When to Stay Home When Sick & School Nurse Care

Please keep your student home from school if they have:

• A temperature of 100.1°F (37.8°C) or higher during the previous 24 hours. Students need to be fever-free without medication for 24 hours before returning to school
• Illness with vomiting or diarrhea. Students who have no vomiting or diarrhea for 24 hours can return to school
• Signs or symptoms of the flu like body aches, chills, headache, and fatigue
  • Please contact your pediatrician or healthcare provider if your student needs medical care

If a student feels unwell during the day, this is what caregivers can expect:

1. The school nurse will check the student
2. If the nurse determines the student needs to go home, they will contact the student’s listed emergency contacts. Nurses will call all listed emergency contacts until they reach someone.
   • Please have a plan in place to pick up your student if they are sick at school

Below is a list of common health concerns for reference. This is not a complete list. The school nurse will use their judgment to decide when a student is unwell and should be dismissed from school.

• Fever: A temperature of 100°F (38°C) or higher is considered a fever. Children should stay at home until they are fever-free for 24 hours without taking any fever-reducing medication like Tylenol or Motrin.
• Vomiting/Diarrhea: Students should stay home until they are symptom-free for 24 hours. They should also be able to drink fluids and eat comfortably.
• Coughs/Colds: If a student has discomfort from cold symptoms, consider keeping them home. A persistent cough or ongoing nasal drainage, especially if green, may need to be evaluated by a healthcare provider.
• Conjunctivitis: Children may need to stay home until they have used prescribed medication for 24 hours or until a healthcare provider clears them to return to school. Good handwashing is important to help prevent the spread.
• Strep Throat: Children must stay home for at least 24 hours after starting antibiotics. They should also feel well enough to return to school. Some children may feel ill for several days.
• Suspicious Rash: Children with a new or unexplained rash should be evaluated by a healthcare provider and cleared before returning to school.
• Mononucleosis (Mono): Please contact the school nurse if a student is diagnosed with mono. A healthcare provider may limit the student’s physical activity, and temporary adjustments can be arranged at school.
• Head Lice: Children should be treated with an appropriate lice treatment product, like Nix. Caregivers should contact a healthcare provider with questions about treatment options.
  • Read guidance from the Massachusetts Department of Public Health on head lice.
  • Read guidance from the Centers for Disease Control and Prevention on head lice.
• Fifth’s Disease (Slapped Cheek Disease):  This is a common viral illness that may cause a red rash on the face. Children are usually no longer contagious once symptoms appear. It can be a concern for pregnant individuals. Please contact the school nurse if a student is diagnosed.
• Chickenpox: Children should stay home for at least five days and until all spots are crusted over, dry, and no new spots are appearing. Please contact the school nurse if a student is diagnosed.
• Impetigo: This is a common skin infection that causes sores or blisters, often around the mouth or nose. Children must stay home for at least 24 hours after starting antibiotics.

School nurses support student health and safety during the school day.

Medications that are taken more than once a day should be given at home whenever possible. For example, many antibiotics can be given before school, after school, and at bedtime.

School nurses do not give vitamins, herbal products, or other supplements at school, as these are not considered medications under Massachusetts regulations (105 CMR 700.001). Caregivers may give these at home before or after school.

Learn more about medication guidelines at school.