Return after flu

Specialties School

Published

What are your guidelines for students returning after having the flu? My campus is currently in freakout mode because a student who was diagnosed on Tuesday is here today. However, per their MD note they returned on Tuesday, they could come back to school either yesterday or today or once they are fever free for 24 hours w/out meds. According to parents student had no fever yesterday and is not running a fever today, therefore, they are here. Teachers are panicking due to the cough this student has.

Is there anything else I can do? Technically this student is cleared to come back per MD note (and assuming parents are telling the truth about no fever yesterday), but we're a really small school. It won't take much to make our attendance drop to the point of closure for illness. If you consider the several I've sent home the last 2 days for ILI, I have to say I'm a little on edge too.

Thanks for any help!

Specializes in Disaster Medicine / Public Health / School Health.

Just read on CDC site yesterday:

“People with flu are most contagious in the first three to four days after their illness begins. Most healthy adults may be able to infect others beginning 1 day before symptoms develop and up to 5 to 7 days after becoming sick. Children and some people with weakened immune systems may pass the virus for longer than 7 days.”

2 Votes
Specializes in IMC, school nursing.
On 2/1/2019 at 11:59 PM, Nurse and Spy said:

Just read on CDC site yesterday:

“People with flu are most contagious in the first three to four days after their illness begins. Most healthy adults may be able to infect others beginning 1 day before symptoms develop and up to 5 to 7 days after becoming sick. Children and some people with weakened immune systems may pass the virus for longer than 7 days.”

In light of widespread Tamiflu use compared to years ago, I believe school districts should develop a policy. Students may be fever free within 24 hours of initiating Tamiflu, but victims reduce their contagious period one day. Because of this, I am sending an email that positive flu must be excluded 5 days after symptoms start. I realize pediatricians are at a disadvantage when it comes to parents not wanting to use sick time, but C'mon now.

4 Votes
Specializes in School Nurse.

Tamiflu - meh.

https://www.webmd.com/cold-and-flu/news/20121114/does-tamiflu-work-questions-continue#1

3 Votes
Specializes in Pediatrics Retired.
10 minutes ago, tining said:

Tamiflu - meh.

https://www.webmd.com/cold-and-flu/news/20121114/does-tamiflu-work-questions-continue#1

Me too...and it's expensive.

4 Votes
Specializes in School Nursing.

If I have an MD note clearing the student and the student appears to be ok. They stay. It's that simple.

4 Votes
Specializes in Cardiology, School Nursing, General.
19 hours ago, OldDude said:

Me too...and it's expensive.

$150 without insurance... we had to do this for my kid this past Christmas.

1 Votes
Specializes in Med-surg, school nursing..
21 hours ago, MrNurse(x2) said:

In light of widespread Tamiflu use compared to years ago, I believe school districts should develop a policy. Students may be fever free within 24 hours of initiating Tamiflu, but victims reduce their contagious period one day. Because of this, I am sending an email that positive flu must be excluded 5 days after symptoms start. I realize pediatricians are at a disadvantage when it comes to parents not wanting to use sick time, but C'mon now.

I've had two recent cases of flu where the md has had them out for 5 days.

3 Votes
38 minutes ago, OyWithThePoodles said:

I've had two recent cases of flu where the md has had them out for 5 days.

That is what I am seeing in my area also along with Fever free x24 hours without medications.

1 Votes
Specializes in IMC, school nursing.
41 minutes ago, OyWithThePoodles said:

I've had two recent cases of flu where the md has had them out for 5 days.

I had a case last month and the physician said OK after 24 hours with Tamiflu. Physicians in my area succumb to patient pressure and customer service is forefront in treatment. I fear pediatricians will do what this last one did and cave to parent pressure. I have reached out to our health department for guidance and to see if a policy that may go against a physician order is prudent.

1 Votes
2 minutes ago, MrNurse(x2) said:

I had a case last month and the physician said OK after 24 hours with Tamiflu. Physicians in my area succumb to patient pressure and customer service is forefront in treatment. I fear pediatricians will do what this last one did and cave to parent pressure. I have reached out to our health department for guidance and to see if a policy that may go against a physician order is prudent.

I'm considering a policy as well now that we're up to 10 confirmed cases. That doesn't include the ones who haven't called and said it was flu.

1 Votes

I wish the parents would keep the kids out an extra day or so - some of them are just not ready to return, exhausted by noon and in my office with me calling parents to pick them up.

I am thankful we have a fever policy - fever free x24 hours without meds. That will keep some of them home even if doctor states they can return after first dose of Tamilflu and they are really still feverish.

2 Votes
Specializes in Med-surg, school nursing..
5 minutes ago, AdobeRN said:

I wish the parents would keep the kids out an extra day or so - some of them are just not ready to return, exhausted by noon and in my office with me calling parents to pick them up.

I am thankful we have a fever policy - fever free x24 hours without meds. That will keep some of them home even if doctor states they can return after first dose of Tamilflu and they are really still feverish.

We don't have a fever free/vomit free for 24 hours policy. I wish we did...

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