When to Keep Your Child Home From School in Texas

Medically reviewed | Last reviewed: October 10, 2026

In Texas, school attendance matters—but so does helping your child recover and protecting classmates from contagious illness. If your child wakes up feeling unwell, you may be wondering: Should they stay home? Could they spread an infection? Do they need medical care?

Here’s a practical guide to common reasons to keep a child home, Texas’s fever threshold, and how to know when it may be okay to return.

Understanding Texas school exclusion rules

Texas school exclusion and readmission requirements for communicable diseases are addressed by the Texas Department of State Health Services (DSHS) and Texas Administrative Code, Chapter 97. These are not simply recommendations created independently by each school. Districts and child-care centers may also have their own attendance or health policies, so check your school’s handbook for additional requirements.

In general, keep your child home and contact the school nurse or your child’s clinician if your child:

• Has a temperature of 100.0°F (37.8°C) or higher.
• Has had two or more episodes of vomiting or diarrhea within 24 hours.
• Has a red eye with discharge or crusting.
• Has an open skin sore that is draining or producing pus.
• Has an unexplained rash accompanied by fever or other concerning symptoms.
• Feels too unwell to participate comfortably in normal school activities.

The specific exclusion period and return-to-school criteria can depend on the illness. For disease-specific guidance, consult the official DSHS School Communicable Disease Chart, which lists exclusions and readmission criteria for individual conditions.

Fever rules for Texas schools

For Texas school exclusion, the threshold is a temperature of 100.0°F (37.8°C) or higher. A child with a temperature at or above this level should stay home and may not return until they have been fever-free for at least 24 hours without fever-reducing medicine, such as acetaminophen or ibuprofen, and are otherwise well enough to participate.

You may have heard that a fever is 100.4°F (38°C). That is a commonly used clinical definition of fever, but it is higher than the 100.0°F threshold used in Texas school exclusion guidance. For school attendance, follow the Texas threshold and your district’s policy.

Keep your child home if they have a temperature of 100.0°F or higher, appear unusually tired or uncomfortable, or cannot participate normally. Contact a healthcare professional if fever persists for more than three days, your child has worsening symptoms, or you are concerned. A baby younger than 3 months with a temperature of 100.4°F (38°C) or higher needs prompt medical evaluation.

Vomiting and diarrhea

Stomach illnesses can spread quickly in classrooms. Texas district guidance commonly identifies two or more episodes of vomiting or diarrhea within 24 hours as reasons for exclusion. A child may also need to stay home if symptoms are ongoing, they cannot keep fluids down, or they are not well enough to participate.

In many school policies, children should be free of vomiting or diarrhea for at least 24 hours before returning, without using medication to suppress those symptoms. Exact requirements can vary by illness and district, so check your school’s rules and the DSHS chart when a specific infection has been diagnosed.

Watch for dehydration, including much less urination than usual, dry mouth, no tears when crying, or unusual sleepiness. Seek medical advice if you are concerned about hydration; severe lethargy, inability to keep fluids down, or other severe symptoms warrant urgent evaluation.

Cough, congestion, and cold symptoms

A mild cough or runny nose does not automatically mean a child must stay home. Your child may be able to attend if they have no fever, are breathing comfortably, have enough energy to take part in the school day, and can manage symptoms without disrupting learning.

Keep your child home if symptoms are severe or worsening, they are too uncomfortable to participate, or they have a fever or other symptoms that meet school exclusion criteria. Seek urgent medical care for difficulty breathing, blue or gray lips, severe dehydration, confusion, or extreme difficulty waking.

Pink eye: redness, discharge, or crusting

A red eye with purulent (pus-like) discharge or crusting is a common reason for school exclusion under Texas district guidance. Pink eye can have different causes, and not every case needs antibiotics. Contact your child’s clinician for advice about evaluation and when your child can return.

Return requirements can depend on the cause of the eye symptoms and the school’s policy. Do not assume that every child must start antibiotics before returning—or that starting treatment automatically means they can return. Check the school handbook and the applicable DSHS guidance.

