Back-to-school season in Pennsylvania brings more than new teachers and packed lunches. It also brings predictable waves of childhood illness — fevers, coughs, stomach bugs, pink eye, and sore throats.
When your child wakes up sick, the question usually isn’t just what is this? It’s:
Should they stay home?
Do we need a doctor?
Can we start with virtual pediatric care — or is urgent care necessary?
Here’s a practical, parent-friendly guide to help you decide.
When to Keep Your Child Home from School in PA
Every school district has slightly different policies, but the general medical guidance is consistent.
Fever and the 24-Hour Rule
If your child has a temperature of 100.4°F (38°C) or higher, they should stay home.
Most Pennsylvania schools follow the 24-hour rule: children should remain home until they are fever-free for 24 hours without fever-reducing medication.
A mild fever alone isn’t dangerous in most otherwise healthy children. If your child is drinking fluids, breathing comfortably, and alert, home care is usually appropriate.
Seek medical guidance if:
- Fever lasts more than 3 days
- Your child develops ear pain, worsening cough, or throat pain
- You’re unsure whether testing is needed
Vomiting and Diarrhea
Stomach viruses spread quickly in classrooms.
Your child should stay home if they have:
- Active vomiting
- Frequent diarrhea
- Signs of dehydration
Most schools recommend being symptom-free for 24 hours before returning.
Signs of dehydration include:
- No urination for 8+ hours
- Dry mouth
- No tears when crying
- Lethargy
If vomiting is mild and your child can keep fluids down, monitoring at home is often enough.
Cough, Fatigue, and “Not Themselves” Days
Coughs and congestion are common during school season. Many children have lingering coughs for 1–2 weeks after a viral illness.
Your child can usually attend school if:
- There is no fever
- Breathing is normal
- They feel well enough to participate
Even without a fever, keep your child home if they:
- Are excessively fatigued
- Cannot comfortably participate
- Have a rash that hasn’t been evaluated
- Simply seem significantly unwell
The goal isn’t perfect attendance — it’s recovery and preventing spread.
When to Start with Virtual Pediatric Care
Many common school-related illnesses can be evaluated safely through virtual pediatric care.
Consider starting virtually if your child has:
- Fever lasting more than 2–3 days
- Ear pain
- Pink eye symptoms
- A sore throat that might be strep
- Persistent cough
- Mild dehydration concerns
Through telehealth, clinicians can:
- Review symptom history
- Assess breathing via video
- Evaluate rashes or eye redness using photos
- Determine whether testing is needed
- Send prescriptions when clinically appropriate
- Provide school documentation when appropriate
In many cases, virtual evaluation helps families determine whether an in-person visit is necessary — avoiding unnecessary urgent care trips during peak illness season.
When Pediatric Urgent Care Is Necessary
While most school illnesses are mild, certain symptoms require in-person evaluation.
Seek urgent care if your child has:
- Difficulty breathing or labored breathing
- Signs of severe dehydration
- Persistent high fever in infants under 3 months
- Severe headache with neck stiffness
- Extreme lethargy or confusion
- Severe abdominal pain
If you are ever unsure, starting with medical guidance — even virtually — can help clarify next steps.
Common School Illnesses in Pennsylvania
Each fall and winter, Pennsylvania families typically see a predictable mix of viruses and infections.
- Colds and Flu. Most are viral and improve with rest, fluids, and time. Flu symptoms tend to be more abrupt and severe than common colds.
- Stomach Viruses. Often cause vomiting and diarrhea for 1–3 days. Hydration is the main priority.
- Pink Eye. May be viral or bacterial. Thick discharge or eyelids stuck shut often warrant evaluation.
- Strep Throat. More common in school-aged children than toddlers. Fever, swollen glands, and absence of cough raise suspicion.
Most of these conditions can be initially evaluated through virtual pediatric care. Testing or in-person evaluation may be recommended when needed.
FAQs About School Sick Days in Pennsylvania
How long should my child stay home after a fever?
Children should be fever-free for 24 hours without medication before returning to school.
Can a virtual pediatrician prescribe medication?
Yes — when clinically appropriate, prescriptions can be sent directly to your local pharmacy.
Is telehealth appropriate for school illnesses?
Many common illnesses — including pink eye, ear pain, mild respiratory symptoms, and sore throats — can be evaluated virtually. You’ll be advised if in-person care is needed.
When should I go straight to urgent care?
Go directly to urgent care for breathing distress, severe dehydration, extreme lethargy, or concerning symptoms in young infants.
The Bottom Line for Pennsylvania Parents
School illness is inevitable — confusion doesn’t have to be.
Most childhood illnesses are mild and resolve with supportive care at home.
Some require medical evaluation.
A few require urgent in-person care.
Knowing when to keep your child home, when to monitor, and when to seek guidance can reduce stress and unnecessary trips to urgent care.
When in doubt, early evaluation — whether at home or through virtual pediatric care — helps ensure your child receives the right level of care at the right time.
