Recommendations for Exclusion due to Health-Related Issues
Recommended exclusion varies by the disease or infectious agent. Children with the symptoms below should be excluded from the childcare or school setting until clinical recovery, a healthcare provider has determined that the child can return or children are well enough to participate in usual activities.
It is recommended that childcare centers and schools have policies that are clearly written for excluding sick children and staff, and that these policies are shared with parents.
Cold Symptoms
No exclusion necessary. Exclusion is recommended if the child is experiencing fever accompanied by behavior change, looks or acts very ill, has difficulty breathing, or has blood red or purpose rash not associated with injury.
Cough
No exclusion necessary. Exclusion is recommended if the child is experiencing severe uncontrolled coughing or wheezing, having difficulty breathing, becomes red or blue in the face, makes high-pitched whooping sounds after coughing or vomits after coughing.
Diaper Rash
No exclusion necessary. Exclusion is recommended if the child is experiencing oozing sores that leak body fluids outside the diaper.
Diarrhea
Defined as the occurrence of three or more loose stools within 24-hours. Exclusion is recommended until clinical recovery, i.e., absence of diarrhea, fever.
Earache
No exclusion is necessary. Exclusion is recommended if the child has a fever, is unable to participate, or behavioral change.
Fever
Defined as the elevation of body temperature, typically considered greater than or equal to temperature over 100.4F. No exclusion is necessary, unless the child has symptoms in addition to the fever, such as a rash, sore throat, vomiting, diarrhea, behavior changes, stiff neck, difficulty breathing, etc.
Headache, Stiff or Painful Neck
No exclusion is necessary. Exclusion is recommended until a medical exam indicates the child does not have Hepatitis A or other communicable disease.
Itching
No exclusion is necessary. Exclusion is recommended until a medical exam indicates the child does not a communicable disease.
Jaundice or unusual color of the skin, eyes, stool, or urine
No exclusion is necessary. Exclusion is recommended until a medical exam indicates the child does not have a Hepatitis A or other communicable disease.
Mouth sores
No exclusion is necessary. Exclusion is recommended if the child has excessive drooling, fever, or behavioral changes.
Rash
No exclusion is necessary. Since rash is a hallmark symptom of many infectious diseases, it is important to try to identify the cause of any rash-related illness. Exclusion is recommended if the child has a rash accompanied by any signs and symptoms related to a communicable disease.
Sore Throat
No exclusion is necessary. Exclusion is recommended if the child has a fever, inability to swallow, excessing drooling with breathing difficulty, behavioral change.
Stomachache
No exclusion is necessary. Exclusion is recommended if the child has severe pain causing the child to double over or scream, there is abdominal pain after an injury, fever.
Swollen Glands
No exclusion is necessary. Exclusion is recommended if the child has symptoms in addition to the swollen glands such as difficulty breathing or swallowing, fever, etc.
Vomiting
No exclusion is necessary, unless vomiting is determined to be caused by a communicable disease or the child is in danger of dehydration.
