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How to know if your sick child is contagious and should be kept home

A doctor recommends children stay at home until 24 hours after their fever breaks.
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CLEVELAND — When a child comes home from school with a runny nose and a cough, it’s usually the sign of a common cold.

But according to Dr. Frank Esper of Cleveland Clinic Children’s, pretty much everything that makes your child sick has the potential to spread to others.

“Everything is contagious if it’s an infection,” he said. “Whether you need medication for it, that’s one question — but for the most part, all of these infections are contagious, and most times you got it from someone else; it didn’t just spring up in you.”

Dr. Esper said when it comes to a minor cold, it’s important to teach children to cough into their elbows and wash their hands frequently to prevent the spread of germs.

He recommends teaching children to wash their hands thoroughly with soap and water for a minimum of 20 seconds.

For children under age 3 who aren’t especially good at hand-washing, using an alcohol-based hand sanitizer is best.

There are times when a child needs to be kept at home, not only to recover, but to keep from spreading illness to others.

Dr. Esper said a child with a fever should always be kept home from school or daycare.

“If you’re having fever, and if you’re having symptoms, generally, you should consider yourself contagious. You could pass that fever and those symptoms to somebody else,” he said. “The general rule is, if you have a fever, to stay home until that fever goes away.”

Once the fever breaks or goes down, Dr. Esper said this typically means the immune system has defeated the germ, or that there’s so little left that it won’t cause infections in other people.

He said you can treat a fever at home — ibuprofen works best, but children under age 1 should take acetaminophen.

Dr. Esper recommends children stay at home until 24 hours after their fever breaks. After that, they should be good to go back to school.

Anytime a fever gets very high and persistent, it’s time to call the doctor.

“Certainly anybody with a high, persistent fever — 104, 105 — you should call your doctor to see whether the child needs to be seen,” Dr. Esper said.