Communicable Disease Exclusion Guidelines

Students and staff must be excluded from the school setting if they are in the communicable stages of a school-restrictable disease. Symptoms which commonly indicate a communicable disease are listed below.

Students and staff should be excluded from the school setting if they exhibit:

1. FEVER: a measured temperature equal to or greater than 100.4°F orally.

   • MAY RETURN AFTER fever-free for 24 hours without taking fever-reducing medicine.

2. COUGH: persistent cough that is not yet diagnosed and cleared by a licensed healthcare provider OR any acute (non-chronic) cough illness that is frequent or severe enough to interfere with participation in usual school activities.

   • MAY RETURN AFTER symptoms improving for 24 hours (no cough or cough well-controlled).

3. DIFFICULTY BREATHING OR SHORTNESS OF BREATH not explained by situations such as exercise: feeling unable to catch their breath, gasping for air, breathing rapidly or shallowly, breathing with extra effort such as using muscles of the stomach, chest, or neck.

   • MAY RETURN AFTER symptoms improving for 24 hours.

   • This symptom is likely to require immediate medical attention.

4. HEADACHE WITH STIFF NECK AND FEVER

   • MAY RETURN AFTER fever-free for 24 hours without taking fever-reducing medicine AND symptoms resolve.

   • This combination of symptoms may indicate a serious condition. Advise student’s guardian to seek medical attention.

5. DIARRHEA: three or more watery or loose stools in 24 hours OR sudden onset of loose or bloody stools OR student unable to control bowel function when previously able.

   • MAY RETURN AFTER diarrhea has improved (no more than two bowel movements more than normal in 24 hours) and the child is no longer having accidents. Bloody diarrhea should be evaluated by a healthcare provider prior to return.

6. VOMITING: two or more unexplained episodes in 24 hours.

   • MAY RETURN AFTER 24 hours after the last episode of vomiting OR after seen and cleared by a licensed healthcare provider.

7. SKIN RASH OR SORES: new rash not previously diagnosed by a healthcare provider OR rash increasing in size OR new unexplained sores or wounds OR draining rash, sores, or wounds which cannot be completely covered with a bandage and clothing.

   • MAY RETURN AFTER rash is resolved OR until draining rash, sores, or wounds are dry or can be completely covered OR after seen and cleared by a licensed healthcare provider.

8. EYE REDNESS AND DRAINAGE: unexplained redness of one or both eyes AND colored drainage from the eyes OR eye irritation accompanied by vision changes OR symptoms such as eye irritation, pain, redness, swelling, or excessive tear production that prevent active participation in usual school activities.

   • MAY RETURN AFTER symptoms resolve OR after seen and cleared by a licensed healthcare provider.

   • Eye redness alone, without colored drainage, may be considered for attendance per CDC guidelines and school nurse assessment.

9. JAUNDICE: yellowing of the eyes or skin that is new or uncharacteristic.

   • MAY RETURN AFTER seen and cleared by a licensed healthcare provider.

10. BEHAVIOR CHANGE: may include uncharacteristic lethargy, decreased alertness, confusion, or a behavior change that prevents active participation in usual school activities.

    • MAY RETURN AFTER symptoms resolve; return to normal behavior OR after seen and cleared by a licensed healthcare provider.

    • These symptoms may indicate a serious condition. Advise student’s guardian to seek medical attention.

11. MAJOR HEALTH EVENT or STUDENT REQUIRING MORE CARE THAN SCHOOL STAFF CAN SAFELY PROVIDE: may include a significant illness lasting more than two weeks, emergency room treatment or hospital stay, a surgical procedure with potential to affect active participation in school activities, loss of a caregiver or family member, or a new or changed health condition for which school staff is not adequately informed, trained, or licensed to provide care.

    • MAY RETURN AFTER health and safety are addressed.

    • Written instructions from a licensed healthcare provider are likely to be required.

    • Schools must comply with state and federal regulations such as the Americans with Disabilities Act ensuring free and appropriate public education (FAPE). School staff should follow the appropriate process to address reasonable accommodations and school health service provision in accordance with applicable laws.

Some children have chronic non-infectious skin conditions—e.g., eczema; they need not be excluded for apparent exacerbations of these conditions.