Contagious

How long am I contagious?

Whether the flu, a cold or a stomach bug, you may wonder if you or your kids are contagious and how long everyone should stay home from work or school to prevent an outbreak
April 17, 2019

How long should I stay home after being sick? Often, this question comes with an internal back and forth about whether you—or your children—should stay home or not. Whether a child or an adult, Alison Pittman, PhD, RN, CPN, CNE, clinical assistant professor at the Texas A&M College of Nursing, gives some basic guidelines on how to tell if you should stay home with a short-term, possibly contagious illness.

Am I contagious with a fever?

“People need to be fever free for 24 hours without the help of a fever-reducing medication before they return to work or school,” Pittman said. According to the Texas Department of State Health Services, school nurses are advised to send children home that have a temperature of 100.4 degrees or greater. The same rule of thumb goes for adults too. “You need to stay home if you have had a temperature of 100.4 degrees in the past day.”

A low-grade fever is any temperature above 98.6 degrees but below 100.4 degrees. Pittman says low-grade fevers are a good thing, because your body is actively fighting an infection.

“If you have a low-grade fever, and you feel fine, you can participate in your usual day-to-day activities, but you need to listen to your body.” She recommends if you start to feel achy, begin to sweat or develop a headache, then take your temperature again, then go home. The same recommendation goes for children.

How long am I contagious after the flu? After I take Tamiflu?

The Centers for Disease Control and Prevention (CDC) recommends people with the flu to stay home until 24 hours after they are fever free without the use of a fever-reducing medication. “Depending on your place of work, you may need to check company policy,” Pittman said. “For example, many health care settings require their employees to stay home seven days after the onset of symptoms.”

Pittman notes individuals with the flu can be contagious for up to three weeks after the onset of symptoms. “In many cases, just because you or your children are fever free and can return to work or school does not mean you are no longer contagious. Proper handwashing goes a long way to prevent the spread of germs.”

The same rules apply even if you have taken a flu antiviral drug like Tamiflu. Stay home until you are fever free for 24 hours without the help of a fever-reducing medication.

How long am I contagious after a cold?

“Most people are contagious with a cold a day before they notice symptoms until about a week after the onset of symptoms,” Pittman said. “The CDC’s recommendation is to stay home until you are fever free for 24 hours without the help of a fever reducer.”

Because you are still contagious after the fever subsides, Pittman emphasizes the importance of handwashing and taking extra care to contain your cough or sneeze.

The CDC recommends to call your primary care provider if cold symptoms last longer than 10 days, or if a child younger than three months of age is showing symptoms.

How long am I contagious after starting antibiotics?

“If you are sick with a bacterial infection, then your health care provider may prescribe you antibiotics,” said Pittman. “The likelihood of spreading infection severely decreases 24 hours after you begin antibiotics.” Some common bacterial infections are conjunctivitis or pink eye, strep throat and meningitis.

Viral infections like colds and upper respiratory infections usually need to run its course. Depending on your health care provider’s suggestions, you may take medications to temporarily ease symptoms but your provider will not suggest antibiotics.

Because it can be hard to tell which illness is viral and bacterial, Pittman suggests calling your health care provider for guidance if your symptoms do not start to improve after two to three days.  The long length of symptoms can be a sign you have a bacterial infection, which will need antibiotics.

“You should always seek a healthcare professional if you or your child has symptoms that are severe or unusual, such as shortness of breath or a high temperature, especially in children under six months of age,” said Pittman.

How long am I contagious after a stomach bug?

“Any time you have had diarrhea—regardless how often—or if you vomited twice in the past 24 hours, then you need to stay home,” advised Pittman. “If you vomit two or more times in one day, then that likely means you did not throw up because of something you ate or because you got too hot outside.”

The stomach flu or a stomach bug is often called viral gastroenteritis, and it is highly contagious. It spreads through contact with an infected person’s stool or vomit.

“Some viruses, such as norovirus, can live on surfaces for more than 24 hours, and it spreads very quickly, especially with children,” said Pittman. “If symptoms last more than 24 hours or if you or your children start to feel dehydrated, then call your primary care provider.”

Is my rash contagious?

“If you have a rash, you should always seek a health care provider’s recommendation. Many rashes can be symptoms of contagious illness like meningitis or measles,” said Pittman. “Do not return to work or send your children with rashes to school until your provider gives you the go ahead.”

Rashes can be a symptom for many things like allergic reactions, chicken pox, impetigo, hands foot and mouth, and shingles. Pittman notes if you have a rash in conjunction with a fever that the combination is often a sign of a more serious illness.

How long should I stay home after getting a nuisance disease like lice/ringworm/pinworms?

“People with head lice should not return to school or work until treatment has begun,” Pittman said. “Pinworms and ringworm are also incredibly contagious, especially for children, but they usually do not require someone to miss school or work. Always follow the health policies at your school or workplace.”

Head lice has over-the-counter treatments you may purchase at your local drug store. Ringworm and pinworms typically require a visit to your primary care provider’s office to get the appropriate prescription.

General rules of thumb

“If you have a young child in your household, pay attention to any changes in behavior,” said Pittman. “Behavioral changes are often the very first signs your child is coming down with something.”

If you are still unsure how long you should stay home or keep your children home, then ask your primary care provider. They are available to answer any questions and give you the support and resources you need to help you and your family get better.

— Mary Leigh Meyer

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