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How to tell if your child is too sick to send to school

Developed and endorsed by the School Health Advisory Board

Please note: The following symptoms may be a sign of COVID-19: fever, chills, cough, congestion or runny nose, headache, sore throat, shortness of breath or difficulty breathing, fatigue, muscle or body aches, or new loss of taste or smell. If your child presents with any of these symptoms, please refer to the Covid-19 Health Plan for further guidance. 


As school absences increase related to illness, Roanoke County Schools offers this directive to parents and staff to assist in the appropriateness of keeping a child home.

It is the belief of this school division that school attendance is essential. Knowing when to send your child to school can sometimes be a difficult decision. Much depends on what type of illness your child has contracted. While we recognize that each situation must be looked at individually, there are factors that parents need to consider. When making these decisions, please consider the following:

  • Depending on how ill your child appears and how similar illnesses have been tolerated in the past, you may want to keep your child at home under your observation until he/she is clearly improving.
  • If your child has missed school several days due to illness, consider having him or her seen by their doctor.
  • Risk of spreading infection can be widely variable depending on an infection’s incubation period, and the period of time your child carries the virus or bacteria.

The Roanoke County School Division realizes the pressures parents face as they balance work and other commitments with caring for their children. In order to maintain a healthy environment, the school asks that families observe the following guidelines on returning after an illness.


  • Colds - Students may continue to attend school with colds. Obviously, they are quite contagious, but it would be folly to try to keep all students with colds at home; the schools would be half empty. Students should not attend school if they have fever, excessive cough, or if they feel particularly ill.
  • Strep Throat - If your child has strep throat, please keep at home for 24 hours from the time antibiotics are started.
    Pink Eye - If your child has pink eye (bacterial conjunctivitis), please keep at home for 24 hours after the first dose of medicine is administered, and there is no drainage from the eye. For viral conjunctivitis not being treated with eye drops, please keep your child home until eye discharge has resolved.
  • Chicken Pox - Chicken pox lesions must be crusted and dried before child returns to school.
  • Head Lice - If your child has lice, he/she must receive treatment before returning to school (see our lice information page for recommendations)
  • Gastrointestinal Illnesses (Vomiting and/or Diarrhea) - If your child has been vomiting, please keep at home until your child is eating and drinking without vomiting for 24 hours. If you child has diarrhea, keep at home until stools are formed.
  • Any Childhood Illness Accompanied by a Fever – An oral or tympanic temperature of 100◦ F or higher is defined as a fever. In order to reduce the spread of infection and to minimize the risk to other children and adults in the school, please keep your child home until he/she is symptom free for at least 24 hours without the use of medication. 

If your child has been treated by a physician for a particular illness, follow his/her instructions on appropriateness of returning to school.

While we realize that the mentioned disorders are not inclusive, they are the most common health related reasons for children’s absences. Remember, children are enrolled in school for educational purposes. If children are well enough to go outside and play or go shopping, then they are most likely well enough to attend school.

Parents with specific questions about their child’s condition are encouraged to call their child’s doctor. If your child does not have a primary care physician, you may contact the nurse at your child’s school.

Knowing whether your child’s stuffy nose is caused by a cold or seasonal or indoor allergies is sometimes difficult to determine. The symptoms for each may appear similar and your children may not be able to describe the differences.

This is why we would like to share a valuable tool with you and your family. The “Cold vs. Allergies – How Can You Tell?” chart below is an easy-to-follow reference tool that can help you recognize symptoms early on, before you have an opportunity to check with your family pediatrician.

Whether at school or while enjoying the great outdoors, kids need to be alert to participate. Allergies can spike during heavy pollen seasons, but many kids suffer all year long. Seasonal or indoor allergies, such as pet allergies, affect up to 40 percent of American children and cause them to miss up to two million school days each year. This causes a significant impact on school performance, participation in sports, and enjoyment of daily life.

Review the “Cold vs. Allergies” chart to better understand the difference between allergies and colds and to help your child stay clear and focused at school and at home!

Clear Signs: Cold Versus Allergies – How Can You Tell?
Allergy symptoms can look like a common cold. Watch for these symptoms in your child/children.


  • Itchy ears, eyes or nose:  this could be a symptom of allergies
  • Sneezing - violent and prolonged bounts: this could be a symptom of allergies
  • Sneezing - occassional: this could be a symptom of a cold
  • Weakness and/or fatigue: this could be a symptom of both allergies or colds
  • Runny nose - watery and clear: this could be a symptom of allergies
  • Runny nose - thick, white or yellow to green: this could be a symptom of a cold
  • Aches, pains: this could be a symptom of a cold
  • Symptoms often last weeks to months for allergies
  • Symptoms often clear up in 7-10 days for a cold
  • Allergies are more common in spring or fall
  • Cold are more common in winter (except southwest U.S.)