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Knowing if a child is well enough to be at school — guidance for schools

Going to school every day is important for all school aged tamariki (children). It helps build their confidence and social skills, and to achieve their education and life aspirations. This information helps school leaders understand when it is okay for a child to still be at school and when an unwell child should be at home.
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  • If a child tests negative for COVID-19 and they do not have any symptoms of concern it is okay for them to be at school if all of these apply.

    • They do not have a fever and they do not need medicine to reduce a fever, like paracetamol or ibuprofen.
    • They only have mild symptoms such as a mild cough, headache, or runny or blocked nose.
    • They appear well - they are happy, eating and drinking normally, and can easily focus on learning.  

    Symptoms of concern

  • If a child has a history of hay fever or allergies and they develop their usual symptoms - sneezing, runny or stuffy nose, coughing or an itchy face - they can go to school.  

    Discussion with the child’s parents may be required, especially if the child needs to take allergy medication (antihistamines) at school.

    If a child has a runny nose after a change in air temperature, for example, moving from outdoors to indoors, or they sneeze because of the sun or dust, it is okay for them to be at school.

  • A child can attend school if they have:

    • insect bites
    • cuts
    • scratches
    • grazes
    • eczema.

    These conditions are not infectious.

When an unwell child should not be at school and for how long

If a child is too unwell to learn or they have an infectious illness that could spread easily to others, they need to be kept at home away from school so they can recover or get health advice or care.

Children should stay at home or their parent or caregiver should be contacted to collect and take them home from school if they:

If a child is experiencing anxiety at school, discuss with the child’s parent or caregiver the best steps to help them manage their anxiety while also being supported to attend school.

Symptoms of concern

There are symptoms of concern that school leaders should be aware of.  

If a child at school has any of these symptoms, the child’s parent or caregiver should be contacted to arrange for them to be picked up and taken home so they can recover or get healthcare if they need it:

  • fever – a temperature higher than 38oC
  • vomiting or diarrhoea
  • school sores (impetigo) or other potentially infectious sores that are uncovered and untreated
  • sore throat that requires pain relief like paracetamol or ibuprofen to feel comfortable
  • a new rash that could be a sign of a serious illness or infection
  • wheezing or difficulty breathing.

Head lice (nits) is another symptom to be aware of. Checking a child or sending them home for nits is not expected of school staff. Instead, if staff suspect a child who is persistently scratching their head might have nits, a quick discussion with their parent or caregiver is recommended to encourage them to take a closer look at what might be causing the irritation.

See further information on these symptoms:

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  • A fever is a temperature that is higher than 38oC.


    A child should not be at school until:

    • their temperature has returned to normal (less than 38°C) without needing to use medicine to reduce it, like paracetamol or ibuprofen
    • they are feeling well and happy within themselves again.

    Symptoms to watch out for are:

    • severe headache
    • sleepiness (hard to wake), seeming floppy or confused
    • a new rash
    • a child is feeling very unwell, upset or unsettled.

    Meningitis is a very rare but serious cause of fever in children.

    Meningitis 

    For general information on fever see:

    Fever | KidsHealth NZ

  • Gastro (also known as a tummy bug, rotavirus or norovirus) is an illness caused by an infection in the gut. Symptoms are nausea, vomiting, diarrhoea and fever.

    Gastro can spread easily to others, so a child should not be at school if they are vomiting or have diarrhoea. 

    A child can return to school after 48 hours (2 days) have passed since the last time they vomited or had diarrhoea.

    Rotavirus

    Norovirus

    Advice on gastro

  • A child should not be at school if they need pain relief for their throat to feel comfortable. Pain relief includes paracetamol or ibuprofen.

    Sore throats

  • School sores (impetigo) is a common skin infection caused by bacteria. Symptoms are red sores or blisters, which burst to leave crusty, golden-brown patches. The sores can be itchy and mostly affect the face and hands, but they can appear elsewhere.

    Other skin infections can also show similar symptoms.

    If a child has sores that are red, swollen, oozing, weeping or blistered, or that feel hot to touch, they should not be at school until:

    • their sores are covered and healing
    • it has been 24 hours since they started antibiotics
    • as directed in the guidance for infectious diseases. 

