RSV, flu and colds: How to tell when your child is too sick for school


A wheeze, a sneeze or a cough can set off alarm bells for families with small children these days.

Mother of two Vicki Leone said her kids, ages 4 and 2, can sometimes go a month or two without bringing anything back from daycare. Then there were the times when it seemed like the Aurora, Colorado family was getting a virus every week.

“Once it hits, we’re on it for a while,” he said.

Many children have spent years practicing social distancing to protect against Covid-19, and now the health care system is overloaded with the respiratory virus RSV – which causes a runny nose, loss of appetite, cough, sneezing, fever and difficulty breathing. may be

Viral infections were always common. The US Centers for Disease Control and Prevention says that almost all children are infected with RSV at some point before age 2. And immunity develops after infection that often wanes over time, leading people to have multiple infections in a lifetime, says Dr. William Schaffner says.

The public health challenge this year is that many children, who were kept at home to protect against Covid-19, were also isolated from RSV, which now means their first — and therefore the most serious — infection

An RSV infection is often mild but can be a cause of concern for young children, children with underlying conditions and older adults, says Schaffner, who is also the medical director of the National Foundation for Infectious Diseases.

That doesn’t mean it’s time to panic, adds Wayne, who is also the author of “Lifelines: A Doctor’s Journey in the Fight for Public Health.” Catching RSV and other viral and bacterial infections is part of children growing and developing their immune systems.

Here’s how to assess when to keep your child home from school and when to see a pediatrician, according to experts.

Between the common cold, influenza, strep throat, RSV and chronic Covid-19, there are plenty of infections swirling around this winter — and they can often look very similar in symptoms, Schaffner said. Even discerning doctors can have trouble telling them apart when a patient is in the office, he adds.

However, pediatricians are well-trained and equipped to treat upper respiratory infections, even when it’s not possible to distinguish exactly which virus or bacteria is the cause, says Wayne.

Whether a virus or bacteria triggers the sniffles, headaches or sore throats in your family, your child’s age, symptoms and health status will likely make a difference in how you proceed, she says.

Ideally, public health professionals would prefer it if any children showing symptoms were not sent to school or daycare, where they could potentially spread infections, Schaffner said. But — especially for single parents or caregivers For those who need to be at work — that’s not always the most practical advice, he added.

He also added that home tests can signal if a child has a Covid-19 infection. But for other viruses like the common cold, there may not be a good way to know for sure.

Some symptoms that could really signal that it’s time to keep your child home from school or daycare include a high fever, vomiting, diarrhea, trouble eating, poor sleep, or trouble breathing, Wayne said.

Donna Magic, a registered nurse and executive director of the National Association of School Nurses, breaks it down into two primary considerations: Does the child have a fever and is they too sick to fully engage in learning?

Families should also check their school’s guidelines, some of which may detail when children need to be kept home from school, while others will rely more on parental judgment, she said.

“When in doubt, consult school policy and make a plan with a pediatrician,” Owen said.

And for babies at high risk for other medical conditions, consult your pediatrician before your baby gets sick so you know what to look for.

Again, this is where schools may have different policies and it becomes important to check with written information, a school administrator or the school nurse, Wayne said.

“Usually, schools will ask the child to relieve the fever without using antipyretics.” The classroom, he said.

For children with asthma or allergies, it may not be reasonable to keep them out of school every time they show any cough or wheezing symptoms, Owen said. This can keep them out for half a year.

And some symptoms, such as a persistent cough, may disappear as the infection clears and a child may recover. In these cases, sending a child back to school may be appropriate, Magic says, adding that it’s important to check the school’s guidelines.

Families often bring their children to pediatricians when they feel sick, Schaffner said. still, With so much moving around, it’s important to remind families that doctors would rather see kids who aren’t feeling well beforehand, she added.

If they seem lethargic, stop eating or have difficulty breathing, parents and caregivers would also be justified in taking their children to a pediatrician and seeking medical advice — especially if symptoms worsen, Schaffner said.

“It’s not something they should hesitate about,” he said.

For young babies and children, it may be time to go to the emergency room if they have trouble taking in fluids or dry diapers, inflamed nostrils, trouble breathing and a chest that constricts when it should be expanding, Owen added.

Wayne said families should seek emergency treatment for school-aged children who have trouble breathing and speaking in complete sentences. Fortunately, most won’t need emergency treatment — and those who do usually return home and do well within a few days, Schaffner said.

“Parents should know that treating RSV and other respiratory infections is the bread and butter of pediatricians and emergency physicians,” Owen said. “This is what we’re doing.”

To prevent these respiratory illnesses, teach your children to use the hygiene practices that health care professionals are promoting Things like washing your hands, using hand sanitizer when there’s no sink, coughing and sneezing into your elbow or a tissue, and not sharing food or utensils with friends, Owen said, were long before the pandemic.

There is still no vaccine for RSV approved by the US Food and Drug Administration, but effective ones are available for influenza and Covid-19, Schaffner said.

If your child hasn’t been vaccinated yet, talk to their doctor about protecting them against the virus, she adds.


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