When to Keep Your Child Home from School
It's crucial to recognize when your child is too sick for school to ensure their well-being and prevent the spread of illness.
Keep Them Home If They Have:
Fever (100.4 F or above)
Cough
Vomiting
Diarrhea
Contagious disease
Medication Needs: If your child requires medication to manage symptoms, it might be a sign they need to stay home. In some cases, we may advise consulting with your healthcare provider before returning to school.
Current Outbreaks: We'll communicate any information about illness outbreaks at school and within the community.
If Your Child Becomes Sick at School
Immediate Care: We'll do our best to care for them and follow our "How Sick is Too Sick" policy.
Pick-Up: For certain illnesses, we'll contact you to pick them up promptly. Please ensure your contact information is up to date with the front desk.
Your Cooperation: We appreciate your timely response in picking up your ill child, so they can rest and recover.
Please consult the resource below for more details, and don't hesitate to contact us with any concerns!
General Exclusion Requirements
Children and staff must be excluded from schools and childcare facilities when they have certain symptoms of illness, including if they are unable to participate or perform the functions required for their position.
A “child” means any child enrolled in the childcare program or a student at a school.
A “staff member or staff” means any person working or volunteering to perform duties in a childcare facility or school.
Symptoms that require exclusion are listed in the attached document; How Sick is Too Sick? When Children and Staff Should Stay Home from Child Care (How Sick is Too Sick). The Colorado Department of Public Health and Environment’s Infectious Diseases in Child Care and School Settings (Infectious Disease Guide) will be used to determine exclusion for symptoms of illness not included in How Sick is Too Sick. There may be additional requirements for specific illnesses like COVID-19 symptoms and illnesses per the federal, county, and town of Telluride guidelines.
Excluding Children
Staff is responsible for observing children at drop-off and throughout the day for signs of illness. If a child arrives at the facility or school with signs of illness that require exclusion, they may not be accepted. If a child develops symptoms of illness that require exclusion during the time of care, the parent/guardian will be contacted to pick up the child. The child will be provided with a place to rest which is separate from the other children until the parent/guardian arrives. The child may return to childcare, or school based on the requirements in How Sick is Too Sick, the Infectious Disease Guide, or as directed by their healthcare provider or public health professional.
Information will be recorded on an illness log when children are sent home due to symptoms of illness that require exclusion. All items used to care for the child (cot, bedding, etc.) will be cleaned and sanitized or cleaned and disinfected if contaminated by body fluids after the child leaves the childcare or school. The date and time when the child returns to the childcare facility or school will be recorded on the illness log.
Excluding Staff
The person in charge of staff is responsible for observing the staff for signs of illness throughout the day. Staff members have the responsibility of reporting, to the person in charge, any signs of infection or illness that may pose a hazard to the health of children and other staff. If a staff member is not well enough to work, they may return based on the requirements in How Sick is Too Sick, the Infectious Disease Guide, or as directed by their health care provider or public health professional.
Outbreaks
When a school or childcare facility has a child or staff member with an illness that is required to be reported to the health department, the health department will be contacted immediately. Outbreaks of illness must also be reported to the health department when there is a larger number than normal of children or staff ill with the same symptoms. For example, above normal seasonal absenteeism for a school or childcare facility would be concerning and the health department will be contacted. The health department will also be contacted when there are two or more people who do not live together and are ill with symptoms including vomiting, diarrhea, or jaundice.
Food Handling Staff Exclusion Requirements
Special attention will be given to staff members who handle food because many illnesses can be spread through food from an infected person. Food handling activities include the preparation of any food (i.e. washing, cutting, cooking, and portioning), the mixing and feeding of bottles, and feeding infants and toddlers solid foods.
Food handling staff must notify the person in charge:
*In addition to waterproof bandages covering wounds on hands and wrists, single-service gloves must be always worn when handling food.
Staff will be allowed to return to work based on requirements in How Sick is Too Sick, the Infectious Disease Guide, as directed by the health department, or as directed by a health care provider, or public health professional.
When Children and Staff Should Stay Home from School or Child Care
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.
There are four main reasons to keep children and adults at home:
Guidance for COVID-19 Symptoms |
Child or staff member must stay home? |
COVID-19 symptoms must be fully resolved before a child or staff member returns to school
need to see a doctor right away for a fever of 100°F or higher)
(Frequent, loose, or watery stools (poop) compared to normal ones that are not caused by food or medicine)
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Yes – These symptoms are often present in individuals with COVID-19 and another contagious infectious disease, and a person with any of these symptoms (whether new or worsening from baseline) should first receive a diagnostic test for COVID-19.
