NOVEL CORONAVIRUS*1, INFLUENZA*2 PROGRESS OBSERVATION SHEET (FILLED IN BY PARENTS)
Measure your child’s body temperature twice in the morning and the evening, fill in the record table below, and watch
the progress while creating a line graph. After the suspension period has passed, fill in the name of the guardian andsubmit it to the school or Kindergarten.
[Criteria for the period of suspension of attendance] *The day of onset, the day of symptom remission, andthe day of fever resolution shall be day 0.
● Novel coronavirus: Until 5 days have passed since the onset of symptoms and 1 day has passed aftersymptoms subside.
* "Symptoms subside" means that the fever is relieved without the use of antipyretics, and the respiratory symptoms
are improved.
*1 The pathogen is limited to the coronavirus of the genus Betacoronavirus (limited to those newly reported from thePeople's Republic of China to the World Health Organization in January 2020 as having the ability to infect humans).
● Influenza: Until 5 days have passed since the start of the symptoms and 2 days have passed since thefever subsides(3 days for kindergarten)* If the school doctor, kindergarten doctor or other doctors confirm that there is no risk of infection, the child
may return to school.
* Fever resolution is the state in which the body temperature is less than 37.5 degrees both in the morning andin the evening.
*2 Excluding pandemic influenza, bird influenza, etc.

Iwata City

Elementary/Junior High School Grade＿ Class＿ Name＿＿＿＿＿＿＿

Iwata CityKindergarten

AgeName

Date when symptoms appeared: YearMonthDay*If the test result is positive using the "antigen test kit," the test date (sample collection date) is the "dateof diagnosis."*When using the "antigen test kit", please use "in vitro diagnostic drugs" or "class 1 drugs".
Diagnosis Date: YearMonthDay
Diagnosis NameDate

1stOnsetDay//

月日Bodytemp.
℃

2nd Day

3rd Day

4th Day

5th Day

6th Day

7th Day

8th Day///////A
M

P
M

Am

P
M

A
M

P
M

A
M

P
M

A
m

P
M

A
M

P
M

A
M

P
M

A
M

P
M

A
M

P
M℃

℃

℃

℃℃

℃

℃

℃

℃

℃

℃

℃℃℃

℃

℃℃℃40℃

39℃
38℃

37.5℃
37℃

36℃

To the School Principal・Kindergarten Director
As the above the period has passed, please lift the suspension of attendance
YearMonthDay

Be sure to rest until this day

Parent’s Name ____________________________________________________________

Guardian entry example

Novel Coronavirus*1 and Influenza*2 Follow-up Chart (Entered by parents)
Measure your body temperature twice in the morning and evening, fill in the record table below, and watch
the progress of your fever while making a line graph. After the suspension period, please fill in the name ofthe parent or guardian and submit it to the school・Kindergarten.
【Criteria for suspension of attendance] * The date of onset, the day of symptom relief, and the day offever reduction shall be 0 days.】● New coronavirus: Until 5 days have passed since the onset of the disease and 1 day after thesymptoms have been relieved* "Mild symptoms" means that the fever is relieved without the use of antipyretic drugs and the respiratory
symptoms are improving.
*1 The pathogen is limited to coronaviruses of the genus Betacoronavirus (limited to those newly reported
to have the ability to transmit to humans from the People's Republic of China to the World HealthOrganization in January Reiwa 2).
●Influenza: Until 5 days have passed since the start of the symptoms and 2 days have passed since
the fever subsides (3 days for kindergarten)* If the school doctor, kindergarten doctor or other doctor recognizes that there is no risk of infection, you
can come to school.
*Antipyretic is a condition in which the body temperature is below 37.5 degrees Celsius in both morningand evening.
*2Excludes new strains of influenza and avian influenza

Iwata Municipal Iwata Elem and Junior High School 5th grade 5 groups Name: Hanako Iwata
Iwata CityKindergarten

AgeName

Date when symptoms appeared: Reiwa__ Month_May_ Day 8*If the test result is positive using the "antigen test kit," the test date (sample collection date) is the "date of diagnosis."*When using the "antigen test kit", please use "in vitro diagnostic drugs" or "class 1 drugs".
Diagnosis Date: Reiwa __Year May_Month _9_Day Diagnosis Name Novel Coronavirus Infection

Date

Date Onset

1st Day

2nd day

3rd day

4th Day

5th Day

6th Day

7th Day

8th Day

5/8

5/9

5/10

5/11

5/12

5/13

5/14

5/15

5/16

AM

AM

AM

AM

PM

AM

PM

AM

PM

AM

PM

38.9 38.5 39.0 38.3 38.0 38.3 37.4

36.9 36.6 36.8 36.7 36.6

36.6℃

℃

℃

℃

℃

℃

℃

℃

AM
Temp℃

PM℃

AM

PM℃

℃

℃

PM℃℃

PM℃

PM℃

℃℃

40℃

39℃
38℃

37.5℃
37℃
解熱日

36℃

To the School Principal・Kindergarten Director

Be sure to rest until this day

As the above has passed, please lift the suspension of attendance.

Reiwa５年５月 14sun

Parent's Name

Iwata Taro