When A Child Is Too Ill To Attend

Children in child care programs are grouped together at the ages when they are most susceptible to infections. To determine what is a significant illness in a child is difficult for both parents and staff. There are important issues in determining when a child is too ill to attend a child care program.  

  1. The protection of other children from communicable disease.
  2. The comfort and safety of the child who is ill.
  3. The capacity of the program staff to look after an ill child.  

With these issues in mind the following guidelines are given:   

  1. Any child too ill to participate in normal activities of the child care facility should be  excluded.
  2. Children with gastrointestinal problems (i.e. vomiting, diarrhea) must be excluded from the program. If vomiting or diarrhea develops while the child is at the child care facility, separate the child from other children immediately and notify the parent to pick up the child. If a cause of the vomiting or diarrhea is identified or if there are 3 or more cases in 4 days or less in the child care facility, notify the licensing officer for further guidance.
  3. Children with upper respiratory infections need not be excluded for the protection of other children. Respiratory viruses are so common and can spread before symptoms start, so it does not make sense to single out for exclusion those who exhibit symptoms.
  4. Children on antibiotics and otherwise well need not be excluded. (No child care facility should require a child to be on antibiotics before returning).
  5. Children with chickenpox should be excluded for 5 days after the onset of the pox rash. They may return even if pox are still present.
  6. In the case of diagnosed communicable disease, the child care facility should advise the Public Health Nurse at the local health unit. For some diseases, like measles, mumps and rubella, children will be excluded. These diseases are rare in Vancouver and require a blood test to diagnose.
  7. Children with chronic symptoms such as persistent cough or persistent fever warrant medical evaluation. Once appropriate medical evaluation is obtained, they need not be excluded from the child care facility unless they fall under the terms of #’s 1, 5, or 6 above.
  8. Whenever a child attending a child care program develops new symptoms of illness (whether mentioned above or not) or has a worsening of symptoms, the parent must be notified. The licensee must provide in the child care facility a quiet and clean resting area for the child and ensure the child is under close supervision until the parent arrives.

Reference: Trumpp C.E., Karasic R: Management of Communicable Disease Centres. Pediatric Annals 12:3, Pages 219-229. 


  • Report any contagious diseases to the Executive Director immediately. This is particularly important when reporting diseases, which may endanger others. Measles, Bacterial Meningitis, Viral Meningitis, Mumps, Pertussis (Whooping Cough) and Rubella are all reportable diseases in British Columbia. Children who are not vaccinated will be excluded from the program if an outbreak occurs.
  • If your child develops a fever or has any gastrointestinal problems (diarrhea and vomiting) you will be called immediately to come and pick up your child. Please keep them at home until they are no longer showing any symptoms.
  • A teacher can administer medicine to your child however, you must complete a Medical Consent Form before any medication can be administered to your child.