When to seek emergency medical attention
These are not all possible symptoms. Please call your medical provider for any other symptoms that are severe or concerning to you. Call 911 or call ahead to your local emergency facility. Notify the operator that you are seeking care for someone who has or may have COVID-19.
If all symptoms are consistent with the usual symptoms of a known chronic condition and the child is otherwise well enough to return to school, no further evaluation is necessary.
If the test is positive, or the individual has not yet been tested, the individual should follow CDPHE’s isolation guidance, which can be found on the Colorado State Website. Further guidance for the school or childcare can be found in Colorado’s School Guide.
If the test is negative AND the symptoms are explained by a specific illness other than COVID-19, then the child or staff can return to school or childcare following exclusion guidelines for that illness.
If the test is negative and the illness is not explained by a new illness or a known chronic condition, the ill individual should still stay home until symptoms have been resolved for at least 24 hours without medication.
*Students and staff may return if the cough is not fully resolved following a discussion with a care provider. |
COVID-19 symptoms must be improving before a child or staff member returns to school or childcare |
Yes – These symptoms are often present in individuals with COVID-19, and a person with any of these symptoms (whether new or worsening from baseline) should receive a diagnostic test for COVID-19. If all symptoms are consistent with the usual symptoms of a known chronic condition and |
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the child is otherwise well enough to return to school, no further evaluation is necessary.
If the diagnostic COVID test is positive, or the individual has not yet been tested, the individual should follow CDPHE’s isolation guidance. Further guidance can be found at the Colorado State Website.
If the diagnostic test is negative and the symptoms are explained by a specific illness other than COVID-19, then the child or staff can return to school or childcare following exclusion guidelines for that illness.
If the COVID test is negative and the illness is not explained by a new illness or a known chronic condition, the ill individual may return to school if all symptoms are improving and cough, shortness of breath, fever, diarrhea, and vomiting have fully resolved.
**Loss of taste or smell can persist for weeks or months. This condition does not need to be resolved or improved before an individual return to school or care. |
Guidance for Symptoms Not Due to a Specific Disease, Following a Negative COVID Test |
Child or staff must stay home? |
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Diarrhea Frequent, loose, or watery stools (poop) compared to normal ones that are not caused by food or medicine. |
Yes – Unless the diarrhea is related to an existing chronic condition, is explained by a diagnosed condition not requiring the person to stay home or is consistent with the person's baseline.
The child or staff member may return to school or childcare 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 the child or staff can return to school or childcare following exclusion guidelines for that illness. |
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Fever Fever is a temperature of 100.4°F or greater. Babies who are 4 months or younger need to see a doctor right away for a fever of 100°F or higher. |
Yes – The child or staff member may return to school or childcare if the fever has been resolved for 24 hours without fever-reducing medications unless the fever is caused by an illness that requires them to stay home longer. If the fever is explained by a specific illness COVID-19, then the child or staff can return to school or childcare following exclusion guidelines for that illness. |
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Flu-like Symptoms Fever Sore throat Runny nose or congestion |
Yes - Children and staff may return to school or childcare 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. If the symptoms can be explained by a specific illness, then follow the exclusion guidelines for that illness.
In consultation with a healthcare provider, additional evaluation for flu-like illnesses, sore throat, and upper respiratory symptoms may be appropriate, including evaluation for strep throat. |
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Vomiting/Throwing Up |
Yes – Unless the vomiting is related to an existing chronic condition or is explained by a diagnosed condition not requiring the person to stay home. If the vomiting is unexplained and inconsistent with the person’s baseline state of health, the child or staff member may return 24 hours after the last episode of vomiting. If the vomiting can be explained by a specific illness, then follow the exclusion guidelines for that illness.
