Tag: contagious

Mask Exemptions for Kids During the COVID-19 Pandemic

If your child doesn’t want to wear a face mask, your pediatric provider might be able to offer more help than just an exemption.

Some parents who don’t want their kids to wear a mask at school might think about asking their pediatrician to write a mask exemption for their kids.

You can easily spread what you don't know you have... Remember, you can be contagious a few days before you have symptoms of COVID-19, which is why mask exemptions for kids aren't a good idea unless they are medically necessary. #BeInformed
You can easily spread what you don’t know you have… Remember, you can be contagious a few days before you have symptoms of COVID-19, which is why mask exemptions for kids aren’t a good idea unless they are medically necessary. #BeInformed

Before they do, they might understand that there are very few real medical reasons for these types of exemptions for wearing a mask.

Masks Control the Spread of SARS-CoV-2

More and more, we are learning that masks can help prevent the spread of SARS-CoV-2, the virus that causes COVID-19, protecting both the person wearing the mask and the people around them.

“The prevention benefit of masking is derived from the combination of source control and personal protection for the mask wearer. The relationship between source control and personal protection is likely complementary and possibly synergistic, so that individual benefit increases with increasing community mask use.”

Scientific Brief: Community Use of Cloth Masks to Control the Spread of SARS-CoV-2

Still, that doesn’t mean that everyone has gotten used to wearing them…

Hopefully, most folks do now understand why they are important though.

Wait, why are they important, especially if you are healthy and the people around you don’t have COVID-19?

Mostly it is because people with COVID-19 can be contagious:

  • up to two days before they start to show symptoms
  • up to two days before they test positive, even if they don’t have any symptoms

So if you are waiting to put on a mask until people around you have symptoms, then you will eventually get exposed, probably without even knowing it, and you might get sick, ending up in isolation, not being able to go to school or work.

And if you wait to put on a mask until you start to show symptoms, then you will likely eventually expose other people to the SARS-CoV-2 virus.

The alternative, if you want to reduce your risk of getting sick, is to just wear a mask any time that you can’t social distance (stay at least six feet apart) from other people.

Mask Exemptions for Kids During the COVID-19 Pandemic

So what are the medical reasons that kids, like adults, can’t wear a mask all day while they are at school?

“The Department supports actions by the airline industry to have procedures in place requiring passengers to wear masks in accordance with the CDC Order, CDC guidance, and TSA SD. At the same time, the ACAA and Part 382, which are enforced by OACP, require airlines to make reasonable accommodations, based on individualized assessments, for passengers with disabilities who are unable to wear or safely wear a mask due to their disability.”

Notice of Enforcement Policy: Accommodation by Carriers of Persons With Disabilities Who Are Unable to Wear Or Safely Wear Masks While On Commercial Aircraft

In general, a child over age two years should wear a face mask unless:

  • they have a physical or intellectual condition that would keep them from being able to remove their face mask by themselves
  • they can’t tolerate wearing a face mask because they have a condition such as autism spectrum disorder, intellectual disability, or a mental health disorder
  • they have a physical or intellectual condition and wearing a cloth face mask gets in the way of their ability to communicate

But shouldn’t these kids just do virtual school if they can’t wear a mask, instead of getting an exemption?

While that might be an option for some kids, others need the extra services that they get at school, which they can’t get with at home schooling.

In addition to a face mask exemption, some things that might work in some situations when a child won’t wear a mask include:

  • a face shield
  • a transparent face mask
  • using different fabrics for the mask
  • trying a bandana or gaiter
  • try to desensitize your child to wearing a mask

What about asthma?

In general, most kids with well controlled asthma should be able to wear a face mask. If your child’s asthma is so severe that it is made worse by wearing a face mask, then they likely need an evaluation by a pulmonologist and it might be best to avoid being around others during the pandemic.

