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Preventing Respiratory Viruses in K-12 Schools and Child Care Programs
VDH is committed to the health and safety of students, teachers, and staff in K-12 schools and child care programs. Respiratory viruses, including COVID-19, influenza (the flu), and respiratory syncytial virus (RSV), are a common source of illness in schools and child care programs. This page contains information on common respiratory viruses and resources for school and child care officials, parents and guardians, and the entire school and child care community.
General Respiratory Virus Information
Everyone can take the following core prevention strategies to protect themselves and others from common respiratory viruses:
- Stay up to date with immunizations
- Practice good hygiene
- Take steps for cleaner air
- When you have a respiratory virus:
- Use precautions to prevent spread
- Seek health care promptly for testing and/or treatment if you have risk factors for severe illness; treatment may help lower the risk of severe illness
Learn more:
- VDH 2024 Back to School Letter for Administrators
- CDC Respiratory Virus Guidance
- CDC Preventing Spread of Infections in K-12 Schools
- CDC Protecting Against COVID-19 and Other Infections in Early Care and Education Programs
Preventing Spread of Illness
Students, teachers, and staff who have symptoms of a respiratory virus can protect others by staying home when sick. Those who have been sick can return to school and child care when, for at least 24 hours, both of these are true:
- Their symptoms are getting better overall, AND
- They have not had a fever (and are not using a fever-reducing medication such as acetaminophen or ibuprofen)
When people who were sick begin returning to their normal activities, it is important that they take added precautions for 5 more days to prevent spreading illness to others. These added precautions can include taking additional steps for cleaner air, hygiene, masks, physical distancing, and/or testing to inform your actions to prevent spread to others.
Learn more here: CDC Preventing Spread of Respiratory Viruses When Sick
Immunizations
It is important for students, teachers, staff and their families to stay up-to-date on the immunizations that are recommended for them; for example, getting a flu shot every year. This can help reduce the severity of the illness, reduce the risk of death, and can also help reduce the chances of getting sick. Talk to a healthcare provider about which vaccines are recommended for you and your family.
Learn more here: CDC Immunizations and Respiratory Viruses
Testing
Testing is an additional strategy to help protect students, teachers, and staff. While testing is not always necessary, it can help identify if someone is infected with a specific virus so that they can make decisions about treatment and learn how to prevent the spread of the virus to others.
Learn more here: CDC Testing and Respiratory Viruses
VDH, in collaboration with the Virginia Department of Education (VDOE), has helpful resources to keep children healthy this school year, including information on immunizations, child well visits, routine oral health, and mental health resources.
The American Academy of Pediatrics (AAP) also has a number of resources, including their website for parents, healthychildren.org.
School Health Resources from the Virginia Chapter of the American Academy of Pediatrics
Resources from CDC for parents are also available:
In This Section:
- VDH 2024 Back to School Letter for Administrators
- CDC Respiratory Virus Guidance applies to community settings, including schools and child care settings.
- CDC Preventing Spread of Infections in K-12 Schools Guidance
- CDC Protecting Against COVID-19 and Other Infections in Early Care and Education Programs
- Certain elements of CDC’s guidance for healthcare settings and core infection prevention and control practices apply to school health clinics and nursing offices.
- Encourage students and staff to stay home when sick.
- VDH outlines precautions to prevent spread of respiratory viruses when you are sick.
- Review school policies and consider revising policies that make it difficult for students and staff to stay home when sick or when caring for others who are sick.
- Schools and child care programs are subject to disease reporting regulations and are required to report the presence or suspected presence of an outbreak to their local health department per 12VAC5-90-90D. Read more about VDH’s outbreak reporting requirements.
- The local health department may recommend control measures in response to the outbreak which could include both core and additional prevention strategies, such as exclusion of ill students/children and staff, increased handwashing, increased environmental cleaning, and parent/guardian notification.
- Outbreaks can be reported using VDH’s Suspected Outbreak Reporting Portal.
- Testing for flu and RSV is available through healthcare providers.
- Testing for COVID-19 is available through healthcare providers and with at-home tests. VDH provides K-12 schools and child care facilities across the Commonwealth with free at-home diagnostic test kits to help prevent the spread of COVID-19.
- Schools
- Schools may send VDH COVID-19 test kits home with families to conduct testing at home or conduct testing on-site if they have the resources to do so. To request test kits for your school, email testinginfo@vdh.virginia.gov.
- Child Care Facilities
- Child care facilities may send home tests for students (aged 2+ years of age), staff, and parents to have on hand if they need to consider testing.
- To request rapid antigen test kits for your child care facility, please contact your local health district.
