Investigation and management of outbreaks of suspected acute viral respiratory infection in schools: guidance for health protection teams - GOV.UK - ISS-G20 Laboratorium Repository

1. Executive summary

This document provides guidance for local health protection teams (HPTs) about assessing and managing outbreaks of suspected acute viral respiratory infection (ARI) in schools and colleges including special educational needs. Approaches to response, including recommendations on testing, may have applicability in related settings such as early years/nurseries and school holiday clubs.

Every autumn and winter, seasonal influenza viruses and other respiratory viruses like rhinovirus and respiratory syncytial virus (RSV) cause school outbreaks. Since early 2020, SARS-CoV-2, the novel coronavirus that causes coronavirus disease (COVID-19), has been in circulation within the UK, and has led to cases and outbreaks linked to schools. All these viruses can present with similar symptoms and so it is essential that suspected ARI outbreaks in schools are investigated and managed appropriately.

Central to the approach to this setting, is the communication of key preparedness messages to schools, including awareness of arrangements for reporting of outbreaks to local HPTs, exclusion advice for unwell children (which will vary depending on the respiratory diagnosis), as well as the national childhood immunisation programmes such as that for influenza.

Schools are experienced in management of cases of childhood respiratory viruses. Schools may escalate concerns to HPTs if they have concerns related to:

• a higher than previously experienced and/or rapidly increasing number of pupil or staff absences due to acute respiratory infection
• evidence of severe disease due to respiratory infection, for example, if a pupil or staff member is admitted to hospital
• a cluster of cases where there are concerns about the health needs of vulnerable staff or students within the affected group, including special educational needs schools
• control of transmission in boarding or residential school environments

Epidemiological definitions of cases and outbreaks are primarily used for surveillance purposes and should not be taken as indicating thresholds for HPT referral or public health action.

A key intervention to limit the transmission of flu in schools is to ensure successful delivery of the childhood influenza immunisation programme in eligible year groups. In influenza outbreak situations, antivirals may also be considered for unvaccinated exposed children in clinical risk groups, in line with national guidance, such as that published by the National Institute for Health and Care Excellence (NICE) and the UK Health Security Agency (UKHSA).

The main guidance relating to specific situations which should be read in parallel with this guidance includes UKHSA guidance on health protection in schools and other childcare facilities (for example, for exclusion advice).

Separate considerations will apply for residential educational settings and special schools (see Appendix 1 and Appendix 2).

Entire content available on: https://www.gov.uk/government/publications/influenza-like-illness-ili-managing-outbreaks-in-schools/investigation-and-management-of-outbreaks-of-suspected-acute-viral-respiratory-infection-in-schools-guidance-for-health-protection-teams