If your child can wear a face mask, but just doesn’t want to, then it might help to allow them to pick their own mask, with a comfortable fabric and fit, maybe even getting a mask with a favorite character on it.

“Model it! Make it familiar by wearing a mask too.”

Getting Your Child to Wear a Mask

And don’t expect your child to want to wear a mask at school if you don’t wear a mask when you go out or if you don’t believe that wearing a mask is necessary.

More on Mask Exemptions

How Can You End Your COVID-19 Quarantine Early?

There are now many options to end your COVID quarantine early.

Breaking News – new CDC guidelines offer even more options to end your COVID quarantine early. (see below)

No one likes the idea of spending fourteen days in quarantine after being exposed to someone with COVID…

A quick reminder that close contacts of someone with COVID-19 need to quarantine for 14 days.
The original recommendations stated that close contacts of someone with COVID-19 need to quarantine for 14 days.

But that’s better than getting sick and exposing others to COVID, right?

Can You End Your COVID-19 Quarantine Early?

Does spending less time in quarantine sound better?

What if you just get a COVID test?

Unfortunately, if you have a negative COVID-19 test early in your quarantine period, it doesn’t mean that you can’t develop symptoms or test positive later on.

“If you are tested and the test is negative, do you still have to be quarantined?
Yes. Someone exposed to a person with COVID-19 needs a 14-day quarantine regardless of test results. This is because COVID-19 can develop between two and 14 days after an exposure.”

Coronavirus Questions and Answers

Testing negative early doesn’t get you out of quarantine.

A negative test simply means that you don’t have an active infection. It doesn’t mean that the SARS-CoV-2 virus isn’t still incubating inside you. And no, we can’t test for that.

So why get tested?

“If you do not have symptoms, it is best to get tested between 5-7 days after you’ve been in a high-risk situation.  If your test is negative, get tested again around 12 days after the event. It can take 2-14 days for COVID-19 to develop, so even if you test negative once, you could still develop COVID-19 later and spread it unknowingly.”

Symptoms and Testing: COVID-19

Getting tested can be helpful because some people can test positive even if they don’t have symptoms, they can still be contagious, and this can help with contact tracing and can help you warn others that you exposed them to COVID-19.

Ideally, since you are in quarantine, you would not have exposed anyone else though…

And if you test positive?

Well, technically that does get you out of quarantine, but only to move you to a period of isolation, which is basically a stricter form of quarantine and lasts at least 10 days.

New Options to End COVID Quarantine Early

And although it is not without risk, the CDC has suggested several alternatives to the traditional 14 quarantine after being exposed to someone with COVID-19.

This includes ending quarantine after day 7 if you have tested negative within 48 hours and you have no symptoms, understanding that you will have to continue to wear a mask, monitor yourself for symptoms each day, and that this strategy has a 5-12% risk of failure (you might still develop COVID-19).

“Persons can continue to be quarantined for 14 days without testing per existing recommendations. This option maximally reduces risk of post-quarantine transmission risk and is the strategy with the greatest collective experience at present.”

Options to Reduce Quarantine for Contacts of Persons with SARS-CoV-2 Infection Using Symptom Monitoring and Diagnostic Testing

Or even ending quarantine after day 10 without testing if you have no symptoms, understanding that you will have to continue to wear a mask and monitor yourself for symptoms each day, and be aware that this strategy has a 1-10% risk of failure (you might still develop COVID-19).

The Latest Options to End COVID Quarantine Early

The CDC has now offered guidelines to end quarantine even earlier than 7 days!

How?

Most people are thought to be most contagious in the 1-2 days prior to onset of COVID symptoms and the 2-3 days after, which allows for guidelines to end COVID quarantine early.
Most people are thought to be most contagious in the 1-2 days prior to onset of COVID symptoms and the 2-3 days after, which allows for guidelines to end COVID quarantine early.

Even if you are not fully vaccinated and boosted, after 5 days, you might be able to end your quarantine, as long as you continue to wear a mask for an additional 5 days. And of course, get tested if you do develop any symptoms of COVID.

