Covid 19: what to do if your child is sick?

Parents have many questions in the context of the 2nd wave of covid-19: what if my child is sick? Can he be excluded from his reception structure? When is it necessary to take a COVID 19 test? Our experts will help you take stock.

Is your child sick?

He has a fever (temperature 38 degrees), cough, diarrhea, vomiting, abdominal pain, loss of taste or smell, unusual headaches, unexplained fatigue ...

The golden rule: like in other years: do not put him together when he is sick.

If you are in any doubt, if your child worries you, contact the doctor who follows him / her. If his condition is really worrying, call 15.

Covid-19 is not a common pathology in children, who are also more often asymptomatic when infected. The usual infections of children (bronchiolitis, gastroenteritis, urinary tract infection, otitis, etc.) are much more frequent than covid. They may themselves require medical advice.

Make sure that your child is well vaccinated according to the vaccination schedule, even against rotavirus gastroenteritis (infants under 6 months) and influenza (from 6 months and especially if the presence of a risk factor such as Asthma for example).

When it comes to covid, there is no hard and fast rule: we can (and must) try to reduce the risk of the disease spreading.

Should we go to the doctor?

If your child's condition is worrying (fever that is poorly tolerated, unusual behavior): see a doctor urgently. If in doubt, call 15 or go directly to the Pediatric emergency room.

If your child has been in contact, without observing the barrier measures, with a person who has tested positive and their condition is not worrying: go to the doctor. This will prescribe a COVID test, regardless of the viral circulation.

If your child is not at risk of contact and his condition is not worrying

If your child is over 6 years old: go to the doctor or get medical advice. Indeed, after 6 years, children are better immunized against common viruses and are less often sick. This is why they should be consulted when they are sick. If the doctor cannot make a precise diagnosis (for example, angina, urinary tract infection, etc.), he will prescribe the necessary examinations and particular a covid test, especially if the circulation of the coronavirus is important.

If your child is less than 6 years old: no need to go to the doctor if the symptoms last less than 3 days. On the other hand, it will be necessary to consult in the event of the persistence of the symptoms after 3 days.

Should a test be done automatically?

What types of tests are there?

Nasopharyngeal PCR: it detects the presence of the genetic material of the virus (its 'RNA'). It is the most reliable test for diagnosing coronavirus infection (with or without symptoms). PCR becomes positive between 4 and 7 days after the contamination, positivity precedes the appearance of clinical signs by 2 to 4 days. It can remain positive while the person is cured and no longer contagious. Indeed, the persistence of “virus fragments” or “dead virus” can positively impact PCR. Since the emergence of Sars-Cov-2 'variants', some of which are more contagious (Brazilian and South African variant), any positive PCR must be 'screened' for these variants.

Antigenic tests: they detect the antigens of the virus. There is no amplification of the gene, so the sensitivity is lower than that of PCR. They are positive if the person has a high viral load (they have a lot of viruses). The point is to have a quick result (in 15 minutes). These tests are reliable for people who are sick in the first 4 days of illness. A positive antigen test means the person has a lot of the virus and is contagious. The antigen test does not make it possible to detect the presence of the variants.

Serology: This checks for the presence of antibodies made against the virus from your body. They appear the 2nd week after the onset of the disease and persist for more than 6 weeks. Serology can diagnose an old infection after recovery

My child is sick: when should it be tested?

If the sick child is in contact: the doctor will order a Covid test, regardless of the viral circulation and regardless of his age. Since the onset of variants, PCR should be done in case of contact with a sick person.
If the sick child is not in contact: it is the doctor who will decide whether or not to test, depending on the viral circulation and age

A Covid test will be necessary (antigen test or PCR):

If symptoms persist for more than three days without an accurate diagnosis in children under 6 years of age
If people said to be 'at risk' of severe forms of covid-19 live in their home
If your child is over 6 years old

For the return to school, a certificate of honor * may be requested from parents.

* certifying that the covid test has been carried out (if prescribed) and that its result is negative or that the doctor consulted has not prescribed a test.

My child has a runny nose, can it be taken out of school?

A cough and/or rhinitis without fever are not grounds for exclusion from the community.

Before 6 years old, only children with a real infectious picture should be excluded from school: fever (temperature above 38 °) and/or difficulty in breathing and/or digestive disorders (several watery stools, at Minus two vomiting). A test will only be done if the child has been in contact and without barrier gestures with a person positive for covid 19 or if the fever increases and the symptoms persist for more than 3 days.

After 6 years, children are less likely to fall ill than younger children. They have already “made their immunity”. You must keep it at home on the same criteria as a child under 6 years old. The doctor consulted will order a test if he does not find a 'usual' cause for the symptoms presented and if the viral circulation is high.

They should not go to school while they are sick (as usual) and will have to wait for the test result if prescribed.

Can his brothers and sisters go to a community?

Pending the doctor's diagnosis and/or the result of the symptomatic child’s test, the reception of other siblings continues in nursery or school, with rigorous application of barrier gestures.

When can a child who has been an ill return to the community?

If your child has not had a test, he can return to the community as soon as he is no longer sick.
If your child has had a test
And the test is positive for covid-19, he will be isolated for at least 10 days.

Return to the community is possible after the 10th day if he is no longer ill. If the child is contaminated with a South African or Brazilian variant, a control PCR is necessary on leaving isolation (on D10), return to class is possible if the child is no longer sick and if the PCR Is negative; If it is positive, the isolation is extended for 7 days.

And if the test is negative, it is possible to return to nursery or school as soon as the child is no longer ill.

It is not necessary to provide a certificate of aptitude for your child's return to school if they have been:

Infected with Sars-Cov-2 (with or without symptoms) after isolation for 10 days.
Infected with a variant (with or without symptoms) after isolation for 10 days and negative PCR test after this period.
Sick but the doctor did not consider it useful to take a test (see infographic): possible return to the community as soon as there are no more symptoms.

However, a certificate of honor may be requested, attesting that a doctor was consulted and that the test was not prescribed or that a test was carried out and that its result was negative.

In any case, reassure your child by explaining the current situation to him, answering his questions about the virus and reminding him of the right actions to follow.

Did you know ?

The readmission of a child is no longer conditional on the presentation of a medical certificate or a test result, but a certificate of honor may be requested for the return to the community

For the return of a child whose care has been suspended, as a preventive measure or following a positive test, the return can be made, depending on the case:

After the doctor consulted did not diagnose a suspicion of Covid-19,
After a negative test result
At the end of the isolation period (7 days or 10 days if varying) and after the recovery of the child

To know

GOOD PRACTICES OF PARENTS

To protect children and professionals, parents are called upon to respect the following instructions:

Do not entrust your child:

- If he has a fever (temperature above 38 °) or any other infectious symptom (febrile cough, diarrhea, vomiting, etc.)

- If he tests positive for Covid-19

-If it is identified as a risk contact (person having been in prolonged and/or direct contact, without barrier gestures, with a person who tested positive)

Inform the reception facilities of any positive results from a screening test for their child and/or one of the members of their household

Take the advice of your child's doctor:

- For everyone: in the event of a fever that is poorly tolerated, if their behavior is unusual, if their condition seems worrying to you or if there is a positive Covid contact - WITHOUT DEADLINE

- For children under 6 years old: in case of fever (temperature above 38 °) which lasts more than 3 days

-For over 6 years old: if he is sick