March 4, 2020

Is My Kid Contagious (and Should I Keep Them Home From School)?

Understand the best way to keep illnesses from spreading

Little girl with fever home from school

Your son’s barely in the door from school when it starts: Achoo! Cough. Cough. Ugh. It’s probably the common cold.

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But pediatrician Frank Esper, MD, says pretty much everything that makes your child sick can potentially be spread to others.

“Everything is contagious if it’s an infection,” Dr. Esper explains. “Whether you need medication for it, that’s one question. But, for the most part, all of these infections are contagious. And most times you got it from someone else. It didn’t just spring up in you.”

How to keep germs from spreading

When it comes to protection from the common cold, it’s important to teach kids to cough into their elbows and wash their hands often to prevent the spread of germs.

When we cough into the open air, we can actually send germs as far as 3 to 5 feet in front of us. And some germs stay suspended for a while – such as measles – which can hang out in the air for hours.

If you cough in your hands, Dr. Esper says, you’re transferring germs from hand to hand when you touch someone, a door knob or money.

“That’s why we try to teach kids to cough into a place where we don’t touch other people,” he says. “Our elbow has been one of the best things that we have found over the last years. So, when we cough into our arm, and into our elbow, we don’t have to worry about moving those germs from place to place.”

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And since kids forget, it’s important to also teach them good hand-washing skills.

The best protocol: He recommends washing hands thoroughly with soap and water for a minimum of 20 seconds. (For kids under 3 who aren’t great at hand-washing, using an alcohol-based hand sanitizer is best.)

When staying home from school or daycare makes most sense

There are times when you should keep your child at home — not only to recover, but to keep from spreading a bad illness to others.

A child with a fever should always be kept home from school or daycare.

“If you’re having fever, and if you’re having symptoms, generally, you should consider yourself contagious,” Dr. Esper says. “You could pass that fever and those symptoms to somebody else. The general rule is: If you have a fever, stay home until that fever goes away.”

Once the fever “breaks” or goes down, he says, this typically means the immune system has kicked out the germ. Or there’s so little left that it won’t cause infections in other people.

You can treat a fever at home. Ibuprofen (Advil®,Motrin®) works best, Dr. Esper says. But children under age 1 should take acetaminophen (Tylenol®).

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How long should kids stay home after a fever?

Children should stay home for 24 hours after their fever breaks, Dr. Esper says. After that, they should be good to go back to school (or daycare).

Anytime a fever gets high and persistent, though, it’s time to call the doctor.

“With a high persistent fever (104, 105), you should call your doctor to see whether your child needs to be seen,” Dr. Esper says.

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