Richland R1 School District

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Nurse » When to Keep Sick Children Home from School

When to Keep Sick Children Home from School

Information compiled from the CDC (Centers for Disease Control); DOH (Department of Health), Stoddard County Health Department, and Richland R-1 School Board Policies


Deciding when to keep a sick child at home from school is not always easy. It’s important for children to attend school and for some parents staying home means missing work. But when a child is truly sick, they need to stay home in the care of an adult to get well and to prevent spreading illness to others.


Please keep the school office up to date with current phone numbers so you or an alternate contact can be reached in your child becomes ill or injured at school.


The following information may help you decide when to keep your child at home. “Child” refers to all school-aged children including adolescents. This information does not take the place of consulting a medical provider.

*Certain illnesses must be reported to the health department. If your child has been diagnosed with an illness please inform the school nurse.

FEVER:  Fevers are a common symptom of infection and children are likely to be contagious to others when they have a fever. If your child has fever, please do not give your child fever reducing medicine (tylenol, ibuprofen, etc) and then send them to school. The medicine will wear off and their fever will probably return and you’d need to pick them up anyway.

WHEN TO KEEP A CHILD HOME FROM SCHOOL: Any child with a fever of 100F or higher should not attend school nor return to school until they are fever free for at least 24 hours without the use of fever reducing medications.

FLU: The flu is a highly contagious respiratory illness caused by influenza viruses and can cause mild to severe illness. A person with influenza can be contagious up to one week after symptoms appear. Children are one of the biggest sources for spreading the flu. To help decrease the spread of regular seasonal flu :

WHEN TO KEEP A CHILD HOME FROM SCHOOL: A child with flu like illness (fever, cough, headache) must be fever free for at least 24 hours without the use of fever reducing medication.*Always follow physician's orders. Most physicians will usually excuse a child with flu from school for 3-5 days.

DIARRHEA/VOMITING: If your child has diarrhea and or vomiting, please do not send them to school. The symptoms will probably return and your child will be sent home from school anyway.

WHEN TO KEEP A CHILD HOME FROM SCHOOL: Children who have vomited or had diarrhea should be kept home and return to school only after being symptom free for 24 hours.

PINK EYE (CONJUNCTIVITIS): Pink eye is a common infectious disease of one or both eyes. The eye typically appears very red and feels irritated. There may be drainage of green and yellow mucous and pus, or clear liquid. Prescription eye drops is typically needed to treat this.

WHEN TO KEEP A CHILD HOME FROM SCHOOL: A child with the above symptoms should be kept home until evaluated by a medical provider and can return to school once treatment has begun.

RASHES: A rash may be one of the first signs of a contagious illness. Rashes may cover the entire body or be in only one area and are most contagious in the early stages.

WHEN TO KEEP A CHILD HOME FROM SCHOOL: Do not send a child with a rash to school until a medical provider has said it is safe to do so, especially with additional symptoms like itching, fever, or appearing ill.

STREP THROAT: A significantly sore throat could be strep throat, a contagious illness. Other symptoms could include fever, white spots/patches in the back of the throat and on the tonsils, headache, and upset stomach. Untreated strep can lead to serious complications.

WHEN TO KEEP A CHILD HOME FROM SCHOOL: Keep your child home with the above symptoms and contact a medical provider. A child diagnosed with strep throat is no longer infectious and can return to school 24 hours after antibiotic treatment has been started.

HEAD LICE: It is important to know the facts about head lice. There are many myths about head lice.


Myth 1: Lice can jump.

Lice do not have wings. They cannot fly and they cannot jump. Instead, they move by crawling. That is why direct head-to-head contact, such as kids putting their heads together while playing, is the most common way for head lice to spread from one person to another.

Myth 2: You are more likely to get head lice if your hair is dirty, you have bad personal hygiene habits or if your home is untidy.

Getting head lice has absolutely nothing to do with personal hygiene or the cleanliness of a home. And washing your hair will not get rid of lice, which cling to hair follicles, nor nits (lice eggs), which are extremely sticky and cling to hair.


Myth 3: An itchy head means your child most likely has head lice.

Itchy scalp is one of the common symptoms of head lice. But there can be other causes of itchy scalp, such as seborrheic dermatitis (dandruff) or dry skin, fleas, sand, dirt, etc. Moreover, some children who have head lice may not experience itching

Myth 4: You can get head lice from pets (and vice versa).

Lice cannot be transmitted from pets, and pets cannot get them from people.


Myth 5: Head lice carry and transmit diseases.

The good news is that lice have not been shown to spread disease. That said, they can be extremely bothersome. Children who have head lice can experience intense itching and develop a rash from the bites, and the skin can become infected from scratching.


Myth 6: Kids are most likely to get head lice in school.

This is a common misconception, probably stemming from the fact that school-age children are at an increased risk for getting head lice. The fact is, kids tend to get head lice from places and activities where they are more likely to have direct head-to-head contact or share personal items, such as combs, bedding, towels and hair accessories. The most common sources of head lice infestations are, in addition to school, camp, daycare, sleep overs and slumber parties and sports activities, among others.


