http://www.scdhec.gov/library/CR-010752.pdf

Dear Parents:

This brochure lists the illnesses for which a child must be kept out of school or childcare.

It tells you if your child needs a doctor's note

or medical treatment to come back to school or childcare after certain illnesses.

DHEC has also posted the School and Childcare Exclusion List on the web at the following address:

http://www.scdhec.gov/Health/ChildTeenHealth/SchoolExclusion/

If you have any questions about the School and Childcare Exclusion List,

please contact your child's school, childcare or your local health

department.

Frequently Asked Questions

When should sick children stay home from school or childcare?

If your child feels too sick to go to school or childcare, or has one of the illnesses on this form,

please keep your child home.

Does my child need to stay home when the child just has a cold?

Most children with mild colds who have no fever and who feel

well enough to go to school or childcare do not need to stay

home. Most colds spread in the 1-3 days before children show

symptoms such as a runny nose or minor cough.

Does my child need to be out of school or childcare if the child

has pinkeye?

It is helpful to think of pinkeye like the common cold. It can be

spread to others, but it usually clears up without medicine. The

best way to keep a child from spreading pinkeye is to encourage

good handwashing. If your child has pinkeye and a fever or

severe eye pain, take him or her to see a doctor.

How long will my child need to stay home if the child is sick?

The inside of this brochure explains how long children should

stay home after they become sick with certain illnesses.

When would my child have to stay out of school or childcare if the child was not sick?

Sometimes children will also have to stay home from school

or childcare if they are exposed to some diseases that are preventable by vaccines.

Your school, childcare center or local health department will discuss the amount of time with you.

If my child was excluded, what does my child need to come back to school or childcare?

The list inside this brochure shows whether a medical note or parent note is required

for your child to return to school or childcare after being absent for an illness.

What illness might keep my child from participating in other activities?

Children with illnesses spread by close contact, like lice, scabies, shingles, staph or

strep skin infections may not be allowed toparticipate in some sports or physical

education (PE) activities. Children with mononucleosis (Mono) or cytomegalovirus (CMV)

may be told not to participate in PE or sports in order to avoid injuries. Children with

diarrhea should not participate in water activities like swimming, splash pads, or

water tables until two weeks after diarrhea stops.

Questions to Consider When Your Child is Sick:

1. Does your child's illness keep your child from comfortably taking part in activities?

2. Does your sick child need more care than the staff cangive without affecting the

health and safety of other children?

3. Could other children get sick from being near your child?

If the answer to any of these questions is "Yes,"

please keep your child out of school or childcare.

School and Childcare Exclusion List:

A Quick Reference for Parents of Children

Chicken Pox / Varicella

Children with chicken pox may return with a parent note once all of the sores and blisters

are dried or scabbed over. If there are no scabs, the child may return to school or childcare

when no new sores appear for 24 hours.

Diarrhea

For most kinds of diarrhea (defined as 3 or more loose stools in 24 hours):

Children in 5th grade or younger should stay home until diarrhea

stops for 24 hours, or until a health care provider clears the child

to return to school. Your child can return with a parent note.

Older children in 6th through 12th grades with diarrhea do not have to stay home,

unless they are spreading illness in the school setting, they have diarrhea with blood

or mucus, or they have diarrhea from one of the contagious conditions listed below.

Exclude children of any age and staff with uncontrolled diarrhea

or stools that contain blood or mucus, unless symptoms are

associated with a non-infectious condition (e.g., IBS or Crohn's

Disease). Return is permitted when symptoms are resolved or

medical evaluation indicates that inclusion is acceptable.

For diapered children or students of any age who require

assistance with personal hygiene, exclude for 2 or more diarrheal

episodes in a school or program day if the frequency or nature of

the diarrheal episodes challenges the ability of the caregiver(s) to

maintain sanitary techniques and/or conditions (diaper spillage

or accidents in toilet trained children):

Campylobacter, Enteropathogenic E.coli (EPEC), Enterotoxigenic E. coli (ETEC), Cryptosporidium, Giardia,

Norovirus, Rotavirus, and most types ofSalmonella:

Your child may return with aparent noteafter diarrhea stops for 24 hours.

