Communicable Disease Prevention and Response in Schools

Information for Educators

Welcome Page Updated 03-29-24

On this page, you will find LAC DPH symptom guidance, reporting criteria, and related resources for communicable diseases that are common among children. This guidance applies to childcare and TK-12 school settings.

Guidance for Schools: Common Signs & Symptoms

Below are suggestions for when to keep your child home when they are not feeling well. Contact a health care provider if your child needs medical care. This document is intended to support decision-making for schools and childcare centers when an individual child is displaying signs and symptoms of illness. A doctor’s note is generally not required to return to school or child care. For more information, please visit the CDPH guidance page.

This document:

  • does not replace the advice of a licensed healthcare provider, nor does it revise guidance related to an individual child’s known medical condition or existing IEP, Section 504 plan, or IFSP plan.
  • is not a diagnostic tool. Related symptoms may inform exclusion decisions, but school staff should not attempt to diagnose.
  • does not replace or revise applicable laws or other requirements.
  • does not address specific disease outbreaks, when recommendations and public health requirements for exclusion may be more strict.
  • is limited to consideration of symptoms as evidence of infection, and does not include considerations for other causes of symptoms such as allergies, toxin exposure, and child abuse or neglect.
  • should be used within the context of an individual student's health and behavior history.
Symptom of Illness When should my child stay home and when can they return?
Overall, not feeling well

STAY HOME IF any new illness or symptom prevents a child from participating meaningfully in routine activities.

Please note that a child with multiple symptoms is more likely to be contagious. Recommendations for all applicable symptoms should be considered.


STAY HOME IF a fever is 100.4°F (38°C) or higher. 

RETURN WHEN fever went away over the night and is gone in the morning without the use of medications such as Tylenol® , Advil® , or Motrin® (acetaminophen or ibuprofen).

Respiratory Virus Symptoms (cough, stuffy / runny nose, sneeze)

OK TO ATTEND WITH MILD SYMPTOMS. Children should test for COVID-19 before attending school, wear a mask for 10 days from symptom onset, and follow COVID-19 guidance.

STAY HOME IF symptoms are accompanied by fever or if child has significant nasal discharge.

SEEK MEDICAL ATTENTION for severe symptoms, including a bad cough, difficulty breathing or trouble catching their breath, or wheezing when not controlled by medication (like albuterol).

RETURN WHEN child has been fever-free for 24 hours without the use of fever reducing medication and other symptoms are improving.


STAY HOME IF vomiting has occurred 2 or more times in 24 hours.

RETURN WHEN vomiting has ended overnight, and child is able to hold down liquids and food.

*Defined as stools that are more frequent (typically at least two more than normal) or less formed than usual for that child AND not associated with a change in diet.

STAY HOME IF child’s stool is likely to leak from the diaper, if they are unlikely to make it to the toilet in time (if potty trained), or if symptoms prevent them from participating meaningfully in routine activities.

SEEK MEDICAL ATTENTION if the stool looks bloody or black.

RETURN WHEN child has not had diarrhea for 24-48 hours or infectious cause has been ruled out. If child has been diagnosed with a specific infection, follow disease-specific guidance from public health or their healthcare provider.

Sore Throat

OK TO ATTEND WITH MILD SYMPTOMS. Child should wear a mask if age 2 years or older.

SEEK MEDICAL ATTENTION for difficulty breathing or swallowing, or continuous drooling.

RETURN WHEN IMPROVING. If an antibiotic is prescribed, take the first dose at least 12 hours before returning.

Ear or eye irritation (including pink eye)


STAY HOME IF there is significant discharge from the eye or ears, or if symptoms prevent child from participating meaningfully in routine activities.

SEEK MEDICAL ATTENTION for difficulty seeing or hearing, an eye injury, or pain they cannot tolerate.



STAY HOME IF child has a fever or recent exposure to measles or chickenpox.

SEEK MEDICAL ATTENTION if rash is worsening, causing pain, has blisters, or is not healing.