Head lice are tiny insects that live only on human scalps and hair. Adult lice are reddish brown, about the size of a sesame seed, and can be hard to see. Lice lay nits (eggs) on strands of hair close to the scalp. Nits are easier to see than lice, look like tan or white dots and are firmly attached to the hair. Nits can usually be seen near the scalp behind the ears, at the nape of the neck, and under bangs. The most important step for getting rid of head lice is daily careful nit removal for at least 14 days using a special lice comb and by “nit picking” which is using your fingernails to manually remove the nits. In addition, over the counter treatments are available at drug stores. If your child only has a few nits and no live lice, treatment is not usually effective as most treatment only kills live lice, not nits. Most over the counter treatments are chemical based, and if used too  frequently or left too long on the scalp, can cause sores. ALWAYS FOLLOW THE DIRECTIONS ON THE MANUFACTURES BOX.

For more information on head lice prevention, identification and treatment, see your school nurse and or visit

WHEN TO KEEP A CHILD HOME FROM SCHOOL: Richland R-1 School’s head lice policy states that any child identified with head lice and or nits may not return to school until treatment has started and all nits and head lice are removed. If your child has head lice and or nits, please keep them home for proper treatment, and inform the school nurse. If a child is identified with having head lice and or nits at school, your child will be sent home so that treatment can be started. The school nurse must check the child’s hair before re-entry to school.


Be sure to contact a medical provider any time there is concern about a child’s health.

In children, emergency warning signs that need urgent medical attention include
  • Fast breathing or trouble breathing
  • Bluish or grey colored skin
  • Not drinking enough fluids
  • Severe or persistent vomiting
  • Not waking up or interacting
  • Being so irritable that a child does not want to be held

Other reasons to contact a medical provider include but not exclusive to:

  • When a child look or acts really sick with or without fever
  • Cold symptoms that last longer than 14 days, getting sicker or there is a fever after the first few days
  • Chronic coughing, uncontrollable coughing; wheezing
  • Rashes, eye drainage, earache, toothache




  • WASH YOUR HANDS OFTEN with soap and water especially after coughing, sneezing or blowing your nose. Alcohol-based hand cleaners are also effective.
  • AVOID TOUCHING YOUR EYES, NOSE OR MOUTH to help prevent the spread of viruses.
  • DON’T SHARE food, utensils, beverages, or anything that might be contaminated with germs
  • STAY HOME WHEN YOU ARE SICK, especially with flu-like symptoms of fever or cough. Stay home for at least 48 hours after being fever free without the use of fever reducing medication
  • COVER YOUR NOSE AND MOUTH WITH A TISSUE WHEN YOU COUGH OR SNEEZE. Throw the tissue in the trash and wash your hands.
  • COUGH OR SNEEZE INTO YOUR ELBOW OR SLEEVE instead of your hands if you don’t have a tissue.
  • CLEAN SURFACES THAT MAY BE CONTAMINATED WITH GERMS using household disinfectant cleaners or bleach based wet wipes.


Please familiarize yourself with the following Richland R-1 School Policies on Medication administration. If your child requires medication to be given during school hours, A PARENT or GUARDIAN must bring the medication to the school nurse or appropriate office. Students ARE NOT allowed to deliver or carry medication with them at school. Also, if your child starts a new medication, please inform the school nurse so that possible side effects of the medication can be monitored at school. Please contact the school nurse about any questions you may have about medication administration at school.

P 2870 Administering Medicines to Students

It shall be the policy of the Board of Education that the giving of medicine to students during school hours be discouraged and restricted to medication that cannot be given on an alternative schedule. The Board of Education recognizes that some students may require medication for chronic or short-term illness/injury during the school day to enable them to remain in school and participate in their education.


R 2870 Administering Medicines to Students

Prescription Medication and Over The Counter Medication

The student's authorized prescriber shall provide a written request that the student be given medication during school hours. The request shall state the name of the student, name of drug, dosage, frequency of administration, route of administration, and the prescriber's name. The diagnosis/indication for use of the medicine shall be provided. When possible, the prescriber should state adverse effects and applicable emergency instructions.


The District shall require that a prescription label be properly affixed to the medication in question. Said label must contain the name of the student, name of the drug, dosage, frequency of administration, route of administration, diagnosis and the prescriber's name.


A parent/guardian must request in writing that the School District comply with the authorized prescriber's request to give medication. (The District will not administer the initial dose of any new prescription except in an emergency.)


A parent/guardian or other responsible party designated by the parent/guardian will deliver all medication to be administered at school to the school nurse or designee. All medication, prescription or over-the-counter, must be in a pharmacy or manufacturer-labeled container. The District shall provide secure, locked storage for medication to prevent diversion, misuse, or ingestion by another individual.


The administration of medication, including over-the-counter medications, is a nursing activity, governed by the State of Missouri Nursing Practice Act. It must be performed by the registered professional school nurse. The nurse may delegate and supervise the administration of medication by unlicensed personnel who are qualified by education, knowledge and skill to do so.