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Guidance for families about winter viruses

COVID-19, the flu and RSV cases are increasing as we head into the winter season. It’s important that anyone experiencing symptoms stay home from school or work. Prior to sending students to school, parents are asked to perform a daily symptom check on their child.

The California Department of Public Health has shared the following guidance for families about winter viruses:


There is no cure for respiratory viruses, but some medications can reduce disease severity in certain situations. For mild symptoms, Dr. Pan provides these tips to help ease discomfort:

  • Reduce congestion with nasal saline with gentle suctioning. Patients should sit or lie upright when possible. Cool-mist humidification also helps to clear congestion and make people feel better.

  • Make sure your loved ones get plenty of rest and drink clear fluids such as water, broth or sports drinks to prevent dehydration. For infants, use electrolyte beverages such as Pedialyte. Healthy snacks and small meals are also recommended.

  • If your child has a fever (100 degrees or higher), acetaminophen and ibuprofen can be given to children 6 months of age and older. Infants and children should not be given aspirin as this can cause a rare but serious illness called Reye’s syndrome. Only use other medications or medications for infants less than 6 months old under the guidance of your healthcare provider.

  • Follow the dosing instructions listed on the back of the medication or from your health care provider.

  • Stay home at least 24 hours after there is no longer a fever or signs of a fever (without the use of fever-reducing medicine).


Most childhood respiratory illnesses are mild and resolve on their own without the need for emergency care or hospitalization. Understanding when to see a doctor or go to the hospital ensures that children receive the right care. Call ahead to get medical advice and see what you can do at home and when it is best to come in to be examined. Seek evaluation right away if your child has:

  • Symptoms of lung disease: fast breathing, flaring nostrils, head bobbing, grunting, or wheezing while breathing; belly breathing; pauses in breathing

  • Symptoms of dehydration

  • Gray or blue color to tongue, lips or skin

  • Significantly decreased activity and alertness

  • Symptoms that worsen or do not improve after 7 days

  • Fever in those under 3 months of age (12 weeks)

  • Fever above 104°F repeatedly for a child of any age

  • Poor sleep or fussiness, chest pain, ear tugging or ear drainage


Early evaluation and treatment by a health care professional can ensure the best possible outcomes for children who are at a higher risk of severe disease. Children who are at higher risk of severe disease include:

  • Younger children, particularly 6 months old or younger

  • Premature or low-birth-weight infants

  • Children with chronic medical conditions, including chronic lung diseases, heart disease, disorders weakening the immune system, or neuromuscular disorders


Testing for RSV is not always necessary. Unlike COVID-19, testing for RSV generally does not change the way doctors manage individual patients with this illness and treatment is based on the symptoms a person is experiencing. Accordingly, individuals should seek care based on concerns about the symptoms listed above and not solely to obtain an RSV test result. 

In most situations, return to school should be based on symptoms and generally, children with respiratory symptoms should not return to childcare or school until symptoms are resolved or at least mild and improving. This includes waiting until 24 hours have passed since the resolution of fever without the use of fever-reducing medications.