“It’s pretty inevitable once you’re in school spaces that your kids are going to get sick,” says Sonja O’Leary, MD, chair of the Council on School Health for the American Academy of Pediatrics. “But you can come into the school year with eyes wide open, knowing that there are risks involved, and weighing those risks versus the myriad of benefits to attending school.”

Viruses in the news

A dose of perspective may help ease anxiety when it comes to recent headline-dominating diseases. Both monkeypox and polio are rare, and it’s very unlikely you’ll see cases in your community, especially in children, says Dr. Tina Q. Tan, professor of pediatrics at Feinberg School of Medicine of Northwestern University and pediatric infectious diseases physician at Lurie Children’s Hospital of Chicago. 

As of August 31, there have been 17 cases of monkeypox in children 15 and younger in the U.S. “The vast majority of monkeypox cases are occurring in adults such as men who have sex with men or anyone who has been very sexually active and has multiple partners.” 

To contract monkeypox, your child would have to have skin to skin contact with an infected person for a prolonged period of time, touch a contaminated surface, or come into direct contact with an infected respiratory excretion like a sneeze. 

A child with the disease typically has a rash of red bumps that start small and become larger and fill with pus before crusting over. They may also feel like they have the flu, with fever, muscle aches, headaches, and swollen lymph nodes. It can be painful, but is rarely fatal—though it’s more likely to cause serious illness in kids under eight.

Polio, an infectious disease that destroys nerve cells in the spinal cord and causes paralysis, is even less prevalent. It surged in the U.S. in the 1950s, but thanks to the polio vaccine, disappeared from the country entirely in 1979. In June 2022, doctors reported a case of polio in an unvaccinated person who had recently traveled out of the country.

But if your child is up to date with their vaccines, Tan says you can rest assured they’re protected. “It’s good to be aware of polio, but you don’t need to worry about it,” she says. 

As for COVID-19, the country is far from being out of the woods, but numbers are improving.

“BA.5 is the most common variant currently circulating in the United States, accounting for about 90% of all kids cases, and the problem is it’s extremely transmissible,” says Tan. Even though it may cause milder symptoms, she says, one person can infect a whole lot of other people. 

“It definitely looks better than it did before,” says O’Leary. “That being said, more kids have died of COVID than of the flu and they have side effects like long-term COVID and experience other repercussions, like giving it to other family members.”

It can be hard to tell if your child is dealing with COVID-19, the flu, a cold, or another virus when they start having symptoms such as cough, fever and chills, shortness of breath, body aches, sore throat, and congestion. Testing can help you know what you’re dealing with, and help you get the right treatment for your child.

Prevention practices

Research shows that multiple prevention strategies can help staunch the spread of viruses in schools.

Steer clear of rashes. Though monkeypox isn’t common, it’s always a good idea not to touch, hug, or cuddle with someone who has a rash. The same goes for using items someone with a rash has touched. Don’t share clothes, towels, utensils, or a bed. 

Ask about sanitization. Although the CDC doesn’t recommend schools and daycares take any additional measures for preventing monkeypox beyond “everyday operational guidance that reduces the transmission of infectious diseases,” it’s still good to know what their sanitizing practices are to ensure they’re helping to prevent cross-contamination of surfaces. 

Wash hands well. Teach your kids proper hand washing at home: cover hands with warm, soapy water and rub them together for at least 20 seconds, or as long as it takes to sing “Happy Birthday” twice. Rinse well. Keep them clean by sneezing and coughing into the crook of the elbow or a tissue.

Keep sick kids home. “Don’t send kids to school sick so they don’t spread [illnesses] to other people,” says O’Leary. If a child has a rash, especially if recent travel puts them at risk for monkeypox, or they’ve had close, personal contact with someone who has monkeypox, they should not go to school and should see their pediatrician. The rule of thumb for COVID-19 is to isolate from others for at least five full days after testing positive. For other viruses, your child should be fever-free and have no diarrhea or vomiting for at least 24 hours before returning to school. 

Vaccinate. Kids as young as 6 months are now eligible for the COVID-19 vaccine. “It really does both help prevent kids from getting seriously ill and hospitalized, but also to lower overall transmission [of COVID],” O’Leary says. There is a vaccine for monkeypox, but doctors won’t give that vaccine to kids unless they’ve had exposure to monkeypox and are at high risk for serious illness. 

Mask up. Monkeypox isn’t an airborne virus, so masks make a difference only when someone in your household actively has it. When it comes to COVID-19, Tan says covering your nose and mouth around others remains paramount. “Wearing mask is still the most effective means of preventing transmission to other people,” she says. School policies vary, but the CDC still recommends wearing a mask indoors if you’re in a community with high rates of the virus, and a mask will block other germs from passing from person to person, too. Make sure your child’s mask is clean, well-fitting, and labeled so they don’t accidentally don someone else’s

Prioritize your own health. School prevention is key, but home health matters more. Casual exposure is very unlikely to spread monkeypox in kids, for example, but sustained close contact in a home puts them at high risk of getting it. Practice the good hygiene habits you teach your kids so your house can be virus-free.