And remember that 14 days of quarantine is still the safest option. While convenient, shorting quarantine periods do come with some risk that these folks will develop COVID after they leave quarantine.

Most importantly, understand that you don’t have to quarantine after an exposure if you are fully vaccinated and boosted!

More on Testing out of Quarantine

How Long Are You Contagious When You Have COVID-19?

There are strict rules that dictate how long you are contagious and when you are most contagious when you have COVID-19.

Why is it so important to know how long you are contagious when you have COVID-19?

There are strict rules that dictate how long you are contagious when you have COVID-19.
There are strict rules that dictate how long you are contagious and when you are most contagious when you have COVID-19.

Of course, it is so that you don’t expose anyone else and get them sick too!

How Long Are You Contagious When You Have COVID-19?

Fortunately, knowing how long you are contagious when you have COVID-19 isn’t as confusing as it might seem.

Those people with severe symptoms or a severely weakened immune system might be contagious for a much longer period of time though, up to 20 days.
Those people with severe symptoms or a severely weakened immune system might be contagious for a much longer period of time though, up to 20 days.

In general, you are contagious until 10 days have passed since your symptoms first appeared, as long as you are free of fever and your other symptoms are improving.

But what if you never had any symptoms of COVID-19?

“If you continue to have no symptoms, you can be with others after 10 days have passed since you had a positive viral test for COVID-19.”

When You Can be Around Others

If you had a positive COVID-19 test, but no symptoms, then you will continue to be contagious until 10 days after the test.

“Given what we currently know about COVID-19 and the Omicron variant, CDC is shortening the recommended time for isolation for the public. People with COVID-19 should isolate for 5 days and if they are asymptomatic or their symptoms are resolving (without fever for 24 hours), follow that by 5 days of wearing a mask when around others to minimize the risk of infecting people they encounter. The change is motivated by science demonstrating that the majority of SARS-CoV-2 transmission occurs early in the course of illness, generally in the 1-2 days prior to onset of symptoms and the 2-3 days after.”

CDC Updates and Shortens Recommended Isolation and Quarantine Period for General Population

You are most contagious at the beginning of your infection though.

That’s why we have new guidelines to help shorten quarantine and isolation periods.

Other things you should understand about COVID-19 include that:

  • although you are generally contagious for 10 days after your symptoms start or you had a positive test, you can be contagious even earlier, up to two days before you develop symptoms (presymptomatic transmission)
  • you are most contagious in the first days when your COVID-19 symptoms start when viral load peaks
  • it is possible that you could continue to test positive for up to three months, even though you are out of the range of time when you are considered contagious (viral load is too low to cause disease), which is why most experts don’t recommend retesting after someone is diagnosed with COVID-19, especially as a method to figure out when to end home isolation
  • you should start making COVID-19 antibodies within 5-10 days of getting sick, which is thought to make you less contagious
  • while you are likely contagious for at least 10 days (how long you should stay in full isolation) when you are sick with COVID-19, if on the other hand, you are exposed to someone with COVID-19, you need to quarantine for 14 days – that’s the full incubation period for COVID-19 – how long it might take to develop symptoms after being exposed

Don’t want to deal with any of this?

Wear a mask, practice social distancing, wash your hands, and get vaccinated and boosted, etc., and work to avoid getting COVID-19!

More on COVID-19

Why Are Social Distancing Kids Still Getting Sick?

Why are some kids still getting sick if they are have been our of school and stuck in the house for weeks because of COVID-19?

COVID-19 has kept most kids out of school for some time now. Many are also out of daycare. And few are out playing with friends.

So why are some still getting sick? What else is going on with kids stuck at home while we are all social distancing to flatten the curve.

Why Are Social Distancing Kids Still Getting Sick?

The first thought of some parents and pediatric providers upon reading this might be, wait, what, kids are still getting sick?

