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of the Commonwealth of Pennsylvania

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    Preventing Respiratory Viruses (and other illnesses) in K-12 Schools

    The Pennsylvania Department of Health (DOH) encourages schools to follow the Centers for Disease Control and Prevention’s (CDC) recommendations on preventing the spread of illnesses, including respiratory viruses like COVID-19, flu, and respiratory syncytial virus (RSV).  Please visit Respiratory Virus Guidance (cdc.gov) and Preventing Spread of Infections in K-12 Schools | CDC.

    Infections are commonly spread in schools by:

    • Shared objects
    • Close contact with others

    Take steps to prevent infection in schools:

    Improve air quality: Ensuring existing heating and air conditioning systems are providing the minimum outdoor air ventilation requirement in accordance with ventilation design codes. Bring in fresh outdoor air (open windows which can be safely opened), gather outdoors, or purify indoor air.

    Cleaning, sanitizing, and disinfecting: Frequently wipe down things that are touched often. Clean other surfaces when they are visibly dirty. Use appropriate cleaning and disinfecting supplies and follow the directions.

    Hand washing: Provide soap and water, or an alcohol-based hand sanitizer with at least 60% alcohol.  Encourage handwashing for at least 20 seconds or use hand sanitizer.

    Respiratory etiquette: Encourage everyone to cover coughs or sneezes with a tissue or elbow, then wash their hands immediately.

    Vaccinations: Everyone, 6 months and older, should receive a flu and COVID-19 vaccination (also an RSV vaccination for some people).   

    For more details, please visit Everyday Actions for Schools to Prevent and Control the Spread of Infections | CDC.

    Additional strategies that may be used during increased illness activity:

    When more people are getting sick within a school community, schools can take more action. Additional strategies include:

    Distancing and cohorting: Use small groups and allow additional space. For example, when illness rates rise, consider keeping staff and students in the same groups all day to reduce the risk of spreading illness.

    Illness monitoring: Keep track of illnesses and symptoms. Schools should create policies for monitoring illness.  See below for symptoms which require exclusion.

    Allow masking: When illness rates are increasing in your school or community allow masking by individuals who opt for that additional measure of protection.

    COVID Testing: Test for COVID when a person has symptoms or 5 days after exposure to a confirmed case. See COVID testing guidance below.

    Managing exposure: Handle contact with sick people carefully using proper personal protective equipment (PPE) and precautions.  For example, if a student shows symptoms of a respiratory virus, offer a mask and a comfortable place to wait away from other students, like the nurse’s office, until their caregiver can take them home.

    For additional information, please visit Additional Strategies that May Be Used to Minimize Infectious Disease Transmission in Schools during Times of Elevated Illness Activity | CDC

    Things to consider when prioritizing additional strategies:

    Local factors to consider include:

    • Type of illness and level of impact on community and community members.
    • Age of students.
    • Students with disabilities.
    • People at high risk of severe illness.
    • Available resources.

    For more details, visit Considerations for Prioritizing Additional Strategies | CDC.

    Schools should expect students and staff to get sick during the school year:

    When students or anyone in direct contact with students get sick, schools should follow the following guidelines:

    Exclusion of sick students or staff:

    • Fever, especially with a new rash or behavioral changes.
    • Persistent vomiting.
    • Persistent diarrhea. Diarrhea that causes ‘accidents,’ is bloody, or is more than two bowel movements above what is ‘normal’ for the person in 24 hours.
    • Sores that are draining fluid and cannot be covered.
    • Worsening respiratory virus symptoms (stuffy or runny nose, cough, sore throat) not caused by something else, like allergies.

    Specific readmission guidelines include:

    • No fever for at least 24 hours (without using fever-reducing medicine).
    • Fever with a new rash has been checked by a doctor and fever is gone.
    • Fever with productive cough has been checked by a doctor and fever is gone.
    • Open sores are crusted over and under medical treatment.
    • Vomiting has resolved overnight, and the child can hold down food/liquids in the morning.
    • Diarrhea has improved, no more accidents and no more than two bowel movements above what is ‘normal’ for the child in 24 hours. Bloody diarrhea should be evaluated by a healthcare provider before return.
    • Respiratory symptoms are getting better overall for at least 24 hours. Consider additional actions to prevent spreading the illness after return (normally for five days).

    NOTE: Schools should have illness-specific policies for illnesses like strep throat or pertussis (whooping cough). These policies should follow CDC guidance and be informed by school health teams and experts in infectious diseases including those from your local or state health department.

    For more details, please visit, When Students or Staff are Sick | CDC.

    Staff caring for sick children should use protective gear:

     

    Planning for outbreaks, epidemics, and pandemics:

    Schools need an emergency plan for outbreaks or pandemics.

    Schools should report any unusual increase in absenteeism or illness among students by calling 1-877-PA-HEALTH.

    For more details, visit Planning for Outbreaks, Epidemics, and Pandemics | CDC.

    Keeping schools open:

    Schools should use multiple prevention strategies to stay open.  Any changes in school operations should be coordinated with their local health authorities and other impacted community partners.

    PA DOH does not recommend school closures in the event of respiratory outbreaks.

    For more details, visit Maintaining School Operational Status | CDC.

    General Guidance & Information

    Immunizations for Respiratory Viruses