What are the guidelines for excusing a student from school due to influenza (flu)?

Guidelines for School Absence Due to Influenza

Students with influenza should stay home from school while ill to prevent disease transmission to others, and should only return to school after fever has resolved for at least 24 hours without fever-reducing medications.

Understanding Influenza and School Attendance

Influenza is a highly contagious acute viral respiratory infection characterized by:

• Abrupt onset of fever
• Cough
• Chills or sweats
• Muscle aches (myalgia)
• Malaise
• Sore throat
• Running nose
• Headache 1

Duration of Illness

• Febrile illness typically lasts for 3-4 days
• Complete resolution of symptoms generally occurs within 7-10 days 1

Official Recommendations for School Absence

The CDC recommends voluntary home isolation of ill persons with influenza-like illness at all times, including during seasonal influenza and pandemics of any severity 2. This is considered a personal non-pharmaceutical intervention (NPI) that helps reduce community transmission.

Key Guidelines for School Absence:

1. Duration of isolation: Students should remain at home while symptomatic
2. Return criteria: Students may return to school when:
   • Fever-free for at least 24 hours without the use of fever-reducing medications
   • Symptoms have improved significantly 2

Rationale for School Absence

• Children have higher influenza attack rates than adults
• Influenza transmission is common in schools 2
• School-aged children are significant vectors for community transmission
• Voluntary home isolation reduces the risk of infection transmission from person to person 1

Writing an Effective School Excuse Note

When writing a school excuse note for influenza, include:

1. Date of examination/diagnosis
2. Diagnosis: Influenza (or influenza-like illness)
3. Recommended absence period: Typically 3-7 days depending on symptom duration
4. Return to school criteria: After being fever-free for 24 hours without fever-reducing medications
5. Healthcare provider information: Name, credentials, and contact information

Special Considerations

High-Risk Students

Students at higher risk for influenza complications include those with:

• Asthma
• Neurological conditions
• Chronic lung disease
• Heart disease
• Weakened immune systems
• Extreme obesity 2

These students may require longer absence periods and closer monitoring before returning to school.

Prevention Measures Upon Return

When returning to school, students should practice:

• Respiratory etiquette (covering coughs and sneezes)
• Hand hygiene
• Avoiding close contact with others if residual symptoms persist 2

Common Pitfalls to Avoid

1. Returning too soon: Sending children back to school while still febrile increases transmission risk
2. Inadequate documentation: Failing to provide clear return criteria in the excuse note
3. Ignoring residual symptoms: Some symptoms may persist after fever resolves, requiring continued precautions

By following these guidelines, you can help reduce influenza transmission in school settings while ensuring appropriate documentation for school absence.