Schools say keep sick students home

Despite the mild winter so far, cold and flu season is in full swing and so is the annual dilemma of when to keep kids home from school.

While school officials expect parents to exercise good judgment in making a decision, they’ve taken some of the guesswork out of the process by listing symptoms that are prohibited at school in the parent-student handbook.

According to School Health Coordinator Pam Trude, guidelines for student illnesses are taken from directives by the Centers for Disease Control and Prevention, as well as the state health department.

“We’re trying to keep the sick children home and the well children in school well,”

In schools, fever is a leading reason children are sent home.

“We send a kid home when their temperature [exceeds] 100 degrees, and we want them home for 24 hours,” Trude said.

According to the guidelines, a child must be fever-free without the assistance of medication for 24 hours before they are cleared to return.

Local pediatricians say children’s temperatures will range anywhere from 97 to 99 degrees and that a slight elevation in temperature usually indicates they are fighting a “lesser illness.”

“Typically, if you’ve got a cold or a runny nose, it can cause you to have a mildly elevated temperature, but as far as I’m concerned those kids can go to school unless the [other] symptoms are so bad they need to stay home,” said Dr. Michael Amster of Warrenton Pediatrics, who serves on the school division’s health advisory committee.

The reason schools insist that students wait a day to return centers around the viral fever cycle, which could abate, then return hours later.

Additionally, keeping students with temperatures above 100 degrees home helps to protect others during the initial stages of an illness.

“That’s when they’re most likely to spread an illness to their peers,” said Dr. Joshua Jakum of Piedmont Pediatrics. “So that’s also when [an individual] should be most acutely aware that they should cover their nose and mouth when they sneeze or cough.”

Coughing into the inner bend of the elbow is preferred to covering the mouth with a hand.

“Your elbow is by far the best because if you cough into your hands, the viral particles or bacteria are simply going to be deposited there and unless you promptly wash your hands with soap and water, or use hand sanitizer, you’re going to resultantly spread the illness,” Jakum said.

Students are allowed to carry a personal supply of hand sanitizer with them to school or access it at strategic locations throughout the building, but Trude believes soap and water will always be the best method for getting rid of germs.

“Your best line of defense for staying healthy is washing your hands and not just the little two second job we all do,” she said. “I tell the kids to sing Happy Birthday because you need to wash your hands for a good 15 to 20 seconds.”

Hand washing is especially crucial in limiting the spread of gastroenteritis, better known as the stomach or intestinal flu.

Students with active vomiting or diarrhea are also required to stay home for a 24 hour period.

“If a child vomits [in school], it becomes a public health issue,” Amster said. “It’s a big deal for the school because it gets everywhere and its contagious.”

Other symptoms that necessitate a school absence include a suspected contagious disease such as chicken pox, pink eye, or ringworm.

In addition to these and other areas of concern, doctors also say fatigue caused by an illness may indicate a child should remain home to rest.

“If kids are so weak that they’re just going to sit in class and not absorb anything...or they look like they’ve been whacked upside the head by a two-by-four, then maybe they should stay home an additional day,” Amster said.

If parents are concerned by a symptom or unusual behavior in their child, it’s never a problem to seek medical advice.

“I always tell parents, ‘You know your kids best. If you think something’s off, then something probably is off,’” Amster said.

Whether the issue is serious or benign, Jakum said it’s his job “to alleviate those fears or confirm the severity of the diagnosis and work with the parent to help that child regain health.

“I will never be upset when a family comes in with a ‘worried well’ question,” he said.

But Jakum is concerned by the number of high school students he treats who are determined to return to school ill in order to meet an attendance requirement that exempts A and B students from their final exam.

“One of the biggest frustrations I have is that kids desire to go to school sick because the school rewards them for attendance and not for caring whether they’re ill or not,” he said. “I’ve got teenagers that come in hacking, coughing and looking disgustingly ill, who really should be home and healing, not spreading a viral or bacterial illness to classmates and teachers.”

While Jakum understands why students who work hard for their grades want to maintain their exemption, he feels the policy rewards “attendance for attendance sake, not for participation sake.”

Although the policy does not provide special exceptions for illness-related absences, Superintendent of Schools Jonathan Lewis said schools relies on parents to provide oversight and only allow students to attend when they’re well.

“I would discourage any student from coming to school ill simply to retain their exam exemption,” he said.

Despite periodic concerns over the policy, Lewis said the school system has allowed high schools to retain the policy because “the principals insist it has a very positive effect overall on getting students to school regularly.”

“If kids are sick, they need to stay home, and that’s the bottom line,” Trude said. “But we know it doesn’t always happen that way.”