Federal health officials have released new guidance on preventing infections in schools. It includes everyday actions, criteria for staying home and caution on requiring a doctor’s note for absences.
The Centers for Disease Control and Prevention (CDC) “has updated actions schools can take to prevent germs from spreading and keep kids healthy and learning,” CDC Director Mandy Cohen, M.D., M.P.H., said in a press release. “This update puts lessons learned into actionable steps schools can follow to keep our kids, teachers, and school staff safe.”
The recommendations consolidate previous guidance and replace guidance for COVID-19 and influenza in schools. It lays out actions for school staff and students, including
- taking steps for cleaner air by improving ventilation;
- handwashing;
- respiratory etiquette;
- vaccinations;
- cleaning, sanitizing and disinfecting;
- staying home when sick and
- using personal protective equipment when caring for sick children.
In times of elevated illness activity in a school or community, schools can consider additional strategies like masking, increasing distancing, monitoring illness, testing and managing exposure.
“Providing clear and accessible communication to families and staff is required for the success of many strategies described in this guidance,” according to the CDC.
Decisions about staying home when sick should balance the risk of spreading a disease with children’s educational, social and mental health needs, the guidance says. People with the following symptoms should stay home:
- fever including with new rash,
- vomiting more than twice in the preceding 24 hours,
- diarrhea that causes accidents, is bloody or results in more than two bowel movements beyond what is usual in a 24-hour period,
- skin sores that are draining fluid on an uncovered part of the body and are unable to be covered with a bandage or
- respiratory virus symptoms that are worsening or not improving and not better explained by another cause like seasonal allergies.
The guidance details when students with these symptoms have improved sufficiently to return to school. Schools also should account for guidance from state and local health departments. It should work with these experts to develop an emergency operations plan that includes infectious disease outbreaks and to craft school policies for common illnesses like strep throat and hand-foot-and-mouth disease. The new guidance links to detailed recommendations for some of these illnesses.
The CDC also is encouraging schools to offer staff flexible, nonpunitive paid sick leave and to avoid incentivizing students and staff to come to school when they are sick. In addition, staff should provide support for students who are learning at home while sick.
Schools should carefully consider requirements that absences be accompanied by a doctor’s note, according to the CDC. Many childhood illnesses can be managed at home, and visiting a health care provider solely for a note puts a burden on families and the health care system and can encourage students to come to school when they are sick.
Resources
- CDC guidance on preventing infectious diseases in schools
- AAP resources on managing infectious diseases in schools
- AAP book Managing Infectious Diseases in Child Care and Schools, 6th Edition
- Information from the AAP Red Book on preventing and managing infectious diseases in schools
