Nursing Department

Visit Outbreak Investigation of Infant Botulism: Infant Formula (November 2025) | FDA to review further details on the outbreak. ByHeart Whole Nutrition Infant Formula and Anywhere Pack™ products are sold in Massachusetts and nationally in the U.S. and were previously available through multiple retailers including Shaws, Target, Walmart, Whole Foods, Star Market, and Wegmans.

 

Information from the Nursing Department:

It is important that you notify the School Nurse of any illness or injuries during the school year, regardless of whether illness occurs at school, sports or at home. 

Symptoms to look out for include:

• Fever (100.0°F or higher), chills or shaking chills
• Difficulty breathing or shortness of breathe
• Muscle aches or body aches
• Cough (not due to other known cause, such as chronic cough)
• Sore throat, when in combination with other symptoms
• Nausea, vomiting, or diarrhea, when in combination with other symptoms
• Headache, when in combination with other symptoms
• Fatigue, when in combination with other symptoms

If your child has any of the above symptoms, please keep them home and contact the school nurse for further guidance.

Respiratory Spread Guidance MA DPH           Flu Symptom Checklist

Norovirus Facts The Flu

When Should a Student Should Stay Home When Not Feeling Well?

We want students to have good attendance but there may be times when you are too ill to come to school. You cannot learn when you are ill and you risk infecting others if you have a communicable disease. It is the decision of the school nurse whether or not a child should be dismissed from school.

Guidelines suggested by the American Academy of Pediatrics ;

When a child is ill, it is recommended to take the following steps:

• Assess the acuity of the child.
• Notify the school nurse.
• Keep the student home.
• Reach out to their healthcare provider.

Decisions are made based upon the following management guidelines:

Fever - Stay Home If:

• An oral fever ≥ 100.0º F is present is present at home;
• Unable to participate in routine activities or needs more care than can be provided by the school staff;
• An oral fever ≥ 100.0º F is present at school, the parent/guardian will be notified for student dismissal.
• Students need to stay home for 24 hours after their temperature has returned to normal without any fever reducing medications, such as Ibuprofen or Acetaminophen.
• Return to school may occur when:

- A child has not had a fever for at least 24 hours without fever reducing medicines; 

- AND the child's other symptoms are improving;

- AND the child starts to feel better.

Diarrhea:

• If a child has an increased number of stools compared with a child's normal pattern, along with decreased stool form and/or stools that are watery, bloody, or contain mucus, the child needs to stay home. Diarrhea is defined as 2 or more loose stools in a 24 hour period.
• The child needs to stay home until 24 hours after the last episode of diarrhea.
• If diarrhea is due to a known pathogen (norovirus, salmonella, c-diff), follow specific disease exclusion guidelines or until a medical exam indicates that it is not due to a communicable disease. Check with your school nurse.

Vomiting:

• If a child has vomited in the previous 24 hours, the child needs to remain home.
• The child needs to remain home for 24 hours after the last episode of vomiting.
• If fever accompanies vomiting, the child needs to remain fever-free and vomit-free for 24 hours, without the use of antipyretics such as Tylenol or Motrin before returning to school.
• In a school setting, the School Nurse will assess a student. The nurse must decide whether vomiting is or is not the result of a potential illness. 
• If the nurse believes the vomiting episode is the result of a potential contagious illness, the parent/guardian will be notified and the student will be dismissed. The student will need to be picked up as soon as possible. The student may not take the bus or school van home.
• The student will then be required to remain at home for 24 hours after the last vomiting event.
• One episode of vomiting may or may not mean the child must be dismissed from school. Vomiting may be attributed to many factors, including various food-related issues, vigorous exercise, asthma-related symptoms, emotions/anxiety, or medications. 
• If vomiting is NOT due to illness and is not communicable, the family and their clinician will need to discuss how to manage ongoing vomiting. Talk with the School Nurse.
• If the child does not have a fever, feels well, and the nurse determines that the vomiting episode is not likely contagious, the child may return to class. 

