Your child can go back to school once they have gone at least 24 hours with no fever, without any fever medicine, and their symptoms are getting better overall. That is the CDC rule for returning to normal activities after a respiratory illness like the flu. A flu cough can last 2 to 3 weeks, so a lingering cough alone does not have to keep them home if everything else is improving. For the next 5 days after they go back, the CDC advises added precautions like good hygiene.
What does the 24 hour rule mean for my child?
The CDC says a person can go back to normal activities when, for at least 24 hours, both of these are true: their symptoms are improving overall, and they have had no fever without using fever-reducing medicine.
The 24 hours only count once your child is both fever-free and off fever medicine. If you gave Tylenol (acetaminophen) or Motrin (ibuprofen) last night and the fever is gone this morning, the medicine may be hiding it, so that morning does not count toward the 24 hours.
The AAP's symptom guide for parents says the same thing in short form: your child can return to school after the fever is gone for 24 hours. The AAP says flu fever usually lasts 2 to 3 days.
- Not yet: fever in the last 24 hours, or the fever only stays down with medicine
- Not yet: no fever, but symptoms are not getting better overall
- Ready: 24 hours or more with no fever and no fever medicine, and clearly getting better
Can my kid go back to school with a cough?
Usually yes, if the fever rule is met and they are improving. The AAP notes that flu causes a cough that lasts 2 to 3 weeks, so it often outlasts the fever. The CDC test is whether symptoms are improving overall, not whether every symptom is gone.
Your child may still spread flu for a while after going back. The CDC says people are most contagious in the first 3 days of illness, and the virus can be found up to 5 to 7 days after getting sick. It adds that young children may be contagious for longer. The CDC also suggests added precautions for 5 days after returning to normal activities. Its examples include:
- Good hygiene, like washing hands and covering coughs and sneezes
- Keeping some distance from others when they can
- Cleaner air, like opening a window when possible
- A well-fitted mask, if your child can wear one
Does my child need Tamiflu, and does it change when they can go back?
Most healthy children with flu do not need an antiviral, according to the AAP. Antivirals like oseltamivir (Tamiflu) are prescription medicines that can shorten the illness by about a day, and they work best when started within 2 days of the first symptoms, per the CDC.
Taking an antiviral does not change the school rule. Your child still needs 24 hours with no fever and no fever medicine, and improving symptoms.
The AAP says to call your pediatrician within 24 hours of the first flu symptom if your child is in a higher-risk group or is around someone who is. A clinician decides whether an antiviral makes sense.
- Younger than 5, and especially younger than 2
- Asthma or other chronic lung disease, a heart condition or diabetes
- Symptoms that are not improving
- Close contact with others at higher risk of flu complications, such as a baby at home
What medicine is safe for flu fever in kids?
Never give aspirin to a child with the flu or a suspected flu. The AAP says aspirin during flu is linked to a higher risk of Reye syndrome, a rare but serious illness, and its symptom guide says to avoid aspirin because of that strong link.
Acetaminophen or ibuprofen, dosed for your child's age and weight, can help them feel better. The AAP notes ibuprofen is for children 6 months and older, and should not be given to a child who is dehydrated or vomiting over and over. For lower fevers, the AAP says fever medicine is not needed. Remember: a fever that stays down only on medicine does not count toward the 24 hours.
When should you get care?
In an emergency, call 911Call your pediatrician within 24 hours of the first flu symptom if your child is younger than 5 or has asthma, diabetes, a heart condition or another chronic condition, if symptoms are not improving, or if your child is around someone at high risk. The AAP also says to call if fever lasts more than 3 days.
Get medical care right away for any of the CDC's emergency warning signs in children: fast breathing or trouble breathing, bluish lips or face, ribs pulling in with each breath, chest pain, severe muscle pain (refusing to walk), signs of dehydration (no urine for 8 hours, dry mouth, no tears when crying), not alert or interacting when awake, seizures, fever above 104 degrees F that fever medicine does not bring down, any fever in a baby younger than 12 weeks, fever or cough that gets better and then comes back or gets worse, or a chronic condition getting worse.
Call 911 if your child is struggling for each breath or can barely speak or cry, has bluish lips or face when not coughing, or you think it is a life-threatening emergency.
How our AI doctor decides when to send you to care ›What if my child's school has a different rule?
Some schools and districts may set their own return rules or ask for a note. Their policy is what applies at the door, so check the handbook or call the school nurse if you are unsure.
If the rules seem different, think of the CDC guidance as the minimum. A school can ask you to wait longer, but both the CDC and the AAP call for at least 24 hours with no fever before going back.
Common questions
When can my kid go back to school after the flu?
Once they have gone at least 24 hours with no fever, without fever medicine, and their symptoms are improving overall. A leftover cough is common and can last 2 to 3 weeks. For 5 days after they go back, the CDC suggests added precautions like washing hands and covering coughs.
Does the 24 hours start when the fever breaks or when I stop Tylenol?
The 24 hours only count while your child is both fever-free and off fever medicine. If you gave acetaminophen or ibuprofen, the time when the medicine could be keeping the fever down does not count. A morning with no fever after a bedtime dose does not count.
My child tested positive but never had a fever. When can they go back?
The CDC test still applies: at least 24 hours with no fever without medicine, and symptoms improving overall. If you are unsure whether your child is ready, ask your pediatrician or the school nurse.
Can my child go back sooner if they are on Tamiflu?
No. An antiviral can shorten the illness by about a day, but the return rule is the same: 24 hours fever-free without medicine and symptoms getting better.
Should siblings stay home too?
The CDC return guidance is for the person who is sick. A sibling with no symptoms is not covered by it, but if they get a fever or other flu symptoms, the same rule applies to them. If a sibling is under 5 or has a chronic condition, tell your pediatrician when you call about your sick child, since the AAP lists contact with high-risk people as a reason to call within 24 hours.
Can I give my child aspirin for the flu?
No. The AAP says never to give aspirin to a child who has the flu or might have it, because of the link with Reye syndrome. Use acetaminophen or ibuprofen dosed for their age and weight instead.
Pymander is not a replacement for a physician and does not provide medical advice, diagnosis, or treatment. Always seek the advice of a qualified health provider with questions about a medical condition. If you think you may have a medical emergency, call 911.