HEALTHWATCH / FLU SEASON : Doctors’ Orders : Three out of three pediatricians surveyed give their advice for determining when your kid’s too sick to go to school.

Remember, as a child, trying to convince your parents that two sneezes in a 30-minute time span were reason enough to keep you home from school? Little did you know what pressure you were placing on them.

As most parents can attest, it isn’t easy deciding whether to send a child to school when he or she is showing some sign of illness.

The decision is made more difficult when that illness hits in winter and what seems to be a simple cold or mild flu could turn out to be strep throat, sinus infection, bronchitis, pneumonia and even scarlet fever. All of those and more have turned up in Ventura County this winter.

Is a runny nose by itself cause for concern? How about a runny nose, plus mild cough? A runny nose, plus mild cough, plus upset stomach? And once it has been determined that the kid is too sick to go to school, working parents face the added problem of finding a qualified baby-sitter.

“Some kids stay home 10 days a year, some stay home one day a year,” said Dr. Stewart Brooks, a Simi Valley pediatrician. “I don’t think the ones who stay home 10 days a year are sicker. There’s just a big difference in what parents do.”

So what should parents do?

“I think a good number of parents tend to keep their kids home more than necessary,” he said. “They can keep children home from school if they have a fever over 100.4 (degrees) or if there is vomiting or severe sore throat, or significant difficulty breathing. If it’s just a runny nose and they don’t have a fever, I don’t think the child should stay home.”

Dr. Mark Freedenberg of the Coastal Pediatric Medical Group in Ventura and Oxnard agreed that a child with a fever should stay away from school. “They are obviously going to be contagious,” he said, “and they are probably not going to get a whole lot out of the school day.”

Freedenberg said he has seen a lot of ear infections this year, as secondary viruses following a cold. And that brings up quandary No. 2 for parents of sick children: When does a “common” cold or virus become serious enough to warrant a visit to the doctor?

Ventura pediatrician Barry Cogen said the parents of most of his patients bring their children in at the first hot blush of fever. “If it’s 99 and above, a lot of parents do panic, and that’s good,” he said. He suggested, at that stage, that parents call the doctor’s office.

“We have a series of questions we ask,” said Cogen. “Has there been any vomiting, any diarrhea, stomachaches, any severe headaches or dizziness, any pain or stiffness in the neck, any pains in the joints? We ask if there’s a rash.” Cogen added to that list questions concerning earaches, pale skin, loss of appetite, difficulty breathing and pus in the eye.

“If parents are certain it’s just a virus or just a flu, there’s nothing wrong with that. But how do they know?”

Brooks, again, said temperature is a good guide for when to take action.

“I think if a fever lasts more than four or five days, it’s probably advisable to see a physician. You have to evaluate how a child is doing in addition to the fever. If the child is alert, not having difficulty breathing and drinking fine, it’s not an emergency,” he said. “If there seems to be an amount of discomfort that is not compatible with the temperature, the child should be seen.”

Brooks said quicker action should be taken with children six months old or younger because they have difficulty expressing certain discomforts.

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