Respiratory Isolation Guidelines

Isolation Location:

Patients in the Neonatal Intensive Care Unit (NICU), Pediatric Ward or Pediatric Intensive Care Unit with confirmed or suspected respiratory viral illness should be placed in a private room on contact and droplet precautions. When a single patient room is not available, consultation with infection control personnel is recommended to assess the risks associated with other patient placement options.

Duration of Isolation:

Isolation precautions should be maintained based on the patient and the organism:

  • For Influenza or RSV illness, precautions should be implemented at the onset of signs and symptoms. In NICU patients with Influenza contact precautions should be used in addition to droplet isolation precautions.

 Precautions should be maintained until the following conditions are met:

    • For a minimum of 14 days after onset of signs and symptoms AND improvement of symptoms. 
    • Patient has 1 negative Influenza/RSV PCR collected after meeting the above conditions.
    • If positive, weekly PCR must be performed until 1 negative result.
  • For Rhinovirus illness detected by multiplex PCR, precautions should be implemented at the onset of signs and symptoms.

Precautions should be maintained until the following conditions are met:

    • For a minimum of 14 days after onset of signs and symptoms AND improvement of symptoms.
    • Patient has 2 negative respiratory viral multiplex PCR, obtained one week apart with the first collection after meeting the above conditions.
    • If positive, weekly PCR must be performed until 2 consecutive negative results are achieved.
  • For any other viral respiratory illness detected by multiplex PCR, precautions should be implemented at the onset of signs and symptoms.

Precautions should be maintained until the following conditions are met

    • For a minimum of 14 days after onset of signs and symptoms AND improvement of symptoms. 
    • Patient has 1 negative Influenza/RSV PCR collected after meeting the above conditions.
    • If positive, weekly PCR must be performed until 1 negative result

In some cases, IPC may advise continued precautions for longer periods based on clinical judgment and outbreak situations.