- Schools
Consider offering seasonal flu vaccination or COVID-19 vaccinations at school and child care facilities for students, families, and staff. If you are unable to offer these vaccines at school, provide resources for parents to identify Vaccines for Children (VFC) providers in the area, who are able to provide these vaccines regardless of insurance status. These steps help remove obstacles to accessing vaccines.
- The School-Age Vaccination Playbook includes resources for planning, operating, and executing COVID-19 vaccination clinics at schools. The playbook covers pre-planning steps, necessary communications, mapped out day-of operations, and important legal considerations. Templates for communications, as well as additional tools and helpful links, can also be found in the playbook.
- Templates and Handouts
Cleaning
Regularly cleaning surfaces in your facility helps prevent the spread of respiratory viruses that make people sick.
- CDC When and How to Clean and Disinfect Your Facility
- CDC Everyday Actions for Schools to Prevent and Control the Spread of Infections (includes cleaning, sanitizing, and disinfecting, as well as steps to take for cleaner air)
HVAC/Indoor Air Quality
Increasing ventilation in indoor spaces is one way to reduce the spread of respiratory viruses in schools and child care facilities. The following resources offer information on how to improve air quality by increasing airflow, cleaning the air, or providing the option to gather outdoors.
In This Section:
- Communicable Disease Chart
- Guidance on Disease and Outbreak Reporting
- Infection Control
- Personal Protection Equipment
- Use of Nebulizers
Communicable Disease Chart: English Spanish
Guidance on Disease and Outbreak Reporting
Schools and child care programs are subject to disease reporting regulations. Any person in charge of a school, summer camp, or child care center is required to report suspected outbreaks of any illness that might be spread from one person to another. Schools should refer to the Virginia Administrative Code 12VAC5-90-90 or the VDH outbreak reporting website. If a known or suspected outbreak of COVID-19 occurs among students or staff, the school should call their local health department to discuss the situation.
An outbreak is an increase in the number of cases of a disease above what is normally expected in a specific location or population over a specific time period. When two or more persons are experiencing similar symptoms, you should report this to your local health department to help determine if an outbreak is occurring. Early reporting to public health authorities helps ensure the early detection of outbreaks and timely interventions to help prevent the disease spread. These may include the exclusion of ill students/children and staff, increased handwashing, increased environmental cleaning, and parent/guardian notification.
Schools, child care programs, and summer camps can use the VDH outbreak reporting tool to report suspected outbreaks of COVID-19 or other communicable diseases.
CDC recommends that staff who work in a healthcare setting follow guidance for healthcare settings. Healthcare settings refer to places where healthcare is delivered, which includes school health clinics and nursing offices. CDC also has Core Infection Prevention and Control Practices for Safe Healthcare Delivery in All Settings that can be utilized by school health clinics.
Personal Protective Equipment (PPE)
- CDC When Students or Staff are Sick
- CDC's Core Infection Prevention and Control Practices for Safe Healthcare Delivery in All Settings (Section 5d. Risk Assessment with Appropriate Use of PPE)
- Understanding the Difference Between a Surgical Mask and N-95 Masks
- OSHA N-95 Fit Testing Videos
There is a lack of expert consensus and guidance on whether a nebulizer treatment constitutes an aerosol generating procedure in the setting of COVID-19 or other respiratory viruses. It is uncertain whether aerosols generated from nebulizer treatments are infectious and may contribute to the transmission of respiratory viruses. Given this uncertainty, schools may consider reserving the use of nebulizers to instances where children cannot use inhalers, do not have access to an inhaler, or for children who are in significant respiratory distress while awaiting emergency transport. Instead, metered dose inhalers (MDIs) with spacers (with or without a face mask, according to each student’s individualized treatment plan) may be used instead of nebulizer treatments whenever possible in the school setting.
If a nebulizer treatment is necessary, schools may, out of an abundance of caution, consider treating it as an aerosol generating procedure. Schools may consider the following factors when determining the policies (including personal protective equipment required by staff) around nebulizer use: 1) the uncertainty about whether nebulizer treatments may general infectious aerosols, 2) the ability to assess if the student has suspected/confirmed viral respiratory infection, 3) level of respiratory virus activity in the community, considering both local and school-based trends. For additional resources, please refer to the CDC SARS-CoV-2 Infection Control Guidance.
Considerations for Students with Disabilities or Special Healthcare Needs:
A customized and individualized approach may be necessary for some children and youth. The CDC provides guidance for direct service providers such as personal care attendants, direct support professionals, paraprofessionals, therapists, and others who may need to consider additional protective measures.
Mental Health and Resilience
Resources on coping with stress and building resilience among the strong emotions surrounding workplace changes due to COVID-19 and the impacts of other respiratory viruses.
Use school newsletters, posters, signage, and other resources to provide reminders for everyday preventative actions to stop the spread of respiratory viruses.
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