Parents often have to make a judgment call about whether a kid is sick enough to be kept at home. A paediatrician in Hong Kong explains the factors to weigh up, including whether they’ll infect classmates and teachers. 

Some parents aren’t sure when to keep sick children away from school and when it’s OK to send them back.

While many schools in Hong Kong make it easy for parents to decide, with clear-cut rules on illness, a US-wide poll by the University Of Michigan C.S. Mott Children’s Hospital found parents differ on how sick is too sick for class, or the importance of sick day consequences such as missing work or children missing tests.

The findings were based on responses from 1,442 parents who had at least one child between the ages of six and 18. Those with children aged between six and nine most frequently considered health issues as a key concern when opting for a sick day, while two in five parents of high schoolers rated missing tests or falling behind in class work equally.

Symptoms also make a difference. According to the poll, 80% of parents would keep home a child with diarrhoea, just 58% a child with vomiting, and 49% a child with a slight fever but still acting normally. Most parents say they are likely to send a child with red, watery eyes but no fever (16%) to school, or one with a runny nose, dry cough and no fever (12%).

“Parents often have to make a judgment call about whether their child’s sickness warrants staying home,” says the study’s lead author and Mott poll co-director Gary Freed. “We found that the major considerations were whether attending school could negatively impact a child’s health or the health of classmates.”

Image result for sick flu gif

Sending a sick child to school compromises health and recovery, and affects others. “As a mum and teacher whose premature 11-month-old just spent a week in hospital for the second time in her first year of life with pneumonia, I’d say please keep your sick kids at home. I picked up a horrendous cold from a student who was visibly sick, which I then passed on to my baby,” says Zoe Blaauw.

Dr Simon Wong, a specialist in paediatrics, says a child’s age, symptoms, general health or immunity levels can determine whether school’s a good idea. Parents of children in kindergarten are more likely to keep them at home than those with children at primary school.

“I guess this could be related to a combination of severity of disease versus age, level of self care, likelihood of spreading or catching the virus at school, missing out important school events and risk of falling behind at school etc,” says Dr Wong.

Most parents wouldn’t send their children to school if they have fever –the “gatekeepers” at school would send them straight back even when a borderline temperature is detected.

“I guess you will need to consider overcrowding as a risk factor for the spread of infectious disease. Our school premises are much smaller and the class sizes are much larger compared to the counterparts in the West and children are at a higher risk of contracting viruses from their classmates. May be this is one of the reasons why we tend to have a more cautious approach to infectious diseases here.”

Easy guidelines to follow

1. If your child has a runny nose but is in good spirits, playing and eating, it’s OK to send them to school with extra tissues. But if symptoms include loss of appetite, lethargy, mood change or breathing difficulty, no school and see a doctor.

2. A slight temperature might be OK but if the fever persists for more than three days or includes other symptoms such as listlessness or vomiting, keep them at home and visit the doctor.

3. Diarrhoea and vomiting could be symptoms of a virus, food poisoning or another cause; No school and see a doctor. – South China Morning Post/Sunory Dutt

* This article has been edited for length. To read the full article, head to