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How Sick Is Too Sick?

When Children and Staff Should Stay Home from School or Child Care 

Colorado Dept of Public Health and Environment logo

At Jeffco Public Schools, we follow the recommendations from Colorado Department of Public Health and Environment (CDPHE) on when is too sick actually too sick to go to school, work, or child care.

There are three main reasons to keep sick children and adults at home:


1. The child or staff member does not feel well enough to take part in usual activities. For example, a child is overly tired, fussy or will not stop crying.

2. A child needs more care than teachers and staff can give while still caring for the other
children.

3. The symptom or illness is on this list, and staying home is required.

Remember, the best ways to stop the spread of infection is through good hand washing and staying home when sick.


Illness Symptoms

Symptoms Child Must Stay Home?
Diarrhea
Frequent, loose, or watery stools (poop) compared to normal ones that are not caused by food or medicine. 
YES - if there are other symptoms along with the diarrhea (such as vomiting, fever, abdominal pain, jaundice, etc.), the diarrhea cannot be contained in the toilet, there is blood or mucous in the stool, the child is in diapers or the staff member handles food or bottles. Children and staff may return 24 hours after their last episode of diarrhea unless the diarrhea is caused by an illness that requires them to stay home longer. 
“Flu-Like” Symptoms
Fever over 100°F with a cough or sore throat. Other flu symptoms can include tiredness, body aches, throwing up, and diarrhea. 
YES - for at least 24 hours after the fever is gone. The fever needs to be gone, without using medicine that reduces the fever (acetaminophen or ibuprofen). 
Coughing YES- if the coughing is severe, uncontrolled, or the child has wheezing, rapid or trouble breathing. Medical attention is needed for wheezing, rapid or trouble breathing.

Note: Children with asthma may go to school with a written health care plan and the school is allowed to give them medicine and treatment.
Mild Respiratory or Cold Symptoms
Stuffy nose with clear drainage, sneezing, and mild cough
NO – children and staff may go to school if they able to take part in usual activities. Children and staff should stay home if the symptoms are severe. This includes fever and if a child is not acting normally and/or has trouble breathing. 
Vomiting/Throwing Up
Throwing up two or more times in the past 24 hours, there are other symptoms in addition to the vomiting (such as fever, diarrhea, etc.).
YES – until 24 hours after throwing up stops or a doctor says it is not contagious. If a child has a recent head injury, watch for other signs of illness and for dehydration. Adults who handle food and bottles must be excluded. 



Illness Diagnosed


Symptoms Child Must Stay Home?
Chicken Pox 
YES - until the blisters have dried and crusted (usually 6 days). 
Conjunctivitis (Pink Eye) 
Pink color of eye and thick yellow/green discharge with behavior
NO - children and adults do not need to stay home unless they have a fever or are not able to participate in usual activities. Call your doctor for advice and possible treatment.
Croup (see Coughing) 

Call your doctor for advice.
Note: Children and staff may be able to go to school unless they are not well enough to take part in usual activities.
Fifth's Disease NO - the illness is no longer contagious once the rash appears. 
Mild Hand Food and Mouth Disease (Coxsakie virus)
NO – unless the child or adult has mouth sores, is drooling and is not able to take part in usual activities.
Head Lice or Scabies 
YES – children may stay at school or child care until the end of the day but cannot return until after they have had the first treatment.
Hepatitis A
YES – until 1 week after the illness starts and when the child or staff is able to take part in normal activities. Children and staff should not go to another facility during the period of exclusion.  
Herpes 
NO – unless there are open sores that cannot be covered or there is nonstop drooling. 
Impetigo 
YES – children and adults needs to stay home until antibiotic treatment has started. 
Head Lice or Scabies 
YES – children may stay at school or child care until the end of the day but cannot return until after they have had the first treatment.
Ringworm 
YES – children may stay at school or child care until the end of the day but cannot return until after they have had the first treatment. Keep the area covered for the first 3 days if participating in sports with person to person contact. 
Roseola 
NO – unless there is a fever or behavior changes. 
RSV(Respiratory Syncytial Virus) 
NO – children and staff can go to school unless they are not well enough to take part in usual activities and/or they have trouble breathing. Call your doctor for advice. 
Strep Throat 
YES – for 12 hours after starting antibiotics unless the doctor says that it is okay to return to school sooner. Children and staff also need to be able to take part in usual activities. 
Vaccine Preventable Diseases
Measles, Mumps, Rubella (German Measles), Pertussis (Whooping Cough) 
YES – children and staff can return to school once the doctor says they are no longer contagious. 
Yeast Infections
Thrush or Candida diaper rash)
NO – follow good hand washing and hygiene practice. 
Other
Symptoms or illnesses not listed
Contact the child care center director or school health staff to see if the child or staff member needs to stay home.

This was developed in collaboration with the Children’s Hospital of Colorado School Health Program. The information presented is intended for educational purposes only. It is not intended to take the place of your personal doctor’s advice and is not intended to diagnose, treat, cure or prevent any disease. The information should not be used in place of a visit, call or consultation or advice of your doctor or other health care provider.

References

American Academy of Pediatrics. Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide. Aronson SS, Shope TR, eds. 5th ed. Itasca, IL: American Academy of Pediatrics; 2020.20.

Colorado Department of Public Health and Environment. Infectious Diseases In Child Care and School Settings: Guidelines for Child Care Providers and Health Consultants, School Nurses and Other Personnel. 2019.

CDPHE source "How Sick Is Too Sick", Dec. 2019 (Espanol) (PDF document)

CDPHE Child Care source website




 The content on this website was sourced directly the Colorado Department of Public Health and Environment website.

January, 2020
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