What is the general rule for exclusion of a child with strep throat?

• A. Return to school 24 hours after antibiotics were first given
• B. Return after fever resolves
• C. Return after 3 days
• D. Return the next day without antibiotics

Answer: (A)

Strep throat is contagious, especially in the first day or so after infection. Starting antibiotics quickly is the key to stopping the spread. After about 24 hours of effective antibiotic treatment, a child is much less likely to pass the bacteria to others, so returning to school after that 24-hour window is considered safe and helps balance keeping classmates safe with minimizing unnecessary exclusion.

Waiting until fever resolves isn’t the most reliable predictor of contagiousness, because fever can come and go and doesn’t directly measure how infectious the child still is. Returning the next day without antibiotics would keep them contagious, and waiting three days unnecessarily prolongs absence without additional protection for others.