Rashes and draining skin sores

Keep your child home and seek guidance for an unexplained rash accompanied by fever or other concerning symptoms, or for an open skin sore that is draining or producing pus. Some rashes and skin infections require specific treatment or a defined period away from school. Covering a lesion may not be enough to meet the return criteria.

If the rash spreads quickly, is painful, is associated with significant illness, or you are unsure what is causing it, arrange medical evaluation. Use the DSHS School Communicable Disease Chart for illness-specific exclusion and readmission rules.

Strep throat and sore throat

Symptoms that can occur with strep throat include sore throat, fever, painful swallowing, and swollen neck glands. A clinician may recommend testing when symptoms suggest strep. If strep is diagnosed, children are generally allowed to return after they have been on appropriate antibiotics for at least 12–24 hours (follow the clinician’s instructions and school policy), are fever-free, and feel well enough to participate. The applicable disease-specific rule should be checked rather than relying on a general rule for every sore throat.

When virtual pediatric care may help

For some non-emergency concerns, a virtual pediatric visit can help you decide what to do next. Depending on the symptoms and the limitations of a virtual examination, a clinician may review the history, recommend testing or an in-person assessment, discuss treatment, and provide school documentation when clinically appropriate.

Virtual care may be useful for certain cases of fever, ear pain, sore throat, pink eye, or rash. If an in-person examination or urgent testing is needed, your clinician can help direct you to the appropriate care setting.

Need a note for school? A Poppins visit gets you one.

When to seek urgent medical care

Get urgent medical help if your child has difficulty breathing, signs of severe dehydration, severe or persistent abdominal pain, confusion, extreme lethargy, or rapidly worsening symptoms. A baby younger than 3 months with a temperature of 100.4°F (38°C) or higher needs prompt medical evaluation. Call emergency services for severe breathing problems, unresponsiveness, or another life-threatening emergency.

School absences and documentation

Districts may have rules about when a parent note or healthcare note is required, including after multiple or consecutive absences. Check your district’s attendance policy so you know what documentation is needed. A Poppins clinician can provide a school note when appropriate following a visit; a note does not override school exclusion or readmission requirements.

Frequently asked questions

What temperature means my child should stay home in Texas?

Texas school exclusion guidance uses 100.0°F (37.8°C) or higher. Although 100.4°F (38°C) is a commonly used clinical fever definition, the school threshold is lower. Keep your child home and follow the rule requiring at least 24 hours fever-free without fever-reducing medication before returning, along with any additional school requirements.

Does the 24-hour fever-free period mean my child can return automatically?

Not always. Your child should also feel well enough to participate, and some illnesses have additional exclusion or readmission criteria. Check the DSHS chart and your school’s handbook.

Can my child go to school with a cough or runny nose?

Often, if symptoms are mild, there is no fever, breathing is comfortable, and the child can participate normally. Keep them home if they meet an exclusion criterion or are too unwell to manage the school day.

Does my child need antibiotics before returning?

Only when antibiotics are indicated for a diagnosed or suspected bacterial infection. Return rules depend on the specific illness; antibiotics are not required for most viral colds. Follow the clinician’s instructions and disease-specific school guidance.

Where can I find the official Texas return-to-school rules?

Review the Texas DSHS School Communicable Disease Chart for condition-specific exclusion and readmission criteria. Your district handbook may include additional requirements.

The bottom line for Texas parents

Keep your child home when they have a temperature of 100.0°F or higher, repeated vomiting or diarrhea, red eye with discharge or crusting, a draining skin sore, an unexplained rash with fever, or symptoms that prevent comfortable participation. For fever, wait until your child has been fever-free for at least 24 hours without fever-reducing medicine before returning, and check for any additional illness-specific rules.

When in doubt, contact your school nurse or your child’s healthcare professional. Attendance matters, but protecting your child’s health and the health of classmates comes first.

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