Illness / Enfermedad Skip To Main Content

Illness / Enfermedad

How Sick Is Too Sick: Guidelines for Determining Student Attendance

Evaluation of a sick child must consider which diseases are currently circulating among students, staff, and the community. Known exposure to cases or an outbreak of a contagious disease (including but not limited to those listed here), even without a confirmed diagnosis, may necessitate more stringent return-to-school requirements. During Colorado's ongoing response to the COVID-19 pandemic, children and staff who have symptoms consistent with COVID-19 should receive testing, and follow the COVID-19 isolation guidance until testing is completed or if they test positive. If the individual tests negative for COVID-19, the individual should then follow the recommendations for their disease or symptoms using the below guidance. 

CDPHE How Sick Is Too Sick | ¿Cual es el punto en que uno esta demasiado enfermo?
CDPHE Infectious Disease Guidelines

There are four main reasons for students and staff to stay home:

  1. The student or staff member could infect others with a contagious illness, either because of symptoms, a diagnosis, or recent exposure to a contagious illness.
  2. The student or staff member doesn't feel well enough to participate in usual activities - in students, this is a behavior change (such as; overly tired, fussy, or won't stop crying, etc.). 
  3. The student needs more care than teachers and staff can give and still care for the other students.
  4. The student or staff member has symptoms or an illness on this list, and staying home is required.
     
  • Fever: The student or staff member may return to school if the fever has been resolved for 24 hours without fever-reducing medications (e.g., Tylenol, Ibuprofen, etc.) unless the fever is caused by an illness that requires them to stay home longer. A temperature of 100.4 is considered a fever, but we use 100.0 due to the variance in thermometers and methods of taking a temperature.
     
  • Respiratory Viruses, COVID-19, Influenza, RSV: Students and staff should remain out of school until they are fever-free for 24 hours without the use of fever-reducing medications and other symptoms have been improving for 24 hours. Additional precautions are recommended for at least five days following the return of anyone recovering from respiratory symptoms, including hand and respiratory hygiene, improved ventilation, masking, physical distancing, and testing. Refer to CDC’s Respiratory Virus Guidance or CDC's FAQs for additional information.
     
  • Vomiting: If the student or staff has vomited in the past 24 hours or in association with other symptoms, they must stay home until it has been at least 24 hours since the last time they vomited (unless vomiting is caused by food, medicine, or a documented condition not requiring the student or staff to stay home).
     
  • Diarrhea: If the student or staff have frequent, loose, or watery stools (that are not caused by food or medicine), they may return to school 24 hours after their last episode of diarrhea unless the diarrhea is caused by an illness that requires them to stay home longer. If the diarrhea is explained by a specific illness, then they can return to school following exclusion guidelines for that illness. 
     
  • Severe or New Cough (including Croup): Severe cough is often present in people with infectious respiratory illness. A person with severe, uncontrolled coughing, wheezing, or rapid or difficult breathing (if new or worsening from baseline) should not attend school and should talk to a health care provider. Students and staff may return to school, even if the cough is not fully resolved, as long as exclusion is not required for other symptoms or diagnosis.
     
  • Flu-Like Symptons: Students and staff may return to school as long as they are fever-free for 24 hours without the use of fever-reducing medications and other symptoms are improving unless the symptoms are caused by an illness that requires them to stay home longer. In consultation with a health care provider, additional evaluation for flu-like illnesses, sore throat, and upper respiratory symptoms may be appropriate, including evaluation for strep throat.
     
  • Strep Throat: Students and staff may return to school after taking an antibiotic for 12 hours, are fever-free, and feel better.
  • Chicken Pox: Exclude until the blisters have dried and crusted (usually 6 days), or in immunized people without crusting, until no new lesions within a 24-hour period.
     
  • Other Vaccine-Preventable Diseases (Measles, Mumps, Rubella/German Measles, Pertussis /Whooping Cough): Students and staff can return to school once they are no longer contagious (see Infectious Disease Guidelines). 
  • Eye Infections/Conjunctivitis: Students and staff do not need to stay home unless they have a fever or are not able to participate in usual activities. Practice good hand hygiene. 
     
  • Impetigo: Students and staff must stay home for 24 hours after starting antibiotics.
     
  • Norovirus: Students and staff are required to remain at home for at least 48 hours after their last episode of vomiting and/or diarrhea. During an outbreak of confirmed or suspected norovirus, exclusion may be increased to 72 hours after the last episode of vomiting and/or diarrhea.
  • Open Sores on Skin: All skin lesions must be covered by a bandage or clothing during the school day. This may include ringworm, scabies, and other fungal, bacterial or viral skin infections.
  • Generalized Skin Rash: Any student with an unexplained body rash with or without a fever must consult a health care provider for diagnosis and/or treatment before returning to school with a note from the health care provider. 
     
  • Head Lice: Your student may return to school only after receiving the first treatment.
     
  • Other Symptons or Illnesses Not Listed: Contact the Health Room to see if the student or staff member needs to stay home (see Infectious Disease Guidelines). A Public Health consultation may be necessary.

Note: A student may also be sent home from school if they are exhibiting any symptoms of illness and they are unable to participate in class.