Flu activity is low in most of the United States.
Flu activity is low in most of the United States.

And that’s because it does seem that in addition to flattening the COVID-19 curve, staying home from school and daycare, washing hands, and general social distancing techniques has worked to keeps from getting sick with the flu and most other contagious diseases!

So while pediatric providers are available to do telemedicine appointments, it certainly isn’t business as usual, even as their days have gotten quite unusual.

Some kids are still getting sick though, and while we know what you are thinking, most probably don’t have COVID-19.

Why?

It might be because:

  1. they aren’t social distancing as well as they think they are, keeping in mind that with many diseases, people can be contagious for a few days before they show symptoms and you can sometimes catch germs from touching fomites, or objects that a sick person has recently touched. That still doesn’t mean that they have COVID-19 though. If they have contact with others, they could catch almost anything.
  2. they caught something from someone who had a disease a few weeks or months ago and is still shedding. For example, some infants can shed RSV for as long as 4 weeks after they get better. And they can shed the virus that causes hand, foot and mouth disease (HFMD) for almost two months! Human parainfluenza viruses (HPIV), a common cause of colds and croup (seal bark cough), can also shed for many months.
  3. they caught something from someone who had a viral disease that causes a lifelong latent infection with periodic reactivation and shedding. Wait, what? While herpes (cold sores) is the main disease you might think of as causing a lifelong latent infection, there are others. You may not realize this, but after getting roseola (causes a high fever for a few days, followed by a rash after the fever breaks), HHV-6 (human herpes virus-6) kind of does the same thing. The big difference is that while you shed HHV-6 in your saliva from time to time, you don’t have any symptoms. You can get other folks sick though, especially older infants, once they lose the passive immunity they got from maternal antibodies.
  4. they have a sore throat caused by a virus, allergies, or reflux, but have tonsil stones and a positive strep test because they are a strep carrier. Nearly 20% of kids are thought to be carriers of strep, which means that every time they get tested, they will be positive, whether or not they actually have strep throat. That means that you don’t have to worry about testing the dog to see if they are carrying strep…
  5. they were exposed to a disease with a long incubation period. While the incubation period (the time between getting exposed to something to when you get sick) is just a few days for many diseases, it can be several weeks or months for others. In fact, your child might not get sick until 30 to 50 days after being exposed to someone with mono!
  6. they had a virus a few weeks ago and now have Gianotti Crosti syndrome (GCS), a post-viral rash on a child’s legs, arms, and buttocks. Although GCS might linger for weeks or months, it eventually goes away on its own. Another rash, this one likely caused by reactivation of the virus that causes roseola, might have you thinking your child is covered in ringworm (how would they get that if they haven’t left the house??). Instead, they likely have pityriasis rosea.
  7. their symptoms are caused by a non-contagious infectious disease that is spread from an animal or insect and not from another person – think Lyme disease (ticks), Cat scratch disease (cats), and West Nile virus (mosquitoes), etc.
  8. they got sick (bacteria, virus, or parasite) from contaminated lake or well water, which can cause diarrhea – giardiasis, Crypto, shigellosis, norovirus,
  9. they got sick (bacteria, virus, or parasite) from eating raw or contaminated food – giardiasis, shigellosis, norovirus, E. coli, salmonellosis
  10. their symptoms are caused by a non-infectious disease, which could be anything from allergies and asthma to poison ivy or herpes zoster (shingles).

It is also possible that their symptoms are being caused by anxiety, fear, and stress, which is not unexpected as they see schools closed, people getting sick and wearing masks, and are likely unsure about what’s coming next.

Has your child been sick recently?

Do you have a pet turtle or chickens in your backyard? They could be a source for Salmonella…

Do you understand why now?

Now call your pediatric provider if you have questions and need help getting them well, especially if they seem anxious or have extra stress from being home all of the time and away from school and their friends.

