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Indications for Exclusion of Sick Kids from Childcare Centers and Schools

Disclaime

Original Adapted from Red Books 2003

The page started on 02/2006, updated on 02/23/2008

If you have, or suspect you have, a health problem you should consult your physician.

Children should be excluded from the child care setting for the following medical conditions

Illness that prevents the child from participating comfortably in program activities.
Illness that results in a need for care that is greater than the staff can provide.
The condition suggesting possible severe illness: fever, lethargy, inexplicable irritability or persistent crying, uncontrolled coughing, wheezing, difficult breathing, or unusual signs for a child
Persistent abdominal pain or intermittent pain associated with fever or other signs or symptoms

AAP recommendations for inclusion & exclusion from out-of-home child care setting/Schools:

“Mild illness is common among children; most children will not need to be excluded from their usual source of care for mild respiratory tract illness, because transmission is likely to have occurred before symptoms developed in the child. Disease may occur as a result of contact with children with asymptomatic infection. The risk of illness can be decreased by following common-sense hygienic practices.” - Red Book 2003

	Medical condition	Re-admission until …
	Diarrhea or stools that contain mucus or blood	Blood in the stool not explained by dietary changes, medication, or hard stools.
	Vomiting two or more times in the previous 24 hours	Vomiting resolves or a physician determines that the cause of the vomiting is not contagious and the child is not in danger of dehydration.
	Mouth sores with drooling	Physician determines that the child is noninfectious.
	Rash with fever or behavior change	A physician determines the illness is not a communicable disease.
	Purulent conjunctivitis (pink eye with white or yellow eye discharge)	A physician exams and agrees for readmission
	Head lice	After the first treatment.
	Scabies	After treatment is initiated
	Impetigo (Skin infection)	24 hours after initial antibiotic treatment.
	Strep throat or other strep infections	24 hours after initial antibiotic treatment.
	Tuberculosis	Physician or local health department authority states that child is noninfectious.
	Varicella (Chickenpox)	All lesions have dried and crusted (usually 6 days after onset of rash).
	Pertussis	5 days of appropriate antimicrobial therapy (which is to be given for a total of 14 days)
	Mump	9 days after onset of parotid gland swelling.

	Hepatitis A virus (HAV) infection	1 week after onset of illness or jaundice (if symptoms are mild).