By Luisa Dillner/London
Your child has a sore throat, pink eyes and a raised temperature. “Do I have to go to school?” they ask. If they live in south Wales then, yes, they do. A health guide, Miss School, Miss Out, approved by Public Health Wales, gives parents a table that lists illnesses alongside recommended time off.
For conjunctivitis, glandular fever and tonsillitis, the recommended time off school is – surprisingly – none. For chickenpox, it is five days from the start of the rash, and for shingles the advice is “keep home only if rash is weeping and cannot be covered” (although it suggests your child stays away from vulnerable children and pregnant women). If your child has head lice or threadworm, they should go to school.
The guide asks parents to think about whether they would take a day off work if they had the same condition. It also asks if the child has a condition that can be passed on to other children (the answer in the case of most childhood illnesses being yes). If the answer to either question is yes, the guidance is to ring a national helpline for advice, or visit a GP.
Media reports say parents are angry, believing they know best about when to keep their children at home. Are we keeping children off school when they’re well enough to be learning?
Children miss an average of 7.5 days of school a year through illness, while teachers miss an average of 4.5 days in England and seven days in Wales.
Some of the guidance, while irritating to parents, makes sense. Minor illnesses resolve themselves without treatment and will already have spread in the classroom.
Opinion is divided over viral conjunctivitis: unlike Public Heath Wales, the Mayo Clinic in America says children should stay away until their eyes are no longer runny and gummed up. I’d keep my child off for 24 hours because it is miserable to have sore, sticky eyes.
A child with a fever should stay at home because they will feel rubbish.
A bout of diarrhoea or vomiting needs 48 hours clear of symptoms before a child returns to school. Chickenpox can be over in five days, but may not be totally crusty (and non-contagious) for a week. To expect zero days off for glandular fever or tonsillitis is rather brutal.
But if all parents kept their children off school for head lice (I was once rung by a nursery and asked to take my child home immediately), the crisis over primary-school places would be solved.
Ultimately, the guidelines are useful, but only in the hands of sensible parents. Not all children will be affected by the same illness in the same way.- Guardian News and Media
- Dr Luisa Dillner heads BMJ Group Research and Development.