If a child with a recent head injury vomits, seek medical attention. |
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Guidance for Specific Diagnosed Illnesses |
Child or staff must stay home? |
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Chicken Pox |
Yes - until the blisters have dried and crusted (usually 6 days), or in immunized people without crusting, until no lesions within 24-hour period. |
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Conjunctivitis (pink eye) Pink color of the eye and thick yellow/green discharge |
No – Children and adults do not need to stay home unless they have a fever or are not able to participate in usual activities. Call your doctor for advice and possible treatment. |
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COVID-19 (clinical diagnosis, symptoms without testing, or a positive diagnostic test) |
Yes – children and staff who have suspected COVID-19 or who have been diagnosed with COVID-19 must be excluded and follow CDPHE’s isolation guidance. Guidance for schools and childcare settings can be found at the Colorado State Website. |
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Fifth’s Disease (parvovirus) |
No – the illness is no longer contagious once the rash appears. |
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Hand Foot and Mouth Disease (Coxsackie virus) |
No - unless the child or adult meets other exclusion criteria, is drooling uncontrollably has mouth sores, or is not able to take part in usual activities. |
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Head Lice or Scabies |
Yes - children may stay at school or childcare until the end of the day but cannot return until after they have had the first treatment. |
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Hepatitis A, Salmonella, Shigella, or Shiga-toxin Producing E. coli |
Yes – children and staff may return to school or childcare when cleared by the health department. |
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Herpes |
No - unless there are open sores that cannot be covered or there is uncontrollable drooling. |
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Impetigo |
Yes – children and adults need to stay home until 24 hours after antibiotic treatment has started. |
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Influenza |
Yes - children and staff should remain out of school or childcare until they are fever-free for 24 hours without the use of fever-reducing medications and other symptoms have been improving for 24 hours. |
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Norovirus |
Yes – exclude children and staff for at least 48 hours after their last episode of vomiting and/or diarrhea. |
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Ringworm |
Yes - children may stay at school or childcare until the end of the day but cannot return until after they have had the first treatment. Keep the area covered for the first 3 days if participating in activities with person-to-person contact. |
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Guidance for Specific Diagnosed Illnesses |
Child or staff must stay home? |
Roseola |
No - unless there are a fever or behavior changes. |
Croup, RSV (Respiratory Syncytial Virus) |
Yes - Children and staff should remain out of school or childcare until they are fever-free for 24 hours without the use of fever-reducing medications and other symptoms that have been improving for 24 hours. |
Strep Throat |
Yes - for 12 hours after starting antibiotics unless the doctor says that it is okay to return to school sooner. |
Other Vaccine-Preventable Diseases Measles, Mumps, Rubella (German Measles), Pertussis (Whooping Cough) |
Yes – Children and staff can return to school once they are no longer contagious (see Infectious Disease Guidelines). Public health consultation may be necessary. |
Yeast Infections Thrush or Candida diaper rash |
No - Follow good hand washing and hygiene practices. |
Other Symptoms or illnesses not listed |
Contact the childcare center director or school health staff to see if the child or staff member needs to stay home (see Infectious Disease Guidelines). |
This document was developed in collaboration with pediatricians, medical epidemiologists, and public health professionals.
The information presented is intended for educational purposes only. It is not intended to take the place of your personal doctor’s advice and is not intended to diagnose, treat, cure, or prevent any disease. The information should not be used in place of a visit, call consultation, or advice of your doctor or other health care provider.
References
American Academy of Pediatrics. Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide. Aronson SS, Shope TR, eds. 5th ed. Itasca, IL: American Academy of Pediatrics; 2020.20.
Colorado Department of Public Health and Environment. Infectious Diseases In Child Care and School Settings: Guidelines for Child Care Providers and Health Consultants, School Nurses, and Other Personnel. 2022.
Colorado Department of Public Health and Environment. COVID-19 Resources. https://covid19.colorado.gov/. October 7, 2020.
Updated November 2022
COVID-19 is a respiratory disease caused by SARS-CoV-2, a coronavirus discovered in 2019 that caused a worldwide pandemic. Different variants of the virus emerged throughout the pandemic.
The signs and symptoms of COVID-19 can vary based on the variant causing the illness.
The incubation period for COVID-19 is thought to extend to 14 days, with a median time of onset of four to five days. The incubation period may be shorter or longer depending on the variant that is circulating.
Treatment of COVID-19 in hospitalized patients remains largely supportive and includes management of complications. NIH treatment guidelines recommend Paxlovid or remdesivir for children aged 12-17 who are at high risk of progression to severe COVID-19. Remdesivir can also be considered in those <12 (aged ≥28 days and weighing ≥3 kg).
Questions or Testing: Call your provider. Ensuring people who are ill stay home (and people with COVID-19 follow isolation requirements, regardless of vaccination status) is critical to preventing the spread of COVID-19.