Childcare Centers, Schools Should Not Require RSV Testing or Physician’s Letter for Return


The Minnesota Chapter of the American Academy of Pediatrics shares with the state’s childcare workers and school leaders a similar goal of keeping children healthy and safeguarding them as they grow and learn.

It is understandable that after years of stress and uncertainty brought on by the COVID-19 pandemic, increased cases of other respiratory illness, such as RSV, would bring about a desire for extreme caution. However, current guidance from the national American Academy of Pediatrics (Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis, 2014) states that testing for RSV testing is not indicated for the majority of children. Most children with RSV will have runny nose, cough and some may have a fever, similar to many other viral illnesses. In most cases, RSV testing does not predict who may go on to have a severe course. In most outpatient settings for children with bronchiolitis, routine specific respiratory viral testing has little effect on management and is not recommended.

Requiring testing of children or teens, particularly asymptomatic children and teens, for RSV to return to a group setting is not consistent with medical recommendations. RSV tests can stay positive for several weeks post-infection and should not be used to test for cure.

The decision to return to childcare or school should be based on clinical symptoms, including the child being fever free for at least 24 hours, lack of shortness of breath and some improvement of overall symptoms. Masking upon return from any upper respiratory illness also helps prevent transmission and should be encouraged in children older than two years of age upon return to group settings after an acute respiratory illness until symptoms completely resolve. We recommend following these community standard guidelines for returning to school, rather than requiring a letter from a physician.

We ask Minnesota childcare centers and schools to encourage families and caregivers to follow reasonable procedures to help prevent the spread of
respiratory illness in the childcare setting. There are many viruses that cause similar respiratory illnesses and all should be treated with good hand washing hygiene and keeping a sick child home while they are symptomatic.

A note to parents and caregivers: To help keep healthcare facilities that care for children from becoming overwhelmed, please keep all eligible children up-to-date with childhood immunizations, particularly influenza and COVID vaccines, which are both approved for children 6 months of age and older. Vaccination against COVID-19 and influenza decreases the risk of
severe illness and hospitalization.

View the statements here:

MNAAP RSV Childcare Guidance

MNAAP RSV School Guidance

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