GENERAL EXCLUSION GUIDELINES FOR ILL CHILDREN/STAFF
Certain symptoms in children may suggest the presence of a communicable disease. Excluding an ill
child may decrease the spread of the disease to others in childcare and school settings.
Recommended exclusion varies by the disease or infectious agent. Children with the symptoms listed
below should be excluded from the childcare or school setting until symptoms improve; or a health
care provider has determined that the child can return; or children can participate in routine activities
without more staff supervision than usual.
NOTE: It is recommended that childcare/preschool providers and schools have policies that are
clearly written for excluding sick children and staff. These policies should be placed in the student
handbook or on the childcare or school website. Parents/guardians and staff should be given or
directed to these resources at the beginning of each school year or when the child is enrolled or the
staff member is hired. This will help prevent problems later when the child or staff member is ill.
Exclude children with any of the following:
Illness
Unable to participate in routine activities or needs more care than can be
provided by the childcare/school staff.
Fever
An elevation of body temperature above normal and accompanied by
behavior changes, stiff neck, difficulty breathing, rash, sore throat,
and/or other signs or symptoms of illness; or is unable to participate in
routine activities. Measure temperature before giving medications to
reduce fever.
Axillary (armpit) temperature: 100° F or higher
Oral temperature: 101° F or higher
Rectal temperature: 102° F or higher
Ear temperatures are not recommended because of inconsistent and
inaccurate results. Each manufacturer may have different temperature
ranges, which makes setting standards difficult.
Signs/Symptoms of Possible severe illness:
Child is unusually tired, has uncontrolled coughing, unexplained irritability, persistent crying, difficulty breathing, wheezing, or other
unusual signs for the child. Exclude until a health care provider has done
an evaluation to rule out severe illness.
Diarrhea
Diarrhea is defined as an increased number of stools compared with a
child's normal pattern, along with decreased stool form and/or stools that
are watery, bloody, or contain mucus. Exclude until 24 hours after
diarrhea stops or follow specific disease exclusion if the pathogen is
known; or until a medical exam indicates that it is not due to a
communicable disease.
Vomiting
Child has vomited two or more times in the previous 24 hours. Exclude
for 24 hours after last episode of vomiting, unless it is determined to be
caused by a noncommunicable condition and the child is not in danger of
dehydration.
Mouth Sores with Drooling
Exclude until a medical exam indicates the child may return or until
sores have healed.
GENERAL EXCLUSION GUIDELINES FOR ILL CHILDREN/STAFF
Rash with Fever or behavior change Exclude until a medical exam indicates these symptoms are not those of a communicable disease that requires exclusion.
Eye Drainage
No exclusion, unless the child has a fever or is not healthy enough to
participate in routine activities. Antibiotics or a note from a health care
provider are not required.
Unusual Color of Skin, Eyes, Stool or Urine
Exclude until a medical exam indicates the child does not have hepatitis
A. Symptoms of hepatitis A include yellow eyes or skin (jaundice), gray
or white stools, or dark (tea or cola-colored) urine.
See following pages for specific disease exclusion guidelines for childcare settings and schools.
There are specific guidelines for “sick childcare” programs. See the Minnesota Department of
Human Services licensing rules for those requirements.
For more information, call Hennepin County HSPHD-Epidemiology at (612) 543-5230 or call your
local health department.
****** If you need to give your child a fever reducing medicine, you may not send them to school for at least 24 hours.
