Too Sick for School

Respiratory viruses like COVID-19, influenza (flu), and RSV can cause a range of symptoms, including but not limited to cough, fever, chills, headache, sore throat, runny or stuffy nose, sneezing, chest discomfort, decrease in appetite, vomiting, diarrhea, fatigue (tiredness), muscle or body aches, new loss of taste or smell, weakness, and wheezing.

If you are sick, stay home and away from others, including those you live with who are not sick.

You can go back to your normal activities when both of the following have been true for at least 24 hours:

• Your symptoms are getting better overall, and
• You have not had a fever and are not using fever-reducing medication.

Test for COVID-19 if available. Testing for COVID-19 can help you get effective treatment and protect people at high risk. You may still have COVID-19 or another contagious respiratory illness, even if you get a negative home test result.

When returning to normal activities, wear a mask and take added precautions over the next five days, such as taking steps to improve air flow and filtration, practicing good hand hygiene, cleaning regularly, physical distancing, and testing when you will be around other people indoors. You may still be contagious with a respiratory virus after returning to your normal activities, so it is important to take additional precautions.

• People with COVID-19 are often contagious for 5-10 days after their illness begins.
• People with flu may be contagious for up to 5-7 days after their illness begins.
• People with RSV are usually contagious for 3-8 days after their illness begins.

Follow the Washington State Department of Health (DOH) What To Do When You Are Sick With COVID-19 or Another Respiratory Virus guidance and/or Respiratory Virus Illness Guidance One-Pager.

Employers must follow Washington State Department of Labor & Industries (L&I) COVID-19 requirements in the workplace: L&I Requirements and Guidance for Preventing COVID-19.

(Updated 7/2025)

There are other medical conditions besides COVID-19 which may require your student to stay home from school. If your student has any of the following symptoms, please keep them at home and contact their school.

• Behavior/appetite - Irritability in students may signal illness, often due to fatigue, fever or general discomfort. Affected students may appear tired, less engaged in play or indifferent. Changes in appetite are also common. Students may eat less, prefer liquids or show interest in only specific foods when they are ill.
• Chickenpox (varicella) - Chickenpox is contagious from 48 hours before the rash appears until all lesions are crusted over – typically 4 to 7 days after rash onset. Students with suspected chickenpox should be referred to a health care provider. Parents/guardians should notify the provider in advance due to the contagious nature of the illness. Students must stay home until all lesions are crusted and no new lesions have appeared for 24 hours. If your student is diagnosed with chickenpox, please inform the school nurse. 
• Cough - While some coughs are related to allergies or chronic conditions, a persistent cough may signal an infection and should be evaluated by a health care provider, especially if it is accompanied by symptoms like gagging, a whooping sound, vomiting, fever, loss of appetite, or weight loss.
• Diarrhea – Students with diarrhea should stay home and return only when symptoms improve, and they are no longer having more than two extra bowel movements above their normal in a 24-hour period and/or no longer experiencing accidents. Seek medical care if diarrhea is bloody, lasts three or more days, or is accompanied by vomiting and high fever. In some cases, local health authorities may require students with certain infections to stay home until symptoms resolve, or a negative test is confirmed.
• Earache and Discharge from Ear - If a student complains of ear pain, pulls at their ear, or frequently touches it, they may have an earache. Any ear discharge—such as blood, pus, or fluid—should be evaluated by a health care provider. Prompt treatment is important, as untreated ear infections can lead to permanent hearing loss. 
• Eyes – Redness, itchiness, pain, light sensitivity, or white/yellow discharge around the eye may indicate conjunctivitis (“pink eye”). Prompt referral to a health care provider is recommended if symptoms include moderate to severe pain, swelling, vision changes, or persistent discomfort.

School exclusion is only necessary if:

• The student has a fever of 100.4°F (38°C) or higher.
• The student feels unwell or cannot participate in normal activities.
• The student cannot avoid close contact with others.
• Exclusion is recommended by a health care provider or local health authority.

