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When children have acute respiratory tract infections

Published Updated

Many parents are unsure how to assess whether children with respiratory tract symptoms need to be kept at home. The NIPH has produced a flowchart to help them. Consult your doctor if you are concerned about your child.

Many parents are unsure how to assess whether children with respiratory tract symptoms need to be kept at home. The NIPH has produced a flowchart to help them. Consult your doctor if you are concerned about your child.


Symptoms of COVID-19 in children

Children of primary school age and younger are less likely to become sick from coronavirus and play a smaller role in transmission. If they do become sick, they usually have a mild course of COVID-19 disease. Their symptoms are often mild and short-lived and can be difficult to distinguish from other respiratory tract infections.

Respiratory tract symptoms include coughs, sore throat, nasal congestion and a runny nose. Children with COVID-19 may not have a fever and cough. The youngest children often do not complain of sore throats and body aches, but they may whine more than usual and/or they may not want to eat. This is called poor general condition.

When you are worried about your sick child

In most cases, children who are sick with a poor general condition will not have COVID-19, but may have other infections or conditions that require treatment. If you are worried about your sick child, contact the health service to assess whether a doctor should examine them. Do not delay seeking medical attention due to concerns about COVID-19.

In general, the younger the child, the lower the threshold for contacting a doctor. Contact a doctor if the child has:

  • poor general condition (the child is lethargic and not their usual self/ altered behaviour)
  • difficulty breathing and / or breathing faster than normal when at rest
  • fever in combination with respiratory tract symptoms and / or feeling unwell

When should children with respiratory tract symptoms be kept home from childcare and school?

If a child has had symptoms of a respiratory infection in the last 24 hours (newly arisen), they should be kept at home, especially if they have several symptoms at the same time or have a poor general condition.

Children at primary school and childcare centre who only have a runny nose and are otherwise in good form do not have to stay at home.

Children with only mild respiratory symptoms and no fever, can be observed at home for up to 48 hours. With rapid recovery, the child can return to childcare / school without being tested. If there is no improvement after 48 hours, contact the health service to assess whether the child needs to be examined by a doctor and/or tested for COVID-19.

When can children of primary school age and younger return to childcare / school?

A child’s general condition determines when they can return to childcare / school after a respiratory tract infection. This applies even if the child still has some residual symptoms such as a runny nose (regardless of the colour and consistency of the mucus) or a cough. These symptoms are common among young children after recovery from a respiratory tract infection.

As long as the residual symptoms are from a past infection, and are not newly arisen or becoming worse, the child can return to childcare / school when their general condition is good / back to normal for that child.

If the child has been tested, the test result must be available before they can return to childcare / school. Anyone who is diagnosed with COVID-19 must be in isolation and followed up by the healthcare service in the municipality.

The child can return to childcare / school even if others in the family have respiratory tract symptoms. If others in the family have been diagnosed with COVID-19, the child must be quarantined and followed up by the healthcare service in the municipality.

When should adolescents with respiratory symptoms be home from school, and when can they return to school?

The disease picture with COVID-19 in adolescents is more similar to that in adults, especially among older adolescents. Adolescents who have experienced symptoms of respiratory tract infection in the last 24 hours should be kept home from school and contact the test station to be tested for COVID-19. This also applies for mild symptoms.

For more information about advice to adolescents (lower secondary school and above) with newly arisen respiratory tract symptoms, see:  

When can children of primary school age and younger attend public health clinics, doctors' surgeries and other services?

Children with residual symptoms following recovery from an infection, and which are not new or increasing as described above, can attend public health clinics, doctors' surgeries and other services when their general condition is good, or normal for the child. In this way, children can still receive the necessary and statutory follow-up in the various services. Other services include the dental health service and the mental health service in the municipality (including BUP and PPT).

Relationship building and security are a major part in the follow-up of children and adolescents, so physical consultations must be strived for and cannot be always be replaced by digital consultations.

For adolescents, this will if they have no symptoms (asymptomatic) they can attend consultations as normal. If adolescents have symptoms, consider what will be the correct way to be able to attend the service: if they need to meet up in person, a negative corona test result should be available for adolescents with symptoms, or consider postponing the appointment if this is appropriate. If it is considered that the quality of the service will be equally good, the appointment can be carried out digitally instead of having to meet up in person.

History

05.03.2021 Removed flowcharts pending updates

18.01.2021: Emphasised that children have a smaller role to play in transmission

02.11.2020: Added paragraph about adolescents attending consultations

30.10.2020: Minor change in paragraph "When shall children with respiratory tract symptoms stay home?"

29.10.2020 Added paragraph about when children can attend public health clinics, doctors etc.

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