    Guidance for specific infectious diseases

    Impetigo 

    Skin problems in children

  • If a child develops a new rash, they may not be able to attend school.

    Most of the time a child with a rash will not need to see a doctor. However, there are some rashes which are more serious and may need treatment to heal.</p/>

    Childhood rashes

    If a child gets a new rash AND they have a fever, headache, they are drowsy or appear to be very unwell, upset, or unsettled, it is recommended that school staff contact the child’s parent or caregiver to let them know and to arrange for them to be picked up from school.

    Meningitis is a rare but very serious cause of a new rash.  A meningitis rash starts out looking like small pin pricks, but it can turn into red or purple bruise-like blotches. 

    Meningitis

  • Head lice (nits) are common in children because of how close they are together at school. Nits are small insects that lay their eggs on strands of hair. Scratching can be a sign that a child has them.

    Children with nits should stay at home from school until treatment has started.

    Head lice (nits)

    Scabies is a very itchy skin rash that is caused by a reaction to a tiny mite that burrows under your skin. Scabies is easily spread between people through close skin contact, shared bedding or clothing. This type of rash needs treatment to get better.

    If a child has scabies, they can go back to school 24 hours after their first treatment.

    Scabies

    Skin problems in children

  • A child should not be at school if they are:

    • wheezing or struggling to breathe (unless they can get quick relief with prescribed medicine, like an inhaler)
    • coughing or sneezing frequently, and it is making it hard for them to concentrate and learn.

    Most coughs will get better on their own, but it can take many weeks for a child to fully recover. A child who has a lingering cough, but is otherwise well, can return to school.

    Coughs in children

Infectious diseases that can spread easily at school

There are many infectious diseases that can spread easily at school where there are a lot of people together in crowded and confined spaces, like classrooms.

It is not expected of school staff to be able identify if a child has an infectious disease.

If a healthcare provider or local public health service has advised a child should stay at home to prevent the spread of an infectious disease, they should not be at school until they are told they can  return.

Infectious diseases (external link)

Returning to school after illness

In general, a doctor’s certificate or clearance is not required for a child to go back to their school after being unwell. 

Depending on how unwell the child has been, a graduated return to school could be considered and discussed with the child’s parent or caregiver.

If the school is concerned about a child’s health or wellbeing on their return to school, school staff are encouraged to discuss with the parent or caregiver whether the child may need to spend more time at home to fully recover.

Anxiety and school attendance

Anxiety is a normal response to situations that are new or stressful. Young people can feel anxious about school for a lot of different reasons. For example:

  • feeling worried about something that is happening at school,
  • making friends or fitting in
  • starting a new school
  • returning to school after a long absence
  • during exams
  • finding relationships with peers or teachers difficult
  • finding schoolwork or lessons confusing, or feeling pressured to learn in a certain way.

Sometimes going through difficult experiences outside of school, such as bereavement, an illness in the family, or being a young carer can also make it harder for a child to feel settled at school.

School staff should work together with parents and caregivers to support children to be able to cope in a school environment and attend as much as possible.

See further guidance on anxiety in school aged children

How to prevent staff and students getting sick or spreading illness to others

There are simple things you can do to stop the spread of infectious diseases and illnesses at home, school and work.

Immunise against infectious diseases

Guidance for school staff:

  • A range of adult vaccinations are recommended, including for protection against COVID-19 and influenza (flu) Adult vaccinations (external link)
  • Whooping cough (pertussis) vaccination is recommended for pregnant people and those who will be around young children and babies.
  • Measles vaccination is recommended for those who are unsure of their measles status - check with your healthcare provider to confirm if you are up to date with doses. School staff who are not immune to measles will not be able to work if they are a contact of a measles case. 
    Immunise against infectious diseases (external link)

Other things you can do

  • keep hands clean
  • stay at home when sick
  • wear a face mask
  • cover coughs and sneezes
  • improve ventilation
  • keep household and work surfaces clean.

Healthy habits

It is recommended that school leaders encourage school staff and students to follow this advice to help everyone in the school environment stay healthy.

Ministry of Education student attendance guidance for schools

Schools along with parents and caregivers are legally responsible for making sure students attend school every day.

The Ministry of Education provides broader guidance for schools on student attendance.

Student attendance: Guide for schools and kura – Education in New Zealand (external link)

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