Coordinated School Health
Health-Related Conditions

Minor Illness at school

School staff or School Nurse will notify Parent/Guardian and arrange for children to go home when a student has the following symptoms:
o Oral temperature above 101 with behavior change or other signs of illness: nausea, vomiting, diarrhea (frequent loose or watery stools), abdominal pain, severe headache, muscle aches, sore throat. (CHILD SHOULD REMAIN AT HOME UNTIL FEVER FREE FOR TWENTY-FOUR HOURS).
o Child appears severely ill (e.g., lethargic, lack of responsiveness, irritability, persistent crying, difficult breathing, or has a quickly spreading rash). Call 911 for emergent conditions.
o Vomiting 2 or more times in the previous twenty-four hours unless vomiting is determined to be caused by a non-communicable condition.
o Diarrhea that exceeds 2 or more stools above normal for that child.
  • School Nurse or School staff will notify Parent/Guardian when students appear ill but do not require exclusion (Examples: an oral temperature of 100 or above, abdominal pain, headache or sore throat).
  • School staff will educate students in the prevention of disease spread through personal hygiene measures.
  • Principals will ensure that supplies needed for proper hand washing (soap, paper towels) are maintained in all restrooms and other hand washing areas.

Head lice

The American Academy of Pediatrics recognizes that it is unlikely that all head lice infestations can be prevented, because young children come into head-to-head contact with each other frequently. It is prudent for children to be taught not to share personal items such as combs, brushes and hats; but one should not refuse to wear protective headgear because of fear of head lice. In environments where children are together, infested children should be treated promptly to minimize the spread to others. Regular surveillance by Parent/Guardian is one way to detect and treat early infestations, thereby preventing the spread to others.
 The American Academy of Pediatrics (Volume 135, number 5, May 2015) and the National Association of School Nurses (Head Lice Management in the School Setting Position Statement) recommend against excluding children for live lice or nits. Because a child with an active head lice infestation likely has had the infestation for 1 month or more by the time it is discovered and poses little risk to others from the infestation, the child should remain in class, but be discouraged from close direct head contact with others. Parent/Guardian of the child should be notified on the day of discovery that prompt treatment is in the best interest of the child.
  • Students should be taught not to share personal items like combs, brushes, ribbons, hats and avoid direct head-to-head contact.
  • The best way to interrupt a chronic lice problem is by regular checks by Parent/Guardian and early treatment with a safe, affordable, over-the-counter pediculicides.
  • Students with a confirmed case of head lice should be treated at once. Never initiate treatment unless there is a clear diagnosis with living lice.
  • Choose one of the non-prescription treatments on the market. Follow directions carefully. Many products require follow-up treatment in 7-10 days.
  • Following treatment, the eggs or nits should be removed from the hair. Complete nit removal either by hand or with a fine-tooth comb is the most important step in resolving this problem.
  • Regular nit checks are recommended for up to a month.
  • Examine all persons in the household for the presence of head lice. If lice or eggs are detected, all infested persons need to undergo treatment.
  • Washing, soaking, or drying items at temperatures greater than 130°F will kill stray lice or nits. Clothing (hats, coats, scarves, etc), bedding, linens, towels should be washed in hot water. Vacuuming carpeting, upholstery, and mattresses is suggested. (Follow treatment recommendations on labels regarding clothing, etc).
  • Upon return to school, send a note with the student stating that treatment was completed. Provide the name of the product used.
  • To minimize the disruption to learning, class-wide screenings are not recommended
  • Class notification only occurs if multiple cases are identified.


Asthma is the number one chronic disease among students in Charlotte-Mecklenburg Schools.  Over 14,000 CMS students have been identified with asthma. 
Asthma also is one of the leading causes of school absenteeism. In an average classroom 30 students 3 students may have asthma. Several students with asthma may go undiagnosed or unidentified.
If asthma symptoms are uncontrolled, students with asthma may:               
  • Lose sleep because of coughing at night and then be tired the next day at school. 
  • Have a hard time in school or physical activities
  • Avoid physical activity, fearing that it may trigger an asthma attack
  • Avoid taking their asthma medication because they do not want to be seen as "different."
  • Express feelings of embarrassment, frustration and isolation.

If your child has asthma, it is very important to tell your child's school nurse, teacher, coach, and caregivers. 

Please contact any CMS school nurse for more information or assistance in managing your child's asthma.