• Fever – A fever is a temperature of 100.4°F or higher. Students must be fever-free for at least 24 hours without using fever-reducing medicine (like Tylenol or Motrin) before returning to school. Giving medicine to lower a fever temporarily does not mean the student is well—it may just hide the symptoms. Keeping a sick student home helps prevent the spread of illness to others. 
• Lice – Immediate or long-term exclusion from school is no longer recommended for head lice. Students with live lice may remain in class and go home at the end of the day for treatment. They may return to school once treatment has started.
• Open Sores or Wounds - Students with open sores or wounds that are draining and cannot be fully covered with a waterproof dressing should stay home. Wounds should be covered with a clean, dry bandage sealed on all four sides. If a wound cannot be safely covered, consult a health care provider to determine when it is safe for the student to return.
  
  Mouth sores with drooling also require exclusion. For contact sports, students with active skin infections should not participate until cleared by a provider, and the wound can be properly covered.
• Pain (Back, Limbs, Neck, Stomach) - While growing pains are common, persistent or severe pain—especially in the back or limbs—may signal an infection and should be evaluated by a health care provider. Pain with spreading redness may indicate a skin infection. Stomach pain is often minor, but persistent or severe pain, especially with vomiting, diarrhea, or fever, should be assessed. Frequent absences due to abdominal pain warrant medical evaluation. 
• Persistent Nasal Drainage – Ongoing yellow or green nasal discharge may indicate an infection or a blockage and should be evaluated by a health care provider. Noisy or labored breathing may signal a more serious issue and requires immediate medical attention. Students with thick or constant nasal drainage should stay home, as younger children often struggle to manage nasal hygiene and can easily spread illness to others. 
• Rash – A rash may be a sign of an infectious disease, especially when accompanied by fever or itching. Students with a new or unexplained rash should be evaluated by a health care provider before returning to school. Return is allowed once a diagnosis is made, and the provider confirms it is safe.  Chronic conditions like eczema, psoriasis, heat rashes, or diaper rashes do not require exclusion. However, rashes that are open, draining, or potentially contagious should be assessed promptly to prevent the spread of illness.
• Scabies - Scabies are contagious until treated, even before symptoms appear. It often causes intense itching, especially at night. Students with suspected scabies should be referred to a health care provider. They may remain in class and go home at the end of the day for treatment. Students can return to school the next day after completing overnight treatment with a prescribed scabicide cream.
• Skin color - A noticeable change in a student’s skin tone may indicate an illness. Signs include: 
  • Changes in complexion or skin color:
    • Pale or pasty complexion in students with lighter skin tones.
    • Grayish complexion in students with darker skin tones.
  • Yellowing of the eyes or skin 
  • Flushed cheeks with glassy or red eyes 
• Sore Throat – A sore throat may be minor but can also signal a more serious infection. If it’s accompanied by fever, difficulty swallowing, or swollen lymph nodes, the student should be evaluated by a health care provider. For strep throat, students are most contagious during the initial period of illness when symptoms are most prominent and contagious. Those who test positive should stay home until at least 24 hours after starting antibiotics, are fever-free without medication, and feel well enough to return. 
• Ringworm - Ringworm is contagious while skin or scalp lesions are present. Students with suspected ringworm should be referred to a health care provider for diagnosis and treatment. They should stay home until they have seen a health care provider and begun treatment.
• Vomiting – Students should stay home until vomiting has stopped overnight and they are able to keep food and liquids down the following morning before returning to school. 
• Other contagious illness diagnosed by a health care professional pursuant to WAC 246-110-010

Contact your health care provider if your student is experiencing any other symptoms that concern you.

A sick student cannot learn effectively and is unable to participate in classes in a meaningful way. Keeping a sick student at home and encouraging rest, hydration, nutrition, and frequent handwashing allows the student the opportunity to recover and prevents the spread of illness in the school community.

• WA DOH Infectious Disease Control Guide for School Staff
• When Students or Staff are Sick | Children & School Preparedness | CDC

(Updated 7/2025)