How Sick Is Too Sick for School?

That's the question asked by a HealthDay article in this morning's Yahoo!News, and one that's being asked by lots of parents this flu-riddled, cold-friendly, bone-chilling season. And it's on my mind after two days of having my sick niece at our house because the school nurse said she was too sick for school, but her parents had to work. If a kid's too sick to stay in school, is she too sick to hang out with my kids? With her elderly grandmother? To tell you the truth, I'm not feeling that good myself.

When I was a kid, back in the Stone Age, determining whether a kid was too sick for school was mostly a matter of telling the aching from the faking. In my family, the rule was: If you have a fever, you're sick. If you don't, get your butt to the breakfast table. Since I was a little overacheiver who wanted to go to school, it never occurred to me to try to rig a thermometer to reflect feverishness, though if sitcoms and mischievous-kiddy movies are to be believed, a lot of children did. These days, of course, the question is not so much, "Is she really sick?" but "Is she really that sick?" Two-career families and single parents juggling snow days and school vacations and teacher in-service days and half days and holidays may find a sniffly sneezy sore-throat day just too much to handle.

So when is a sickish child okay to suffer through a school day, and when do they absolutely, positively, have to stay in bed? Fever's still a reliable indicator, although to what degree is up for debate. I'd say if a kid's not running a fever in the morning, he or she is good to go, but our school nurse wants 24 hours of fever-freedom before kids come back to the classroom. If that means keeping a seemingly healthy child home, I'd say she's probably dreaming. Vomiting has always been a pretty quick ticket home -- I've had to pick up kids who have thrown up numerous times, even though their at-home demeanor indicates that whatever was sickening them got thrown-out with the throw-up -- but the HealthDay article claims that it's perfectly okay to send a kid with diarrhea to school, as long as they wash their hands. HealthDay also says head lice are no reason to deny a kid the right to learn, and although I personally agree, I don't think the school nurses of America have jumped on that particular bandwagon.

Most of the "keep them home?" quandaries I've had center on those long-term, season-spanning cough-and-cold combos that never involve fever or serious illness but turn kids into biohazards, spewing spit and snot, hacking and honking and generally appearing way sicker than they are. You can keep a kid home a day or two for that, but there have been school years where my two would have had to sit home a whole quarter, so tenacious was the upper respiratory nastiness. My niece, on the other hand, clearly had herself a little fever and some coughing and some listlessness going on Thursday, and her mom hoped she wasn't really that sick, and the school nurse begged to differ. What I wonder is: What happens when the school nurse's kids get sick?