Health Office

A school nurse or program director might exclude a LABBB student from school or school-related activities for health reasons if that student has returned from a hospital visit— including an emergency room visit that did not result in hospital admission—without the required documentation unless that visit was for routine lab tests. Students may also be excluded during the infectious period of a variety of communicable diseases or for the following:

• A fever greater than 100°F unless that student has a documented temperature regulation issue and is otherwise asymptomatic. The student’s temperature must be below 100°F for 72 hours, without the use of medication, before returning to school.
• COVID-like symptoms or a known COVID exposure.
• Strep throat. Students may return to school 24 hours after beginning antibiotic therapy.
• Pending culture labs. (Exceptions can be made at the discretion of the school nurse.)
• Respiratory precautions due to a significant change in their respiratory status.
• Chickenpox or shingles with an active rash. All dry, non-weeping shingles rashes must be covered before returning to school.
• Significant seizure activity.
• Excessive sleepiness.
• Excessive bleeding, especially after a dental visit.
• Persistent vomiting or diarrhea. Students must be symptom-free for 24 hours before returning to school.
• A condition, like a broken bone, that requires immediate medical attention.
• A condition that requires ongoing medical supervision that cannot be provided in the school setting.
• Posing a significant health risk to the general school population. For example:
  • students in the infectious stage of an airborne illness or disease;
  • students unable to manage their bowel and bladder functions who are in the infectious stage of an oral-fecal transmitted disease such as Hepatitis A, Rotavirus, Giardia, Salmonella, or parasites;
  • or students with a disease that can be transmitted through body fluids whose developmental level makes it difficult for them not to touch lesions. Examples of such diseases include herpes, impetigo, hepatitis B, staph, strep, and conjunctivitis.

On March 22, 2024 the Massachusetts Department of Public Health released updated
guidelines for COVID and other respiratory illnesses to reflect the previously released CDC
guidance for respiratory viruses. Instead of guidance specific to testing positive for COVID, this
updated information is for respiratory infections like Influenza, Pneumonia, RSV, and COVID as
they share similar transmission methods, symptoms, and prevention strategies.

There is no longer the requirement to stay home for five days if you test positive for COVID.

If a student or staff member feels sick (sore throat, runny nose, fever, chills, fatigue, cough,
headache, nausea, vomiting, etc.), consider testing for COVID and/or visiting a healthcare
provider. A physician’s office can test for many respiratory illnesses including COVID and
provide treatments for viruses/bacterial infections.

Students or staff members who test positive for COVID or any other any respiratory illness
should stay away from others and remain at home to recover. They can return to school when
they meet both the following criteria:

• Improved symptoms for at least 24 hours and
• No fever for at least 24 hours and are not using fever-reducing medications like
  Tylenol and Motrin.

When a student or staff member returns to school, the CDC recommends they take
added precautions over the next five days. Some recommendations for school are:

• Practice good respiratory hygiene:
  • Wash hands with soap and water or use hand sanitizer frequently.
  • Sneeze into the crook of the elbow or a tissue.
  • Clean high touch surfaces regularly.
• Wear a well-fitting mask except when actively eating, drinking, or outside.
• Keep distance from others, especially the elderly and those who are
  immunocompromised.

If a student or staff member tests positive for a respiratory infection, including COVID, but
does not have any symptoms, they:

1. May attend school.
2. May be at risk for spreading the infection to others. They are strongly encouraged to
   wear a mask for five days from symptoms onset or the positive test date and follow the
   prevention strategies listed above.

If the student or staff member was exposed to someone with a respiratory infection:
They do not need to stay home if they don’t have symptoms. To protect high-risk individuals,
consider having student or staff member wear a mask for five days. If symptoms appear, they
should stay home and test.

For more detailed information:

• MA DPH Respiratory Virus Guidance Update
• Respiratory Virus Guidance Update FAQs