E. coli 0157:H7 and other Shiga Toxin Producing E. coli (STEC):

For all ages do not allow recreational water activities (pools,

splash pads, water tables, etc.) until 2 weeks after diarrheal

symptoms stop.

• Children in childcare and students in kindergarten

must have 2 back to back tests taken at least 24 hours apart test

negative for E. coli O157:H7.

If antibiotics were prescribed the stool cultures must be collected at least 48 hours after

antibiotic completion. A health care provider must clear the child to return to school or childcare.

• Students in grades 1-12: Exclude until diarrhea has stopped for at least 24 hours. A

parent note is required to return to school or childcare.

Salmonella Typhi (Typhoid fever):

Children of any age must beout of school or childcare until the diarrhea stops and 3 lab tests

taken at least 24 hours apart test negative for Salmonella Typhi.If antibiotics were prescribed the

stool cultures must be collected at least 48 hours after antibiotic completion. A

health care provider must clear the child to return to school or childcare.

Shigella:

Children of any age are excluded for Shigella.

•Children in childcare and students in kindergarten must be

removed for 24 hours or more after diarrhea has stopped

and at least one stool culture is negative. If antibiotics were

prescribed the tests must be collected at least 48 hours after

antibiotic completion. A health care provider

must clear the child to return to school or childcare.

• Students in grades 1-12: Remove until diarrhea has stopped for 24 hours or more:

provided that the student has good handwashing and is able to self-toilet. A parent note

is required to return to school or childcare.

• A student with questionable or poor hand hygiene may

be required to have at least one Shigella -negative stoolculture and to be diarrhea-free

for at least 24 hours prior to returning. If antibiotics were prescribed, stool cultures

must be collected 48 or more hours after the antibiotics arecompleted.

Fever only

Keep your child home for a fever of 101 degrees or higher by

mouth or 100 degrees or higher if taken under the arm. Your

child can return to school or childcare with a parent note when

the fever is gone for at least 24 hours without the use of fever

reducing medications. Please note: An infant 4 months of age or

younger with a fever (100.4 F) should receive medical attention.

Flu, Influenza or Influenza-Like Illness (ILI)

(ILI is defined as an oral temperature of greater than 100° F

with a cough and/or sore throat for which there is no other known cause)

A child will be excluded for a fever of 100 degrees with cough

and/or sore throat. Your child can return to school or childcare with a

parent note when the fever is gone for at least 24 hours

without the use of any fever reducing medications.

Hand, Foot, and Mouth Disease

Children with hand, foot, and mouth disease should be out of

school or childcare while they have fever, above normal drooling,

trouble swallowing, or are too sick to do normal school or

childcare activities. Your child may return with a parent note.

Head Lice

Children with crawling lice or with nits (eggs) 1/4 inch or closer

to the scalp may be sent home at the end of the day, if head-

to-head contact with other children can be avoided. Otherwise,

they may be sent home immediately. Your child may return with a

parent note after their first treatment with a facility-approved lice removal product, if there

are no active lice crawling on your child's head.

The school or childcare should check your child's scalp for any

newly hatched lice 7-10 days after treatment. If any are present,

your child will have to be removed and retreated for lice in order

to come back to school or childcare.

Haemophilus influenzae

Type B (Hib) Children with a Hib infection are excluded until cleared by a

health care provider to return to school or childcare.

Hepatitis A

Children are excluded until 1 week after the start of illness or

jaundice. The child may return with a medical note 1 week after the start of the jaundice.

Impetigo

Your child may return after receiving antibiotics for 24 hours,

as long as the sores have stopped oozing and are starting to

get smaller, or if the sores can be covered completely with a

watertight bandage. A parent note is needed to return to school or childcare.

Measles (Rubeola)

Children with measles can return with a medical note 4 days

after the rash begins, if they have no fever and feel well enough

to participate in regular school or childcare activities.

Meningitis

A child with signs of meningitis (high fever, rash, stiff neck) must remain out of school or childcare until a

health care provider provides a medical note stating that the child may return.

Mouth Sores

Exclude young children for sores, including mouth ulcers and blisters, inside the mouth associated

with uncontrolled drooling, unless the child's health care provider states that the child is

noninfectious. A parent noteis required to return.

Mumps

Children with mumps can return with a medical note 5 days after

the beginning of swelling.

