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Is My Child Contagious?

We are in full sick mode at my office these days. Most of the visits are reserved for same day sick visits and by 9 a.m., the slots are usually full. The number one question I got in clinic today was, “Is my child contagious?” With family parties and Christmas around the corner, everyone wants to know if they need to stay home.

Signs and Symptoms that indicate your child has a contagious bug/virus.

  1. Cough. Especially during the first few days of the cough. That is the time of most viral shedding and when the cough tends to be the most frequent and productive.
  2. Fever. When a child has fever, usually indicates the time when a virus is replicating the most. That is, the child is the MOST contagious. Certainly stay home during those times (even if the other symptoms haven’t shown up yet—they usually will with time).
  3. Rash. (This is a trick symptom). Some rashes are related to bugs that are contagious and some are not. You should consult your doc about that one. For example, chicken pox, herpes, and hand, foot, and mouth disease are all contagious rashes. Eczema is not a contagious rash.
  4. Red eyes: Most causes of red (or pink) eyes are contagious. Irritation, allergies, and corneal abrasions are all causes of red eyes that aren’t contagious. Be very careful, especially this time of year, to not wrongly chalk up your child’s red eyes to “allergies.”
  5. Runny nose. All that goo pouring out of your child’s nose is swimming in viral particles. When your child wipes his/her nose with his/her hands, then touches something, that is how the bug is spread.
  6. Vomiting and/or diarrhea. Both of these symptoms are usually part of contagious bugs. The great exception is food poisoning (which isn’t contagious). Again, be careful not to chalk up your child’s GI bug to food poisoning if there is a question. No one wants to risk that bug.

Contagious or NOT contagious by specific illness:

  1. Allergies. NOT contagious. The problem is that many people, especially this time of year, falsely attribute viral symptoms to allergies. Keep in mind that allergies don’t cause fever.
  2. Conjunctivitis (pink eye). Generally speaking considered contagious until the white part of the eye is cleared up.
  3. Ear infections. Not contagious. The trick is that ear infections are usually a complication of a illnesses/viruses that are contagious. So look at other symptoms to help guide that specific call (if the cough and runny nose has stopped, you’re probably ok).
  4. Emotional problems (e.g., anxiety, depression, suicidal thoughts). Not considered contagious in the traditional sense. You don’t catch these problems, but a person with any of them may influence those around him/her.
  5. Gastroenteritis (vomit/diarrhea bug). Highly contagious. Worse at the beginning of the bug, but can continue to be contagious even after the original sick person appears to be better. It happens because that infected person can still “viral shed,” even after symptoms are improved.
  6. Influenza (the bad respiratory bug, not the vomit/diarrhea bug) is very contagious. As long as the person has symptoms, he/she is still contagious.
  7. Pneumonia. This is another trick problem. Pneumonia itself is not contagious, since technically speaking it is a complication of something else. The original illness that caused the pneumonia (whether that be a virus or a bacteria) is the contagious element.
  8. Roseola. This bug is contagious until the rash appears. In the first few days with fever and irritability is when the child is contagious. Once the rash appears (although that is when the child looks bad), there is no more concern.
  9. RSV (respiratory syncytial virus). This virus is in full swing now and it is very contagious. While the child has fever, cough, and/or runny nose, there is still risk of spreading it.
  10. Sinusitis. Just like the explanation to pneumonia, sinusitis is a trick question. Sinusitis is a complication of something else. On its own merit, sinusitis isn’t contagious, but the bug that caused it may be.
  11. Strep Throat. Strep throat is highly contagious. However, once a person has been on antibiotics for 24 hours, we generally consider that person no longer contagious.
  12. RSV (respiratory syncytial virus). This virus is in full swing now and it is very contagious. While the child has fever, cough, and/or runny nose, there is still risk of spreading it.
  13. Fever. Generally not contagious. Keep in mind that any fever higher than 101 degrees is not teething (and don’t falsely attribute illness symptoms to “teething.”)
  14. Teething. Not contagious. Keep in mind that any fever greater than 101 is not teething though (and don’t falsely attribute illness symptoms to “teething.”)

In no way is this a comprehensive list, but hopefully it helps guide you in your decision making about whether or not to take your sick kid to the big holiday family party. After all, nothing says “Merry Christmas” quite like, “I brought you the plague.” Hope you have healthy holiday celebrations.