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Managing respiratory illnesses in schools and early childhood settings

The following refers to management of respiratory illnesses in schools and early childhood settings. For additional questions, please contact the Health Department’s pediatric partnerships team at or (215) 685-5488 or at (215) 686-4514 outside of business hours.

This content was last updated on April 23, 2024.

Taking precautions to help reduce the impact of COVID-19, flu, or RSV on your school or early childhood education center is essential for the health and safety of students staff, and the community.

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Safety measures for students and staff

The following safety measures are essential for all:

Staying at home when sick

If a child (including children under 2 years of age) or staff member is sick with symptoms of a respiratory illness, they should:

  • Stay home and away from others.
    • Be seen for testing/treatment from a health care provider if there are risk factors for severe disease. People with risk factors include:
      • Older adults.
      • Young children under 5.
      • People with weakened immune systems.
      • People with disabilities.
      • Pregnant people.
    • Return to normal activities when, for 24 hours:
      • Symptoms are getting better overall AND
      • They are fever free without fever-reducing medicine.
  • If an individual  develops a fever or starts to feel worse after going back to normal activities, they should stay home and away from others, for at least 24 hours, until:
    • Their symptoms are getting better overall AND
    • They are fever-free without fever reducing medicine.
    • Then consider taking added precautions again for the next 5 days (see above).

Exposure, but no symptoms

  • If a student or staff member has had an exposure but does not have symptoms:
    • Monitor symptoms for 1-2 weeks.
    • In case they did get a virus, using added precautions can help reduce the risk of getting anyone else sick. See added precautions (see above).
    • If they develop any symptoms of a respiratory illness, they should stay home and away from others and follow guidance for staying home when sick (see above).
  • Children under 2: Young children may remain in the childcare setting for their exposure period but may be monitored for symptoms for 1-2 weeks and tested on day 5, or sooner if symptoms develop. Parents should discuss options for more frequent testing with their child’s healthcare provider.

Tested positive, but no symptoms

  • If a student or staff member has no symptoms but tested positive for a respiratory virus, they may be contagious.
    • For the next 5 days,added precautions are suggested (see above).

Prevention strategies for schools

The CDC recommends that all people and organizations use core prevention strategies. These steps are important to keep the students, staff, and entire school community safe:

Reporting suspected outbreaks

Outbreaks of individuals with symptom onset within 7 days of each other must be reported to the Philadelphia Department of Public Health. You can report COVID-19 cases to the Health Department by completing a REDCap pediatric survey.

If your school is not receiving daily REDCap surveys, please call (215) 685-5488 or email for further guidance.

A “defined group” may be a sports team, an extracurricular activity cohort such as band, a grade, a class, or any other group of staff or students that regularly meets.

Examples of suspected outbreaks:

  • In <17 person classroom/defined group, 3 positive cases.
  • In 18-49 person classroom/defined group, 5 positive cases.
  • In >50 person classroom/defined group, 10 positive cases

In order to complete the reporting form, you will need the following information about the classroom(s) impacted:

  • Total number of classrooms/cohorts that have cases.
  • Total number of students and staff that have tested positive within each group being reported.
  • Total number of students and staff that are in the defined group.
  • The first positive individual in each classroom/cohort’s reported or observed symptom onset date
  • The last positive individual in the classroom/cohort’s last date spent in school or child care center
  • The positive individuals’ test dates.

The Health Department will follow up to ensure that appropriate infection control measures have been put into place and that outbreak is under control.

Additional information about layered mitigation strategies for respiratory illness season (generally early October to late April)

Optimizing indoor air quality (ventilation)

Schools and ECEs should take advantage of all ventilation strategies available to them especially during respiratory virus season. Read more from the CDC about Taking Steps for Cleaner Air.


Surgical masks or respirators (KN95, KF94, or, for older children N95) can be made available to schools and early childhood education settings. Reach out to us for more information: (215) 685-5488.


This 2023-24 school year, the Health Department will be providing rapid at-home COVID-19 test kits, point-of-care test kits, masks, and other resources for the K-12 school and early childhood education center communities, including staff and families. To request test kits and supplies for your school, email

You can also pick up free rapid antigen at-home test kits at Health Department resource hubs.


As the COVID-19 pandemic in Philadelphia evolves, there may be additional changes to the guidance, so please connect to the COVID-19 texts (text COVIDPHL to 888-777) to receive the most up-to-date information.

You can contact the Health Department at (215) 685-5488 or at (215) 686-4514 outside of business hours. For medical advice, call your healthcare provider.