You especially want to call if you think that they might actually have COVID-19. While most kids have mild symptoms or are asymptomatic, if your child has a fever, cough, and difficulty breathing, you should call your pediatric provider or seek medical attention.

More on Covid-19 Kids Getting Sick

How Long Are You Contagious When You Have the Flu?

Although your child may be contagious with the flu for up to a week, your child only has to stay home from school or day care until they are feeling better and are fever free for at least 24 hours.

Do your kids have the flu?

When their kids have the flu, one of the first questions most parents have, after all of the ones about how they can get them better as quickly as possible, is how long will they be contagious?

How Long Is the Flu Contagious?

Technically, when you have the flu, you are contagious for about a week after becoming sick.

And you become sick about one to four days after being exposed to someone else with the flu – that’s the incubation period.

“Most experts believe that flu viruses spread mainly by droplets made when people with flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby. Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching their own mouth, eyes or possibly their nose.”

CDC on Information for Schools

That’s why the flu spreads so easily and it is hard to control flu outbreaks and epidemics once they begin.

Most school closures are not to prevent the spread of the flu and clean the school, but simply because so many kids and staff are already out sick.
Most school closures are not to prevent the spread of the flu and clean the school, but simply because so many kids and staff are already out sick.

Another reason it spreads so easily is that most people are contagious the day before they even begin to develop flu symptoms!

And again, they then remain contagious for another five to seven days.

When Can You Return to School with the Flu?

Does that mean kids with the flu have to stay home for at least seven days?

Not usually, unless they have a fever for that long, or severe flu symptoms, which is definitely a possibility for some kids with the flu.

“Those who get flu-like symptoms at school should go home and stay home until at least 24 hours after they no longer have a fever or signs of a fever without the use of fever-reducing medicine.”

CDC on Information for Schools

In general, as with many other childhood illnesses, you can return to school or daycare once your child is feeling better and is fever free for at least 24 hours.

Keep in mind that even if they don’t have a fever, if your child still isn’t feeling well and isn’t going to be able to participate in typical activities, then they should probably still stay home.

But Are They Still Contagious?

Many childhood diseases have contagious periods that are far longer than most folks imagine. That’s because we continue to shed viral particles even as we are getting better, and sometimes, even once we no longer have symptoms.

Teach your kids proper cough etiquette to help keep cold and flu germs from spreading.
Teach your kids proper cough etiquette to help keep cold and flu germs from spreading.

For example, some infants with rotavirus are contagious for up to 10 days and some with RSV are contagious for as long as 4 weeks!

Like the child with flu that doesn’t have a fever, that doesn’t mean that these kids have to stay out of school or daycare for that whole time. But since they are still contagious, it does raise the issue of what to do about non-essential activities.

Should you keep going to playdates after your child had the flu? How about the daycare at church or the gym?

In general, you should probably avoid non-essential activities while your kids are still recovering from an illness, even if they feel better, because they are likely still contagious.

Most parents have the expectation that their own kids won’t be exposed to someone who is sick in these settings.

So you probably don’t want to bring your sick kid to a playdate or birthday party, etc., even if he is already back in school or daycare.

And whether they have a cold or the flu or another illness, teach your kids to decrease their chances of getting sick by washing their hands properly, not sharing drinks (bring a water bottle to school), and properly covering their own coughs and sneezes. They should also learn to avoid putting things in the mouth (fingers or their pencil, etc.) or rubbing their eyes, as that helps germs that could have made their way onto their hands get into their body and make them sick.

What to Know About Staying Home When You Have the Flu

Although your child may be contagious with the flu for up to a week, your child only has to stay home from school or day care until they are feeling better and are fever free for at least 24 hours.

More About Staying Home When You Have the Flu

 

Incubation Periods of Childhood Diseases

The incubation period or latency period is the amount of time between being exposed to a contagious disease and when you begin developing symptoms.

