Symptom Guidance

  • Updated January 2024

    This information is intended to support decision-making for schools and childcare centers when an individual child is displaying signs and symptoms of illness.

    Below are suggestions for when to keep your child home when they are not feeling well. Contact a health care provider if your child needs medical care. A doctor’s note is generally not required to return to school or child care. For more information, please visit the CDPH guidance page.

    This document:

    • does not replace the advice of a licensed healthcare provider, nor does it revise guidance related to an individual child’s known medical condition or existing IEP, Section 504 plan, or IFSP plan.
    • is not a diagnostic tool. Related symptoms may inform exclusion decisions, but school staff should not attempt to diagnose.
    • does not replace or revise applicable laws or other requirements.
    • does not address specific disease outbreaks, when recommendations and public health requirements for exclusion may be more strict.
    • is limited to consideration of symptoms as evidence of infection, and does not include considerations for other causes of symptoms such as allergies, toxin exposure, and child abuse or neglect.
    • should be used within the context of an individual student's health and behavior history.

     

    Symptom of Illness When should my child stay home and when can they return?
    Overall, not feeling well

    STAY HOME IF any new illness or symptom prevents a child from participating meaningfully in routine activities.

    Please note that a child with multiple symptoms is more likely to be contagious. Recommendations for all applicable symptoms should be considered.
    Fever

    STAY HOME IF a fever is 100.4°F (38°C) or higher.

    RETURN WHEN fever went away over the night and is gone in the morning without the use of medications such as Tylenol® , Advil® , or Motrin® (acetaminophen or ibuprofen). If fever is accompanied by additional symptoms, follow all symptom-specific guidelines.
    Respiratory
    Virus
    Symptoms
    (cough, stuffy /
    runny nose, sneeze)

    OK TO ATTEND WITH MILD SYMPTOMS. Children should test for COVID-19 before attending school, wear a mask for 10 days from symptom onset, and follow COVID-19 guidance.

    STAY HOME IF symptoms are accompanied by fever or child has significant nasal discharge.

    SEEK MEDICAL ATTENTION for severe symptoms, including a bad cough, difficulty breathing or trouble catching their breath, or wheezing when not controlled by medication (like albuterol).

    RETURN WHEN child has been fever-free for 24 hours without the use of fever-reducing medication and other symptoms are improving.
    Vomiting†

    STAY HOME IF vomiting has occurred 2 or more times in 24 hours.

    RETURN WHEN vomiting has ended overnight, and child is able to hold down liquids and food.
    Diarrhea†

    STAY HOME IF child’s stool is likely to leak from the diaper, if they are unlikely to make it to the toilet in time (if potty trained), or if symptoms prevent them from participating meaningfully in routine activities.

    SEEK MEDICAL ATTENTION if the stool looks bloody or black.

    RETURN WHEN child has not had diarrhea for 24-48 hours or infectious cause has been ruled out. If child has been diagnosed with a specific infection, follow disease-specific guidance from public health or their healthcare provider.
    Sore Throat

    OK TO ATTEND WITH MILD SYMPTOMS. Child should wear a mask if age 2 years or older.

    SEEK MEDICAL ATTENTION for difficulty breathing or swallowing, or continuous drooling.

    RETURN WHEN IMPROVING. If an antibiotic is prescribed, take the first dose at least 12 hours before returning.
    Ear or eye irritation (including pink eye)

    OK TO ATTEND WITH MILD SYMPTOMS.

    STAY HOME IF there is significant discharge from the eye or ears, or if symptoms prevent child from participating meaningfully in routine activities.

    SEEK MEDICAL ATTENTION for difficulty seeing or hearing, an eye injury, or pain they cannot tolerate.
    Rash

    OK TO ATTEND WITH MILD SYMPTOMS.

    STAY HOME IF child has a fever or recent exposure to measles or chickenpox.

    SEEK MEDICAL ATTENTION if rash is worsening, causing pain, has blisters, or is not healing.

    RETURN WHEN IMPROVING or as guided by health care provider. In general, for conditions such as lice, impetigo, ringworm, scabies, and pinworms, your child may return as soon as they start appropriate treatment. Recommend covering rash if possible.

    † Multiple cases may indicate an outbreak. See Outbreak Reporting Requirements or call (888) 397-3993 to report a suspected outbreak of any kind.

    CDPH Guidance for K-12 Schools and Child Care, 2023-2024
    CDPH Guidance When a Child Has Symptoms of Illness in School or Child Care
    LA County Disease Prevention and Response in Schools

     

    Symptom Guidance - English
    Symptom Guidance - Español

     

    LACDPH COVID-19 Guidance