10 Steps to Safety for Kids with Allergies and Asthma

by: Kathleen May, MD (Original Article)
For millions of children with allergies and asthma, fall pollens and molds and exposure to potential allergens and viruses in class can really take a toll. Asthma, which can be triggered by allergies and respiratory illnesses, is the number one reason why students chronically miss school. The American College of Allergy, Asthma and Immunology (ACAAI) suggests the following strategies to help prevent allergy and asthma flare-ups at school. asthma child
  1. Schedule a fall check-up. Visit your allergist to be sure your child’s allergy and asthma symptoms are under control. If you suspect your child is suffering from allergies but have never taken her or him to see an allergist, fall is the perfect time to schedule an appointment to find out what triggers symptoms and develop a plan for treatment.
  2. Share the treatment plan with school staff. School staff, including all adults who supervise your child during the school day, should have a copy of your child’s treatment plan, which should include a list of substances that trigger your child’s allergies or asthma, a list of medications taken by your child, and emergency contact information.
  3. Ward off the flu. Have your child get a seasonal and an H1N1 (swine) flu shot, especially if he or she has asthma. Because asthma, seasonal flu, and H1N1 flu are respiratory diseases, people with asthma may have more frequent and severe asthma attacks when they have the flu.
  4. Tour your child’s school. Visit classrooms, the art studio, the gymnasium, the cafeteria, and other areas where substances that may trigger your child’s asthma or allergies may be present.
  5. Investigate class pets. If your child is allergic to animal dander, ask that class pets that could trigger a reaction, such as hamsters and rabbits, be removed.
  6. Meet with the school nurse, teachers, and coaches. Discuss how they can help in control your child’s symptoms. Signs of irritability or an inability to concentrate may be subtle signs that your child is having asthma or allergy symptoms. Ask school staff to identify when and where your children’s symptoms worsen, so you can work with your doctor to adjust the treatment plan accordingly.
  7. Discuss how to handle emergencies. With an allergist’s written recommendation, children should be permitted to keep inhaled medications with them at school; most states have laws protecting this right. Children who are at risk for a life-threatening allergic reaction (anaphylaxis) caused by allergies to certain foods or insect stings also should carry an epinephrine kit. Be sure that your child and school staff know how to use emergency medications and complete a permission form that allows school staff to administer medications, if needed.
  8. Make sure your child understands what triggers allergies or asthma. Discuss steps to avoid triggers while at school, such as sitting far from the blackboard if chalk dust triggers asthma.
  9. Discuss risks of physical activity. Work with coaches, recess monitors, physical education teachers, and PTA leaders who handle after-school sports programs so they recognize the major signs and symptoms of asthma, such as coughing, wheezing, and shortness of breath.
  10. Share food allergy information. Share a list of the foods your child is allergic to and safe alternatives with teachers, lunch attendants, the school nurse, and class volunteers. Don’t forget to alert your PTA leaders as well; food is often available at after-school activities.


Meningitis is an infection of the fluids and covering of the brain or spinal cord that can be caused by bacteria.  While viral meningitis is fairly common, and people usually recover fully, bacterial meningitis is very rare, but much more serious.  Meningitis is spread by close exchange of saliva and respiratory secretions through sharing of drinking glasses, cigarettes or kissing.  Symptoms of bacterial meningitis include severe headache, high fever, nausea/vomiting and stiff neck.  Symptoms can worsen very quickly.  Children with any of these symptoms should be checked by a doctor right away.  A vaccine against bacterial meningitis is available through private physicians and the Mecklenburg County Health Department, and is recommended for children in their early teens. 

Influenza (The Flu)

Influenza (the flu) is a viral infection that can cause illness ranging from mild to severe and to life-threatening complications.  Symptoms of the flu include fever, headache, extreme tiredness, muscle aches, dry cough, sore throat and runny, stuffy nose.  Children sometimes also have nausea, vomiting, or diarrhea.  Flu is spread through respiratory droplets from a cough or sneeze, or from droplets on unwashed hands.  Vaccine against flu is available every year beginning in October through private physicians and at the Mecklenburg County Health Department.  The vaccine is recommended for people at high risk for complications of the flu, (the elderly and those with chronic illnesses, including asthma) and people in close contact with them (this includes household contacts).  When vaccine supplies are in good supply, flu shots are also available for children and adults in the general public.

Human Papillomavirus (HPV)

HPV is a common virus that is spread from one person to another by close intimate contact.  There are about 40 types of HPV that can infect both men and women, and can raise the risk of cervical cancer in women.  The virus lives in the body and usually causes no symptoms, but some people may develop a visible growth or bump.  Most people with HPV do not know they are infected which is why males and females can pass it on without realizing it.  A new vaccine can now protect females (ages 9-26) from four major types of HPV.  For more information about HPV vaccine, check with your physician or the local Health Department.

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