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School and Childcare Exclusion list

School and Childcare Exclusion List: Information for Parents with Young Children


In an effort to help protect well children from unnecessary exposure to contagious or infectious diseases, South Carolina requires that children and staff with certain diseases and conditions stay home from school or out-of-home childcare while contagious.

DHEC publishes the School and Childcare Exclusion List each year.  The Exclusion List explains how long an ill child, student, school employee, or childcare employee should stay out of school or childcare, and what is needed before the child/student or employee is permitted to return.

The exclusion guidance on this page applies to

  • All children in out-of-home childcare, including after-school care,
  • All students in 3-, 4-, or 5-year-old kindergarten, and
  • Some school-aged children with special health care needs and/or certain developmental delays.  Your child's school will let you know if the exclusion guidelines for younger children apply to your medically fragile child.

Exclusion guidance for most students in 1st through 12th grades is found on this page: http://www.scdhec.gov/Health/ChildTeenHealth/SchoolExclusion/

If you have any questions about the School and Childcare Exclusion List or about ways to help children stay healthy, please call your child's childcare provider, school or your local health department.

If you think that your child has an illness that can be spread to others, please keep him or her home from school or childcare and call your healthcare provider

Questions to Consider When Your Child is Sick:

  1. Does your child's illness keep him/her from comfortably taking part in activities?
  2. Does your sick child need more care than the staff can give without affecting the health and safety of other children?
  3. Could other children get sick from being near your child?

If the answer to any of these questions is "Yes," please keep your child out of school or childcare.


Frequently asked Questions

When should my sick child stay home from school or childcare?
If your child feels too sick to go to school, or has one of the illnesses listed on this page,  keep him home.

Does my child need to stay home when she just has a cold?
Many children with mild colds who have no fever and who feel well enough to go to school or childcare do not need to stay home.  Most colds spread in the 1-3 days before a child gets a runny nose,  cough, or other symptoms.

Does my child need to be out of school or childcare if she has pinkeye?
No, unless your healthcare provider recommends it or the child has fever or pain.  Pinkeye is similar to the common cold in that it can be spread to others, but  usually clears up without medicine.  Frequent, good handwashing is the best way to keep your child from spreading pinkeye. 

How long will my child need to stay home if he is sick?
It depends.  See the information on this page for specific illnesses.  

Would my child ever be required to stay out of school for reasons other than her own illness?
If your child is ever exposed to a vaccine-preventable disease (such as measles), she may be asked to stay home from school or childcare.  Your school or DHEC will discuss this with you.

If my child is excluded from attending school, what will he need to present in order to return to school or childcare?
Sometimes a parent note or a medical note is required.  See below on this page for details.

Could an illness prevent my child from participating in sports or other school-related activities?
Some illnesses or conditions spread by close contact -- lice, scabies, shingles, staph or strep skin infections, for instance -- may prevent your child from participating in some sports or physical activities.  If your child has mononucleosis or CMV, she may be told she can't participate in physical education or sports in order to avoid injuries. If your child has diarrhea, she should not participate in water activities life swimming, splash pads, or water tables until 2 weeks after the diarrhea stops.


Help your child stay healthy and ready to learn.
We hope that your child never has to miss school because of illness.  The best protection from disease is prevention.  You can help prevent many illnesses by making sure your child receives immunizations and washes his or her hands often.


School and Childcare Exclusion List:  A Quick Reference for Parents with Young Children

(P) A parent note is required to return.
(M) A medical note clearing your child for return to school/childcare is required.

