• Excessive crying, clinginess, fussiness
• Doubled over in pain, unable to move
• Listless, lethargic, unresponsive
• Vomiting, diarrhea
• Feverish
• Seizure (although child has no history of seizure disorder)

Breathing 

• Fast, shallow, gasping breaths
• Difficulty breathing, wheezing
• Sucking in around ribs
• Flaring nostrils
• Persistent or uncontrollable coughing

Appearance of Urine/Stool 

• Gray or white stool
• Black or blood-flecked stool
• Unusually dark or tea-colored urine

Skin 

• Pale, grayish, flushed, yellowish skin
• Hot or cold and clammy skin
• Skin rashes, sores, swelling, or bruising
• Scratching at skin or scalp
• Skin doesn’t spring back when pinched

Eyes, Nose, Ears, and Mouth 

• Eyes swollen, red, crusty, watery, yellowish, or sunken
• Nose congested or runny
• Ears draining pus or blood
• Pulling at ears
• Mouth or lips with sores
• Sore throat, difficulty swallowing
• Excessive drooling

• Colds/sore throats/etc.: These illnesses are common and usually on the milder side. They’ll probably get passed around, but we just can’t keep kids out of school every time they have a stuffy nose. Kids can come to church as long as symptoms aren’t severe enough to keep them from participating. 
• Influenza or flu-like-illnesses: Influenza (or flu) can be pretty serious and spreads easily. Children should stay home from school and return after being fever-free for 24 hours. Flu shots can prevent a lot (but certainly not all) of these illnesses.
• COVID: Per the CDC guidelines as of May 2023 – If you have COVID-19, you can spread the virus to others. There are precautions you can take to prevent spreading it to others: isolation, masking, and avoiding contact with people who are at high risk of getting very sick. Isolation is used to separate people with confirmed or suspected COVID-19 from those without COVID-19. These recommendations do not change based on COVID-19 hospital admission levels. If you have COVID-19, also see additional information on treatments that may be available to you. This information is intended for a general audience. Healthcare professionals should see Ending Isolation and Precautions for People with COVID-19. This CDC guidance is meant to supplement—not replace—any federal, state, local, territorial, or tribal health and safety laws, rules, and regulations.
  • When to Isolate – Regardless of vaccination status, you should isolate from others when you have COVID-19.
  • You should also isolate if you are sick and suspect that you have COVID-19 but do not yet have test results. If your results are positive, follow the full isolation recommendations below. If your results are negative, you can end your isolation.
  • IF YOU TEST
    • Negative – You can end your isolation
    • Positive – Follow the full isolation recommendations below.
  • When you have COVID-19, isolation is counted in days, as follows:
    • If you had no symptoms: Day 0 is the day you were tested (not the day you received your positive test result). Day 1 is the first full day following the day you were tested. If you develop symptoms within 10 days of when you were tested, the clock restarts at day 0 on the day of symptom onset.
    • If you had symptoms: Day 0 of isolation is the day of symptom onset, regardless of when you tested positive
      Day 1 is the first full day after the day your symptoms started.
    • Isolation: If you test positive for COVID-19, stay home for at least 5 days and isolate from others in your home. You are likely most infectious during these first 5 days. Wear a high-quality mask if you must be around others at home and in public. Do not go places where you are unable to wear a mask. For travel guidance, see CDC’s Travel webpage. Do not travel. Stay home and separate from others as much as possible. Use a separate bathroom, if possible. Take steps to improve ventilation at home, if possible. Don’t share personal household items, like cups, towels, and utensils. Monitor your symptoms. If you have an emergency warning sign (like trouble breathing), seek emergency medical care immediately
• Strep throat: Kids who have a sore throat and a positive strep test should stay awayl until they’ve been on antibiotics for 24 hours (although recent research indicates that 12 hours may be enough). Treating with antibiotics limits the spread and reduces the risk of a really rare (like insanely rare) complication called rheumatic heart disease. 

• Ear infections: Ear infections are contained within the middle ear and aren’t typically contagious. They may or may not need antibiotic treatment, but kids should go to school unless they are so miserable they wouldn’t be able to participate. 
• RSV: Respiratory syncytial virus, or RSV, can cause typical cold symptoms, or more severe breathing problems in children under 2 (usually worse in little babies). Just like other cold viruses, your child’s classmates will probably get sick. Fortunately, most of these illnesses will be relatively mild. Unless children are too sick to participate, it’s ok for them to go to church. 
• Conjunctivitis/pinkeye: Conjunctivitis is just inflammation of the eye, and it can be caused by a lot of different things: viruses, allergies, and (more rarely) bacteria. And while the eyes can look similar, the treatment depends on the cause. Many of these cases are viral and don’t require treatment—yes, it can still be spread, but we can’t do anything about it. (Think of it like a cold in your eye.) Red eyes caused by allergies aren’t contagious, but can be treated with antihistamine drops or other allergy medicines. Sorry to make things complicated, but it’s an important point: not all pink eyes need antibiotics. However, cases thought to be caused by bacteria can return after antibiotic drops are started. 
• Vomiting: If kids are vomiting 2 or more times in 24 hours, they should stay home until their symptoms resolve. If they are evaluated and determined not to be contagious, they may return. (As a side note, the list of possible causes for vomiting without diarrhea is more concerning than for vomiting with diarrhea—although the majority of cases are due to viral illnesses.) 

