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Health » Health at Joy » Illness Guidelines

Illness Guidelines

We aim to follow current public health guidance, including recommendations from the CDC and NCDHHS, when developing our school health policies. These guidelines are designed to reduce the spread of illness within our school community while also supporting consistent student attendance.

 

Keeping students home when they are ill not only helps protect classmates and staff, but also ensures that your student is well enough to participate fully in the school day. Following these guidelines allows us to maintain a healthy learning environment for everyone.

When Should a Student Stay Home?

Please keep your student home if they have any of the following:

 

Fever

  • A temperature of 100°F or higher, or
  • Any fever within the past 24 hours
  • Students must be fever-free for 24 hours without the use of fever-reducing medication before returning

 

Examples:

  • A student has a fever Sunday night, takes medication, and wakes up without a fever → should still stay home on Monday
  • A student has a fever Wednesday at 12 PM and is fever-free Thursday morning → may return to school after 12 PM on Thursday
  • A student has a fever Saturday but takes medication around the clock → medication should be stopped to ensure the fever does not return before coming back to school (with the guidance of your medical provider)

 

 

Vomiting

  • Any vomiting within the past 24 hours
  • This refers to true illness-related vomiting (not due to exercise, gag reflex, or other isolated causes)

 

 

Diarrhea

  • Two or more watery or loose stools in a day

 

Stool Chart

Positive Test for Contagious Illness

  • Positive test for flu, COVID-19, or another illness requiring isolation
    • Can be from a Rapid At-home test or from a medical clinic
  • Follow all healthcare provider recommendations and send a copy of these recommendations to the school
  • See section below for more information on respiratory illnesses

 

 

Unable to Participate in School

  • Symptoms that prevent the student from fully participating in the school day, such as:
    • Severe pain or discomfort
    • Difficulty walking or moving between classes
    • Significant fatigue or other symptoms that interfere with learning

 

 

Open or Draining Skin Conditions

  • Open, draining sores that cannot be covered
  • Includes conditions such as impetigo or other skin infections
  • Students should be evaluated by a healthcare provider and may return when:
    • Treatment has started, and
    • Affected areas are scabbed over or can be fully covered
    • Students are cleared by a medical provider to return to school

24 hour rule

Students must be fever-free, vomit-free, and diarrhea-free for at least 24 hours without the use of medication before returning to school.

 

This means:

  • No fever for a full 24 hours without Tylenol, ibuprofen, or other fever-reducing medications
  • No vomiting for 24 hours
  • No diarrhea for 24 hours

 

Students who become ill at school (including fever, vomiting, or diarrhea) will be sent home and must meet this requirement before returning.

 

Why This Matters

The 24-hour rule helps ensure that students are truly recovering and no longer contagious, not just temporarily feeling better.

  • Medications may mask symptoms (such as fever), but do not treat the underlying illness
  • Symptoms can return once medication wears off, often during the school day
  • Returning too soon increases the risk of spreading illness to other students and staff
  • It also helps ensure your student is well enough to fully participate in school activities

 

If medication is still needed to keep symptoms controlled, the student is not yet ready to return to school

Contagious Illnesses & Skin Infections

Students with certain contagious conditions must be evaluated by a healthcare provider before returning to school. These may include:

  • Hand, Foot, and Mouth Disease
  • Impetigo
  • Other bacterial or contagious skin infections

 

In most cases, students may return when:

  • They have been on treatment (such as antibiotics) for at least 24 hours,
  • They are fever-free, and
  • Symptoms are improving and affected areas can be covered

 

When can a student come to school?

Students may attend school if they meet the following guidelines and are well enough to participate in the school day:

 

No Fever

I have not had a fever in the past 24 hours without the use of fever-reducing medication (such as Tylenol or ibuprofen)

 

 

No Recent Vomiting

  • I have not vomited in the past 24 hours
  • I am able to eat and drink normally without becoming sick

 

 

No Diarrhea

  • I am free of diarrhea for at least 24 hours
  • I am able to comfortably remain in class without frequent or urgent bathroom use

 

 

Mild Cold Symptoms Only

  • I have a runny nose, mild congestion, or mild cough only
  • Symptoms are manageable and not worsening
  • I do not have a persistent, disruptive cough

 

 

Minor Stomach Discomfort

  • I may have a mild stomachache, but:
    • No vomiting
    • No diarrhea
    • Symptoms are improving and not interfering with participation

 

 

Symptoms Are Improving

  • I am feeling better overall, and symptoms are mild and manageable
  • I do not require frequent rest breaks beyond what can be supported at school

 

 

Able to Participate

  • I am able to:
    • Stay in school for the full day
    • Participate in class activities
    • Move safely between classes
    • Engage in learning without significant discomfort
  • If your student would not be able to comfortably participate in a full day of school, it is best to keep them home.

 

 

After Illness

  • I have completed any required exclusion period (e.g., after fever, vomiting, or contagious illness)
  • I am returning with improving symptoms and feel ready for the school day

 

 

 

 

 

 

Flu, COVID-19, and Similar Illnesses:

Students diagnosed with flu, COVID-19, or similar contagious illnesses may require a longer recovery period away from school.

  • Families should notify the school nurse if their student has been diagnosed with one of these illnesses so appropriate guidance and support can be provided
  • Diagnosis should be confirmed by a healthcare provider or a documented positive at-home test
  • Students should follow return-to-school guidance provided by their healthcare provider

 

In general:

  • Students may be out of school for at least 3 days and up to 1 week from the first day of symptoms, depending on the severity of illness
  • Students must be fever-free for 24 hours without medication and have improving symptoms before returning
  • Recovery time may vary from student to student. If you are unsure when your child should return to school, please contact the school nurse for guidance.

 

After returning to school:

  • Students should wear a mask for one full week to help reduce the spread of illness

 

Additional Common Illness Guidelines

Head Lice

  • Students may remain at school for the day
  • Treatment should begin at home as soon as possible
  • Students may return after appropriate treatment has started

 

Pink Eye (Conjunctivitis)

  • Mild symptoms without fever: student may attend school
  • With significant drainage or bacterial infection: evaluation may be needed
  • If prescribed antibiotics: may return after 24 hours of treatment

 

Strep Throat

  • May return after 24 hours of antibiotics and being fever-free

 

Cough / General Illness

  • Students with a persistent or worsening cough or who are too fatigued to participate should stay home