The incubation period or latency period is the amount of time between being exposed to a contagious disease and when you begin developing symptoms.

This is not the same as the contagious period or the time during which your child can get others sick.

Incubation Period

Depending on the disease, the incubation period can be just a few hours or can last for several months. Knowing the incubation period for a disease can help you understand if your child is still at risk of getting sick or if he is in the clear — whether he is exposed to someone with strep throat, measles, or the flu.

“The incubation period is the time from exposure to the causative agent until the first symptoms develop and is characteristic for each disease agent.”

CDC

It can also help you figure out where and when your child got sick. For example, if your infant develops chickenpox, a vaccine-preventable disease, you can’t blame it on your cousin who doesn’t vaccinate her kids and who was visiting just three days ago. The incubation period for chickenpox is at least 10 to 21 days. So your child who is too young to be vaccinated likely caught chicken pox from someone he was exposed to a few weeks ago.

As we saw in recent outbreaks of Ebola and measles, a diseases incubation period can also help you figure out how long an exposed person needs to stay in quarantine. After all, if they don’t get sick once the incubation period is over, then they likely won’t get sick and can be released from quarantine.

Incubation Periods of Childhood Diseases

The incubation period for some common diseases includes:

  • Adenovirus – 2 to 14 days, leading to a sore throat, fever, and pink eye
  • vomiting after exposure to Bacillus cereus, a type of food poisoning – 30 minutes to 6 hours (short incubation period
  • Clostridium tetani (Tetanus) – 3 to 21 days
  • Chickenpox – 10 to 21 days
  • Epstein-Barr Virus Infections (Infectious Mononucleosis) – 30 to 50 days (long incubation period)
  • E. coli – 10 hours to 6 days (short incubation period)
  • E. coli O157:H7 – 1 to 8 days
  • Fifth disease – 4 to 21 days, with the classic ‘slapped cheek’ rash
  • Group A streptococcal (GAS) infection (strep throat) – 2 to 5 days
  • Group A streptococcal (GAS) infection (impetigo) – 7 to 10 days
  • Head lice (time for eggs to hatch) – 7 to 12 days
  • Herpes (cold sores) – 2 to 14 days
  • HIV – less than 1 year to over 15 years
  • Influenza (flu) – 1 to 4 days
  • Listeria monocytogenes (Listeriosis) – 1 day to 3 weeks, but can be as long as 2 months (long incubation period)
  • Measles – 7 to 18 days
  • Molluscum contagiosum – 2 weeks to 6 months (long incubation period)
  • Mycobacterium tuberculosis (TB) – 2 to 10 weeks (long incubation period)
  • Mycoplasma penumoniae (walking pneumonia) – 1 to 4 weeks
  • Norovirus ( the ‘cruise ship’ diarrhea virus) – 12 to 48 hours
  • Pinworms – 1 to 2 months
  • Rabies – 4 to 6 weeks, but can last years (very long incubation period)
  • Respiratory Syncytial Virus (RSV) – 2 to 8 days
  • Rhinovirus (common cold) – 2 to 3 days, but may be up to 7 days
  • Roseola – about 9 to 10 days, leading to a few days of fever and then the classic rash once the fever breaks
  • Rotavirus – 1 to 3 days
  • gastrointestinal symptoms (diarrhea and vomiting) after exposure to Salmonella – 6 to 72 hours
  • Scabies – 4 to 6 weeks
  • Staphylococcus aureus – varies
  • Streptococcus pneumoniae (can cause pneumonia, meningitis, ear infections, and sinus infection, setc.) – 1 to 3 days
  • Whooping cough (pertussis) – 5 to 21 days

Knowing the incubation period of an illness isn’t always as helpful as it seems, though, as kids often have multiple exposures when kids around them are sick, especially if they are in school or daycare.

Conditions with long incubation periods can also fool you, as you might suspect a recent exposure, but it was really someone your child was around months ago.

More About Incubation Periods

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