• Diarrhea: According to the American Academy of Pediatrics and infectious disease experts, kids with diarrhea can go to church as long as they aren’t having 2 more bowel movements per day than whatever their usual number is. For kids who aren’t potty trained, it needs to stay contained in the diaper (no blowouts). And potty trained kids should not be having accidents. If stools contain blood or mucus, keep your child out of until symptoms resolve (and see your pediatrician—these cases can sometimes require more workup or treatment). 
• Hand, foot, and mouth disease: This is a common outbreak in daycare facilities that can cause some painful mouth ulcers and a rash. Kids should be kept at home for fever or if they are unable to control their drooling. (Although if drooling is controlled, it’s not drooling, right?) 
• Rash: Rashes can be caused by all kinds of things. Some are contagious, and some aren’t. In general, if they don’t fall into another category here, and there’s no fever or change in behavior, they’re ok to go to church. 
• Cold sores: Kids with cold sores can go to church. It’s not that they aren’t contagious; it’s that they are always even without a current outbreak, kids can still spread the virus, so it doesn’t do any good to banish them for a week. If you want to reduce the risk, teach your children to avoid sharing drinks and utensils. And nobody should kiss anybody, ever. 
• Wounds/skin infections: These are usually fine to go to church, as long as the wound can be covered. Impetigo (a bacterial infection that looks like yellow crusty spots, usually on a toddler’s face) is church-ready 24 hours after starting treatment.  

• Ringworm (on the skin or scalp): Just in case your mother lied to you, this infection is caused by a fungus. There is no worm. There never was.  The treatment usually an antifungal cream for the body or oral antifungal medication for the scalp. Repeat: there is no worm. 
• Lice:  Children should be allowed to return after their second treatment (which you can purchase over-the-counter and apply the same evening). Nits (eggs) should be combed out. 
• Scabies: This is an itchy rash caused by tiny mites that crawl around under your skin. (Now I’m itchy everywhere.) Children may be sent home from church if thought to have scabies, and can return after starting treatment (which is often a cream that is applied to the body overnight). Even after successful treatment, it can take a few days for the itching to stop. 
• Bed Bugs: If a family finds that they have bed bugs at home, we ask that you keep your child(ren) out of church until the problem is resolved in your home.  Bed bugs can be carried on clothing, diaper bags, back packs etc. The only effective treatment is high temperature heat.  Once your home has been certified bed bug free from a reputable pest control company, your child can then return to church.  We don’t want to infest the church and other families. 
• Erythema infectiosum (Fifth disease): This is a viral infection common in preschoolers that can cause fever, rash (classically a “slapped-cheek” appearance), and sometimes joint pain or other symptoms. In most healthy children, it resolves without major problems. The rash tends to show up late, after kids are no longer contagious. So if they’ve had it long enough to figure out that they have it, anybody else that was going to get it already got it.  

• Hepatitis A: This is a virus that causes inflammation of the liver; in some cases, it can be pretty serious. It’s spread by the “fecal-oral” route—I’ll let you look that one up. Fortunately, there’s a vaccine that can prevent it. If your child is unfortunate enough to get it, he should avoid contact for one week after the start of symptoms. 
• Measles: This is a viral illness that causes a fever and rash, and can make kids feel pretty miserable. And while some people don’t see it as being very serious (because it was essentially a rite of passage just a few decades ago), about 1 in 1,000 people that get this disease will die, and others can have permanent neurological damage. That’s why there’s a vaccine to prevent it. You should take advantage of that. Hopefully it never comes up, but children with measles can return to school four days after the beginning of the rash. 
• Mumps: You know, the one that makes your cheeks swell up. But it can also cause meningitis or infertility in males. We vaccinate for this one, too—it’s like a bonus track with the measles vaccine. There have been a few recent outbreaks, mostly in adolescents or adults after the immunity from the vaccine wears off. But any child with mumps should stay out of school for five days after beginning of the facial swelling. 
• Varicella/chickenpox: This is yet another disease that we can prevent with a vaccine. Like measles, some people downplay chickenpox as an itchy rash. And in reality, most children who got it had a really itchy rash. But it can cause some serious complications as well (including death). The handful of kids that are unlucky enough to get it can return to school when all the lesions are crusted over. 
• Pertussis: Also known as “whooping cough,” pertussis causes a cough that lasts weeks. For older children, this is really annoying. For babies it can be deadly. We have a vaccine for this one, too—we need a better one, but it’s still really important. Pertussis is treated with antibiotics (for the whole family), and kids can return after five days of treatment.