Bronchiolitis or RSV
Keep your child home while he has a fever or is too sick to play with other children.
(P) Chicken Pox / Varicella
Your child may return  once all of the sores and blisters are dried or scabbed over.  If there are no scabs, your child may return when no new sores appear for 24 hours.
(P) Diarrhea:
For most kinds of diarrhea (defined as 3 or more loose stools in 24 hours), your child should stay home until diarrhea stops for at least 24 hours, or until a doctor clears the child to return to school or childcare.
Special Circumstances
(M) Blood or mucus in stool with diarrhea.
If your child can use the restroom or can contain his stool in diaper-type underwear, he does not have to remain home if the diarrhea is known to be from a non-contagious condition, or if it continues after he completes antibiotics for a diarrhea-causing illness. 
If your child is medically fragile child or needs help with going to the bathroom,  she may need to be out of school if her condition makes it hard for  caretakers keep the classroom clean.
Diarrhea from a diagnosed infection:
(P) Campylobacter, Cryptosporidium, Giardia, Norovirus, Rotavirus, and most types of Salmonella -- Your child  may return to school/childcare  after diarrhea stops for 24 hours.
(M) E. coli -- For the most severe type of E. coli, students of must be out of childcare or school until the diarrhea stops and 2 lab tests taken at least 24 hours apart test negative for E. coli O157:H7.
(M) Salmonella Typhi (Typhoid fever) -- If your child has Typhoid fever, she must be out of childcare or school until the diarrhea stops and 3 lab tests taken at least 24 hours apart test negative for Salmonella Typhi.
(M) Shigella -- Students of any age  in childcare, or medically fragile students in school must be out of school until the diarrhea stops for at least 24 hours AND a lab test is negative for Shigella.
Fever:
(P) Fever by itself
Infants under 4 months old -- Keep your infant home if she has a rectal temperature (taken in the bottom) 101°F or higher.
Children over 4 months old -- Keep your child home if she has a fever 101°F or higher (if taken by mouth), 100°F or higher if taken under the arm, or 102°F or higher if taken in the bottom. 
Once her fever is gone, your child  can return to school/childcare.
(M) Fever with Rash, Behavior Change or other Symptoms
Keep your child home and take him to a doctor or clinic if he has a fever with other signs of severe illness such as a rash, change in behavior, earache, vomiting, confusion, sore throat or irritability
Flu / Influenza or Influenza-Like Illness (ILI)
If your student has the flu, she will be excluded from school/childcare for a fever of 100°F or higher with cough and/or sore throat.  She cannot return until she is fever free for at least 24 hours, without any fever medicines.
(M) German Measles / Rubella / 3 Day Measles
Keep your child home until 7 days after rash starts.
Hand, Foot, and Mouth Disease
If your student has hand, foot, and mouth disease, she should be out of school or childcare while  she has fever, excessive drooling, difficulty swallowing, or are too sick to do routine activities.
(P) Head Lice
If your child has crawling lice or with nits (eggs) ¼ inch or closer to the scalp, and if head-to-head contact with other children can be avoided, he may be sent home at the end of the day. Otherwise, he may be sent home from the school/childcare immediately. After his first treatment with a school-approved lice-removal product, if there are no active lice crawling on your child's head, your child may return to school/childcare.
The school or center should check your child 7 days after treatment for any newly hatched crawling lice.  If any are present, your child will have to be re-treated for lice before coming back  to school or childcare.
(M) Hepatitis A / Yellow Jaundice
If your child has acute hepatitis A, she may return 1 week after the start of the jaundice. 
(M) HIB (Haemophilus influenzae Type B)
If your child has a proven HIB infection, she will need to be out of school/childcare until a health care provider clears the student to return.
(P) Impetigo
If your child has dry, honey-colored crusty sores that can be covered, he will be sent home at the end of the  day.  If the sores are weepy, oozing or wet or cannot be covered and kept dry, the child will be sent home immediately.  He may return after receiving antibiotics for 24 hours, if the sores have stopped oozing and are starting to get smaller, or if the sores can be covered completely with a watertight dressing.
(M) Measles / Red Measles / 10 Day Measles
If your child has measles, she can return 4 days after the rash begins, if she has no fever and feels well enough to participate in regular school activities.
(M) Meningitis
If your child shows signs of meningitis (high fever, rash, stiff neck), he must remain out of school or childcare until a healthcare provider says that he may return.
(M) Mouth Sores inside the mouth
If your child has sores inside the mouth, and also drools, she should stay home until her health care provider says that the sores are not contagious.
(M) Mumps
If your child has mumps, she can return to school/childcare 5 days after the beginning of swelling.
Pinkeye / Conjunctivitis
If your child has pinkeye, he does not have to stay home unless your health care provider has recommended it.  If your child has fever or severe eye pain, take him to see a doctor.
(M) Rash
If your child has a rapidly spreading rash or a rash with fever or behavior change, she will be excluded from school or childcare immediately
(M) Ringworm
If your child has ringworm of the scalp, he must remain out of school/childcare from the end of the day until he has begun treatment with a prescription oral antifungal medication. 
If your child has ringworm of the body, he does not have to be out of school/childcare, as long as the affected area stays completely covered by clothing.  However, we recommend treatment for your child..
(M) Scabies
If your child has scabies, she cannot attend school/childcare until treatment/medication has been applied.
(P) Shingles
If your child has shingles sores or blisters that cannot be covered, he must be kept home until the sores are dried/scabbed.
Skin Infections from Staph or Strep (including MRSA), or Herpes Gladiatorum
Your child may attend school/childcare if the sores are covered with clothes or dressings, and if the drainage does not come through clothes or dressing.
Stomach ache (severe) or abdominal pain
If your child suffers with severe stomach pain for 2 hours or more, you should take her to see a healthcare provider, especially if the child has a fever.
(M) "Strep Throat" / Streptococcal Pharyngitis
If your child has Strep throat,  he can return to school or childcare 24 hours after starting antibiotics if there is no fever.
Sty (or Stye)
If your child has a draining/oozing sty that cannot be covered, she should remain home until the draining stops.
(M) Tuberculosis (TB)
If your child has active TB, keep him home until the doctor treating the TB says the child is no longer contagious.
Vomiting
If your young child has vomited 2 or more times in 24 hours, keep her home until the vomiting stops, unless you are certain that the vomiting is not due to a contagious condition.
(M) Whooping Cough / Pertussis
If your child gets whooping cough, she can return to school/childcare after completing 5 days of prescribed antibiotics, unless you are directed otherwise by DHEC or your school nurse.


If there is an outbreak of disease in your child's school or childcare, DHEC may need to change the exclusions found in this document in order to stop the spread of disease.

If your child has not received immunizations (shots) to protect against diseases like measles, mumps, German measles, or chickenpox, he may need to be out of school if there are cases of these conditions in the school.  Your school nurse will provide more information if there is ever an exposure or outbreak.


OK to Attend

Children with the following conditions do not have to be excluded from school or childcare, if they feel well enough to participate in regular activities:

Canker Sores
Chronic Hepatitis B or C
Colds or coughs, without fever or other signs of illness
Cold Sores
Croup
Cytomegalovirus (PE and sports exclusions may apply)
Disease spread by mosquitos: malaria, West Nile Virus
Diseases spread by ticks: Babesiosis, Ehrlichiosis, Lyme Disease, Rocky Mountain Spotted Fever, Tularemia
Ear Infection
Fifth Disease
HIV Infection
Mononucleosis (PE and sports exclusions may apply)
MRSA, if child is only a carrier
Pinworms
Rash without fever or behavior change
Roseola, once the fever is gone
Thrush
Urinary Tract Infection
Warts, including Molluscum contagiosum
Yeast Diaper Rash

If you have any questions about the School and Childcare Exclusion List, please contact your child's school or childcare provider or your local health department .

Updated January 31, 2015

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