from strep to shouting at the hockey game on TV.

WHEN TO GO: It doesn’t show up with any other symptoms.

WHEN TO STAY: If it’s accompanied by a fever, which could indicate strep throat.

DR. CARSON SAYS: “Strep is not highly contagious but most kids feel pretty lousy. I use the general rule that your child should be on antibiotics for 48 hours before you go back.”



SYMPTOM: Rash

COMMENT: Most rashes in younger kids are the result of a virus and most aren’t contagious.

WHEN TO GO: Small bumps, not too itchy, not on the face, not oozing.

WHEN TO STAY: Big bumps, itchy, yellowy, on the face, oozing. If its all of that, see the doctor as it could be impetigo. If it is, stay home for a day after beginning treatment.

DR. CARSON SAYS: “I wouldn’t so much keep them out for the rash, per se, but for the other symptoms that are associated with the rash.”



SYMPTOM: Bloodshot eyes

COMMENT: Pinkeye would be the worry. It can be caused by either a virus or bacteria, though public health policy requires all cases be treated

WHEN TO GO: Bloodshot eyes, both of them and no discharge.

WHEN TO STAY: Bloodshot eyes and a yellowy discharge: Treat today, school tomorrow.

DR. CARSON SAYS: “You should get eye drops. Children should be out for 24 hours before they go back.”



SYMPTOM: Diarrhea

COMMENT: It can be due to many things, and can often be highly infectious as long as it persists.

WHEN TO GO:  If it’s not extreme.

WHEN TO STAY: If it’s extreme and not easily controlled, and you are unable to keep the child fully hydrated.

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