Strep Throat or Bacterial Conjunctivitis (Pink Eye) or Illnesses for which primary care providers have diagnosed and prescribed treatment:

• Students must stay home for 24 hours after the first dose of antibiotics.

Respiratory:

• When a child is sick from a respiratory virus, the child may spread germs for about 10 days after symptoms start, even if the child doesn’t have symptoms.
• If a child has new symptoms of a respiratory virus, such as a fever, sore throat, cough or a runny or stuffy nose, the child should stay home.
• If the child does not have fever, does not appear to have decreased activity or any other symptoms, it is not necessary for the child to stay home.
• If the child has any other symptoms then the child needs to stay home.
• Return to school may occur when:
• A child has not had a fever for at least 24 hours without fever reducing medicines; 
• AND the child's other symptoms are improving;
• AND the child starts to feel better.

- While staying home with respiratory symptoms, get tested for Flu and COVID-19. 

- Talk to your healthcare provider about getting treatment if you test positive.

If Testing is Positive for COVID-19 or Flu:

• A child may spread germs for about 10 days after a positive test, even if the child does not have symptoms.

• Stay away from others in the household. 

• Wear a mask around others, even in the same household.

• Wash your hands often with soap and warm water. If soap and water are not available, use hand sanitizer containing at least 60% alcohol.

• Cover mouth when coughing or sneezing.  Use a tissue or inner elbow, not hands. Respiratory hygiene and etiquette should be promoted.

• Clean high-touch surfaces (countertops, handrails, and doorknobs) often.

• A child should stay home even if it is not known what virus is making them sick.

• Return to school may occur when:

• A child has not had a fever for at least 24 hours without fever reducing medicines; 
• AND the child's other symptoms are improving;
• AND the child starts to feel better.

For at least the first 5 days after returning to school after testing positive for COVID or Flu, take these extra precautions:

• Avoid crowded indoor spaces. 
• Wear a mask anytime you are indoors around other people. 
• Wash your hands often with soap and warm water. If soap and water are not available, use hand sanitizer containing at least 60% alcohol.
• Avoid spending time with people who are at increased risk for severe disease.

If you have tested positive for a respiratory virus but do not have any symptoms, you can still spread the virus for at least the first 5 days. Take these extra precautions:

• You can still spread the virus. 
• Take additional precautions to protect others from getting sick.

• Avoid crowded indoor spaces. 
• Wear a mask anytime you are indoors around other people.
• Wash your hands often with soap and warm water. If soap and water are not available, use hand sanitizer containing at least 60% alcohol.
• Avoid spending time with people who are at increased risk for severe disease.
• Although not required, choosing to stay home for about 72 hours may help reduce the chances that you spread the virus to others. 

• Stay away from others in your household. 
• Cover your mouth when you cough or sneeze with a tissue or inner elbow, not hands.
• Clean high-touch surfaces (such as countertops, handrails, and doorknobs) often.
• If you develop any other symptoms of respiratory virus or you get a fever, you should go home. 

Persistent Coughing:

• Could be caused by many illnesses.
• Students experiencing persistent coughing should see their primary care provider and stay home until it is resolved.

You may begin to resume normal activities with some precautions when:

• You have not had a fever for at least 24 hours without the use of fever reducing medicines; AND your symptoms are improving again.
• Take the recommended extra precautions during the next 5 days:
• Avoid crowded indoor spaces.
• Wear a mask indoors around other people.
• Wash your hands often.
• Cover your coughs and sneezes.

If you were exposed to someone with a respiratory virus illness (exposure precautions):

• You do not need to stay home as long as you remain asymptomatic. 
• You may be able to spread a respiratory virus before developing symptoms.
• To protect others, especially those with risk factors for severe illness, take precautions.
• Wash your hands often.
• Consider wearing a mask and avoiding crowded places.
• Monitor yourself for symptoms carefully.
• Stay home if you start to develop any signs of illness. 
• Protect people with risk factors for severe illness from respiratory viruses.