RETURN WHEN IMPROVING or as guided by health care provider. In general, for conditions such as lice, impetigo, ringworm, scabies, and pinworms, your child may return as soon as they start appropriate treatment. Recommend covering rash if possible.

†Multiple cases may indicate an outbreak. See Reporting Requirements below or call (888) 397-3993 to report a suspected outbreak of any kind.

Download LAC DPH Symptom Guidance

Symptom Guidance for Children
Symptom Guidance Chart for Children
Symptom Guidance for Children
Symptom Guidance Cover Letter
Disease-Specific Reporting Requirements & Resources

Suspected outbreaks of any disease must be reported to Public Health immediately. For consultation and/or questions, call (888) 397-3993 or (213) 240-7821.

Below are the reporting requirements and resources for communicable diseases that commonly occur in education and childcare settings. A PDF version is available in English and Spanish.

If outbreak criteria for a disease is met, it must be reported to Public Health. Additionally, some diseases may require reporting of individual cases. For comprehensive disease reporting requirements in LA County, view the LAC DPH Reportable Diseases and Conditions List.

Epidemiologically Linked Group: Epidemiologically linked groups involve individuals who were together in the same location when at least one person was contagious. In educational settings, this could mean students and/or teachers in the same classroom or athletic team who become ill around the same time. These situations suggest that the disease spread among these people is due to their shared environment rather than random transmission from outside.

Reporting Requirements:

Per the LA County Health Officer Order, Education Settings are required to report within 24 hours when the following criteria are met.

In an epidemiologically linked group (e.g. classroom, sports team, after-school group):

  • A minimum of 5* cases (at least 20% of the group) meets case definition for acute respiratory illness within a 7-day period.

Facility-wide (e.g. entire school or center):

  • At least 10% of the average daily attendance are absent and/or reporting symptoms of acute respiratory illness, with a minimum of 5* ill, within a 3-day period.

*In settings where an epidemiologically linked group is fewer than 15 people, the minimum number of cases to report is lowered to 3.

How to Report
Report all viral respiratory clusters through SPOT. For assistance reporting via SPOT, please review our resources: Additional Information
Reporting Requirements:
  • 5 or more epidemiologically linked confirmed or suspected cases with symptoms consistent with conjunctivitis occurring within a 7-day period.
  • In settings where an epidemiologically-linked group (such as a single classroom, sports team, or after-school group) is fewer than 15 people, the minimum number of cases to report is lowered to 3.
Additional Information
Reporting Requirements: Additional Information
Outbreak Reporting Requirements:
  • Minimum of 5* confirmed cases or suspected cases with symptoms consistent with HFMD occurring within 3 to 5 days and within an epidemiologically linked group.
    *In settings where an epidemiologically‐linked group is fewer than 15 people, the minimum number of cases to report is lowered to 3.
Additional Information
Reporting Requirements:
  • Minimum of 3 cases or suspected cases with symptoms consistent with MRSA occurring within 3 to 5 days and within an epidemiologically linked group.
Additional Information
Reporting Requirements:
  • The outbreak definition can vary. All known or suspected individual cases should be reported to LAC DPH.
Additional Information
Reporting Requirements:
  • Generally, an outbreak is defined as three or more epi-linked cases within a 3-week period. However, if there is exposure among a group at high risk for complications (immunocompromised or susceptible groups), the threshold may be lower. Contact or call 213-351-7800 to discuss concerns.
Additional Information
Icon: Get Adobe Reader
Adobe Reader

Note: PDF documents on this site were created using Adobe Acrobat 5.0 or later. Document functionality may be reduced if you are using an earlier version (4.x or less). Get the latest version of Adobe Acrobat.

Public Health has made reasonable efforts to provide accurate translation. However, no computerized translation is perfect and is not intended to replace traditional translation methods. If questions arise concerning the accuracy of the information, please refer to the English edition of the website, which is the official version.

Los Angeles County Seal: Enriching lives through effective and caring services