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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.

During Colorado's response to the COVID-19 pandemic, children and staff who have been exposed to a positive case or who have symptoms consistent with COVID-19 listed below, must follow the Guidance for Cases and Outbreaks in Child Care and Schools.

MAJOR SYMPTOMS of COVID-19
  • Feeling feverish, having chills or temperature of 100.4° F or greater
  • Loss of taste or smell
  • New or unexplained persistent cough
  • Shortness of breath or difficulty breathing
MINOR SYMPTOMS of COVID-19
  • Sore throat
  • Runny nose
  • Muscle or body aches
  • Headache
  • Fatigue
  • Nausea, vomiting
  • Diarrhea

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

1. Someone who the child lives with or the staff lives with (or has had close contact with) has been diagnosed with COVID-19, or has symptoms of COVID-19.

2. 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.

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

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

5. Someone who the child lives with or the staff lives with is being tested for COVID-19.

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 the diarrhea can be explained* by a specific illness then follow the exclusion guidelines for that illness.

If the diarrhea is unexplained then follow the Guidance for Cases and Outbreaks in Child Care and Schools.

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. 
Fever
Fever is a temperature of 100.4° F or greater. Babies who are 4 months or younger need to see a doctor right away for a fever of 100° F or higher. 
YES - if the fever can be explained* by a specific illness then follow the exclusion guidelines for that illness.

If the fever is unexplained then follow the Guidance for Cases and Outbreaks in Child Care and Schools.
Vomiting/Throwing Up YES - if the vomiting can be explained* by a specific illness then follow the exclusion guidelines for that illness.

If the vomiting is unexplained then follow the Guidance for Cases and Outbreaks in Child Care and Schools.

Children and staff may return 24 hours after their last episode of vomiting unless the vomiting is caused by an illness that requires them to stay home longer.

If a child with a recent head injury vomits, seek medical attention. 




* An explained symptom means that the symptom can be attributed to one of the following:

  1. A known occurence (ex. a child gagged which caused vomiting); or

  2. A known health condition (ex. diarrhea caused by irritable bowel syndrome, cough caused by asthma or allergies etc.); or

  3. A documented diagnosis from a health care provider (ex. fever caused by strep throat) which excludes other conditions of concern. 

In the instance of a known occurence or health condition, separate the child from group care and monitor them. If symptoms improve and COVID-19 has been ruled out in accordance with Guidance for Cases and Outbreaks in Child Care and Schools exclusion guidelines for COVID-19 they may return to group care. If the symptoms worsen the child or staff member needs to 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.
COVID-19
symptoms may include any of the following:
fever or chills
new loss of taste or smell
fatigue
new or unexplained persistent cough
shortness of breath or difficulty breathing
sore throat
runny nose or congestion
muscle aches or body aches
headache
nausea or vomiting
diarrhea

Yes - Children and staff who have been diagnosed with COVID-19 must be excluded until:

  1. The child or staff member has not had a fever for 24 hours, AND
  2. Other symptoms have improved (ex. the cough or shortness of breath has improved), AND
  3. At least 10 days have passed since the symptoms first appeared. 

Prior to diagnosis, children and staff with symptoms or known exposure to COVID-19 should follow the exclusion guidelines in Guidance for Cases and Outbreaks in Child Care and Schools.

Fifth's Disease NO - the illness is no longer contagious once the rash appears. 
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. 
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. 

Follow Guidance for Cases and Outbreaks in Child Care and Schools.
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", September, 2020  (PDF document)

CDPHE Child Care source website

Coloardo Department of Public Health and Environment. COVID-19 Guidance: Cases and Outbreaks in Child Care and Schools. 9.29.20




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

September, 2020
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