How long is long enough? Taking time off after an illness
Different illnesses require that patients stay home from school or work for different lengths of time.
One of the most frequent questions clinicians get asked is “How long should I stay home from work?” followed by “How long should I keep my child out of school?” When it comes to conditions like broken fingers or sprained ankles, each case is subjective and depends on the patient's condition. If they broke their ankle, time off depends on their daily activities at work or school. However, when it comes to illnesses, the guidelines are a little more clear-cut.
Many times as clinicians, we find ourselves in a situation where a parent needs to be able to take their child back to daycare as soon as possible, so they themselves can return to work. Because of this, they want to know how quickly their child can return. Since there are so many different illnesses with so many different rules, I often need to remind myself exactly what the guidelines are.
For illnesses treated with antibiotics, most people think that the patient is no longer contagious 24 hours after the antibiotics are initiated, a concept that is often but not always correct. On the other hand, viral illnesses vary, and each individual illness has its own recommendations. Most of the time, this information is available on the website for the CDC. Recently I realized that it would be much easier to have this information organized into one concise place, including multiple illnesses and the recommendations for each one. After perusing the internet, I found a handy reference that I now use frequently. The publication comes from England's Department of Public Health, and is titled “Guidance on Infection Controls in Schools and other Childcare Settings.”1 Even though the information if from a different country, I have found that generally the information is not very different from what is recommended by the CDC.
The reference breaks down illnesses into 4 sections, including rashes and skin infections, diarrhea and vomiting illness, respiratory infections, and “other” infections. Each illness includes a guideline of how long it's recommended to keep a child home and a comments section which has useful tips like how to prevent the spread of the illness or how to accelerate healing time. There is some additional information that is both useful (which illnesses can be very dangerous to a pregnant woman) and not so useful (how to keep your children from contracting illnesses when visiting a farm).
Having this resource available has definitely saved me time when I need to quickly remind myself how long a child should stay home; I also use this information to help treat my adult patients. And if in the future I plan on taking any children to a farm, this may be the first resource I utilize as well.
Jillian Knowles, MMS, PA-C, is an emergency medicine physician assistant in the Philadelphia area.
- Guidance on infection control in schools and other childcare settings. London, UK: Public Health England. Published September 2014. Updated May 2016. Accessed August 2016.