The 3 a.m. call interrupted a deep sleep: “Mommy! I throwed up!”
Once the cleanup was done and we had tucked our son back in his bed, it was time to assess the implications for the next day. Could he go to school? In the case of vomiting, the answer, school health officials say, is simple: No.
With different symptoms, though, it isn't always clear.
In general, a child should stay home if he is too uncomfortable to participate in all activities and stay in the classroom; if he needs more medical attention than the school can give; or if he might be spreading harmful diseases to others, according to Cynthia Devore, chairwoman of the American Academy of Pediatrics Council on School Health.
“If you think they're not going to learn much or they will be miserable, it’s not worthwhile,” said Joseph Bresee of the Centers for Disease Control and Prevention.
Here is what experts said about some of the most common childhood symptoms.
Fever: A child with a temperature, taken orally, below 101 degrees who has no other symptoms and is acting normally can probably go to school, Devore said in an email. She notes that a child’s temperature might fluctuate throughout the day from overdressing, getting overheated at recess or other factors, so behavior, rather than temperature, is often a better indicator that a child is sick.
Rash: Skin irritations are difficult because they can be a harmless allergic reaction or a sign of a serious illness. They are also tricky because with many diseases, such as chickenpox, they don't materialize until after the child has been contagious for a few days. A rash with no accompanying fever, symptoms or change in behavior probably is not cause for concern, Devore said. But if the child seems sick or the rash comes on suddenly, a trip to the doctor might be wise, said Linda Davis-Alldritt, a registered nurse and the president of the National Association of School Nurses.
The common cold: Stuffy noses, low-grade fevers and coughs are fine as long as the symptoms are mild, the student can do her work and she is not disturbing her classmates.
“By the time symptoms manifest, the child has likely already been contagious,” Devore said. “Most kids and teachers are exposed to common viruses, including cold viruses, regularly. There are enough viruses to have a fresh cold every week and still have a normal immune system.”
Influenza: Stay home. Signs that your child has the flu and not a cold include higher fever, aches and pains, fatigue and severe cough. “With flu, the fever can be 102 or even higher,” Davis-Alldritt said. “Look at your kids and you can tell when they are really sick.”
Eye discharge: Conjuctivitis, or pinkeye, is just that: eye discharge paired with pink or red in the whites of the eyes. It can be caused by a virus or bacteria, or by dust or allergens. The viral and bacterial versions are contagious.
“It's very hard to differentiate” between allergic eye irritation and an infection, Davis-Alldritt said. “If parents think it’s pinkeye, it’s a good idea to call their health care provider.”
Sore throat: Sometimes it’s strep. Sometimes it's just irritation from a cold or other respiratory infection. If it’s not severe and not accompanied by a significant fever, a child can go to school. If it is strep, she will need to stay home until after she has been on antibiotics for a full day and is feeling better, Devore said. For a viral sore throat, a child should stay home until she has been fever-free for 24 hours.
Vomiting and diarrhea: There’s very little gray area here. If your child is throwing up or has diarrhea, he needs to stay home from school. “Unless the parent is absolutely convinced this is a one-time deal, he really should stay home until he is symptom-free for at least 24 hours,” Davis-Alldritt said.
Prevention: Kids can prevent many common illnesses with a few simple steps: frequently washing hands for at least 20 seconds with soap and warm water; coughing and sneezing into their elbows; keeping their hands away from their eyes and face; and getting a flu shot and keeping other vaccines up-to-date.