HSE guidance regarding RSV, flu and COVID-19

As we enter the peak winter season, levels of common childhood respiratory illnesses are on the increase, especially in those in the under-5 age group. This increase is reflected in the memo issued to all Early Years service providers by Dr Abigail Collins, Consultant in Public Health Medicine; National Clinical Lead Child Health Public Health on Wednesday, 9 November 2022.

The HSE has reported a significant increase in the rates of Respiratory Syncytial Virus (RSV) infection – a respiratory virus which causes bronchiolitis in young children. Symptoms of bronchiolitis usually include a runny/blocked nose, mild fever and cough. In babies, however, it can cause more significant difficulties in breathing and feeding, and young babies are more likely to need hospital care. More details on bronchiolitis can be found here.

With this is mind, it is therefore important to act to minimise the onward spread of winter viruses, such as RSV, flu and Covid-19 in Early Years services. The HSE has set out the following guidance which may assist you in your service while also important to share with the families using your service.

Important measures

The most important measure is to ensure no child/adult attends your service if they are unwell.

Many children might have a runny nose or a slight cough in winter season and they should not be stopped from attending if well with one mild symptom. However, if a child is feeling unwell with more significant symptoms, or combination of symptoms (cough, runny nose and mild fever) then they should be at home until the fever and their symptoms have gone. Children may have a persistent cough after infection for a few weeks; once the fever and any other symptoms have finished, they should not be excluded because of this persistent cough alone. Spread of viruses, including RSV which causes bronchiolitis, are more likely in children who are unwell with symptoms and therefore keeping children with symptoms out of services will help stop the spread to staff and other children, and help protect babies, who may become more unwell if they get the infection. The same applies for staff. If a staff member is unwell, they should not attend until their symptoms have resolved. Older children and adults may not be particularly unwell with RSV, but a baby could become very unwell if infected. Therefore, it is important to consider the interactions that older children/ adults with symptoms have with babies within your facility to ensure such interactions are minimised even if they only have mild symptoms.

Infection, prevention and control measures

Many of the measures that we all got used to with COVID-19 are still important for the prevention and minimisation of onward spread of many infections. It is important that services and families encourage and help teach appropriate hygiene amongst young children, e.g. respiratory etiquette (coughing or sneezing in to their elbow) and appropriate hand washing. This applies to staff too. Usual recommended cleaning practices should be implemented.

Notifying Tusla

Registered providers are required to notify the Early Years Inspectorate within three working days of becoming aware of a notifiable disease of a pre-school child attending the service, an employee, unpaid worker, contractor or other person working in the service, by using a notification of incident form in accordance with Regulation 31 of the Child Care Act 1991 (Early Years Services) Regulations 2016 (SI 221 of 2016). Further information on Respiratory Syncytial Virus can be found on the Health Protection Surveillance Centre, available here.