Pink-eye / Conjunctivitis

Exclude symptomatic children who have fever, severe eye

pain, purulent drainage or are too sick to participate in routine

activities. Your child may return with a parent note.

Rash with fever, behavioral changes or other symptoms

Exclude children with rash until a health care provider has

determined that the illness is not a communicable disease. A

medical noteis required to return.

Ringworm

Children with ringworm of the scalp must remain out of school

or childcare from the end of the day until they have begun

treatment with a prescription oral antifungal medication.

Your child may return with a parent note. Children with

ringworm of the body must remain out of school

or childcare from the end of the day until they have begun

treatment with a topical antifungal medication

. Your child may return with a parent note.

RSV (Respiratory Syncytial Virus)

Exclude younger children with RSV if the child has a fever or if the

child is too sick to participate in activities with other children and

staff. Your child may return with a parent note.

Rubella / German Measles

Keep your child home until 7 days after rash starts. The child may

return with a medical note.

Scabies

Keep children with scabies out of school or childcare until treatment/medication has been completed (usually overnight).

A medical note is required to return.

Shingles

Keep children home who have shingles sores or blisters that cannot be covered. Your child may return with a

parent note once the sores are dried or scabbed.

Skin Infections from Staph or Strep (includes MRSA) or Herpes

Gladiatorum

Children may attend school or childcare if the sores are covered with clothes or dressings, and if the drainage does not come

through clothes or dressing.

Strep Throat / Streptococcal Pharyngitis

Your child with "Strep throat" can return to school or childcare with a medical note

24 hours after starting antibiotics, if there is no fever.

Tuberculosis (TB)

Keep children with active TB home until the health care provider treating the TB writes a

medical note that says that the child is no longer contagious.

Vomiting

Keep young children home when vomiting has occurred 2 or

more times in a 24 hour period, or for vomiting and fever (101

or higher). All children should stay home for any green or bloody

vomit. If the child is vomiting and also has not urinated for 8

hours the child should stay home. Your child may return with a

parent note.

Whooping Cough / Pertussis

Children with whooping cough can return to school or childcare with a medical note

after completing 5 days of antibiotics.

If there is an outbreak of disease in your child's school or childcare,

DHEC may change the exclusions found in this document in order

to stop the spread of disease.

If your child has not received immunizations to protect against

diseases like Measles, Mumps, Rubella (German measles), or

Chickenpox, your child may need to be removed from school

or childcare if there are cases of these illnesses in the school or

childcare. Your school nurse will provide more information if

there is an exposure or outbreak.

OK to Attend

Children with the following conditions do not have to be

excluded from school or out-of home childcare,

if they feel well enough to participate in regular activities:

•Canker Sores

•Chronic Hepatitis B or C

•Colds or coughs, without fever or other signs of illness

•Cold Sores

•Croup

•Cytomegalovirus (your child may need to stay out of PE and sports)

•Disease spread by mosquitos: Malaria, West Nile Virus

•Diseases spread by ticks: Babesiosis, Ehrlichiosis, Lyme

Disease, Rocky Mountain Spotted Fever, Tularemia

•Ear Infection

•Fifth Disease

•HIV infection

•Mononucleosis (your child may need to stay out of PE and sports)

•MRSA, if child is only a carrier

•Pinworms

•Rash without fever or behavior change

•Roseola, once the fever is gone

•Thrush

•Urinary Tract Infection

•Warts, including Molluscum contagiosum

•Yeast Diaper Rash

Help your child stay healthy and ready to learn.

We hope that your child never has to miss school or childcare

because of illness. The best protection from disease is prevention.

You can help prevent many illnesses by making sure your child

receives immunizations and by making sure your child washes his

or her hands often.

DHEC / Bureau of Disease Control

Division of Acute Disease Epidemiology 2600 Bull Street Columbia SC 29201

Phone: 803.898.0861 / Fax: 803.898.0897
Safari Montage
Safari Montage
Email - Employee
Email - Employee
Sponsor Image
Typing Quest NCSD - Grades 2 - 5
Typing Quest NCSD - Grades 2 - 5
Boxtops for Education
Boxtops for Education
My School Bucks
My School Bucks
Exact Path
Exact Path
Sheppard's Software
Sheppard's Software
Sponsor Image
Hour of Code
Hour of Code