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Pandemic or Panic?


It’s impossible to say, but here’s what you—and your school—can do in the face of avian flu fears.


By Sheree Crute

bird illustration for avian flu storyYou can’t turn on the TV or read a newspaper these days without hearing about the avian flu. So, it’s no surprise that with ongoing media reports about a possible worldwide pandemic, and frightening spectacles like the TV movie Fatal Contact: Bird Flu in America, even the most level-headed folks have begun to fear the worst.

Nowhere has the concern been felt more strongly than among caregivers, be they parents, teachers, school nurses, or other education workers. Spurred by federal officials, many school districts have begun crafting contingency plans, identifying ways to continue operating in the face of widespread absences, and even providing distance learning programs should schools need to be closed outright.

The Big Picture

Influenza viruses have always been with us. The World Health Organization (WHO) reports that the first avian strain was discovered in Rome as early as 1878. But avian influenza A (H5N1), the current strain that has so many people worried, made its first appearance only recently, in 1996 in Guangdong, China. Initially, this new virus affected only geese; human cases wouldn’t be confirmed until the Hong Kong outbreak a year later.

The virus didn’t capture the world’s attention until it crept across Asia in 2003 and surfaced a year later in Europe. Ordinarily, avian flu lives only in birds (and sometimes pigs or other animals), and flu viruses usually stick to a single species. H5N1 has caused great concern because it has crossed this barrier to infect humans. To make matters worse, humans have no natural immunity against this new form of flu, a particularly virulent strain that travels with migrating birds and continues to evolve.

How Real Is the Risk?

This, of course, is the question that no one can answer with confidence. As of July, 232 people in 10 countries have been diagnosed with H5N1, and 134 have died, according to the WHO. So far, threatened nations have swiftly identified, contained, or eliminated the virus, but “statistically, we’re due for a new pandemic [global outbreak] influenza strain,” says William Schaffner, M.D., chairman of Vanderbilt University’s department of preventive medicine and an expert in biological weapons and infectious diseases.

Still, Schaffner cautions against jumping to conclusions. “The big concern is a strain that can go from person to person, through casual contact, but this virus cannot do that right now,” he says. “It’s good to be informed about the avian flu, but realize it’s not even in our hemisphere.”

 In order for the virus to cause a worldwide pandemic, the WHO reports that one of two things must occur. There would have to be a sharing of genetic material between human and avian viruses, or the avian virus would have to mutate to a form that could be transmitted from person to person through casual contact. Early summer news reports of an infection that spread between members of an Indonesian family raised concerns that the virus had mutated, but “tests showed it was the bird form of the virus, not a mutated form, passed through extremely close contact,” says Schaffner.

For now, the risk to humans comes from butchering, defeathering, slaughtering, or other handling of infected birds. In countries that have reported avian flu, aggressive poultry slaughtering, vaccination (there’s a vaccine for poultry, not people), and quarantine programs have stopped or greatly slowed all outbreaks.

In the United States, carefully monitored poultry plants and farms offer excellent protection, experts say. But, in the event of an outbreak, there’s a great deal individuals and communities can do to make a difference, and in the case of the nation’s school districts, an important part of that work is already underway.

Your School District: What To Expect

Doug O’Neil, coordinator of safety and environmental health for Virginia’s Fairfax County, one of the nation’s largest school districts, is just one of the hundreds of school nurses, education workers, and health experts working with local or national task forces to ensure the nation’s schools are ready for any disaster, not just the flu pandemic. Each district may have different plans, but many have preparations in place.

What’s going on in your district?

O’Neil explains that “the idea is to maintain a continuity of school operation during the height of emergencies, especially in cases where 20 or 30 percent of staff might be missing.” Your district’s security office probably already has plans to keep supplies in the schools, step up cleaning operations to prevent infection, and perform disease surveillance, so it may be a good place to ask questions.

What about the national level?

The National Association of School Nurses (NASN) and the Centers for Disease Control and Prevention (CDC) are both involved in efforts to produce expert preparedness information for school districts. “School nurses have an all-hazards approach, but we’re trained in detection and surveillance of illness patterns and communicating to health departments, teachers, and parents,” says NASN’s Sue McCarroll. 

A national panel may have information ready as early as September, according to CDC epidemiologist Carol Stanwick, who is working with the federal agency’s Division of Adolescent and School Health (DASH) on a pandemic preparedness plan for the nation’s schools. A wide range of issues will be considered, including how to continue meals or medical care for children who must get those services at school, making sure everyone has a role in infection control—even providing distance learning in the event of school closings, she says. To learn more, go to www.pandemicflu.gov/plan/ schoolchecklist.html.

You and Your Family: Taking Control

Rather than worry about a pandemic that may not occur, consider this an opportunity to take a new approach to personal, family, and community safety, experts say. Preparing for a pandemic is a “significant local and individual effort—the cavalry won’t be coming,” says Stanwick. 

School nurse Janice Doyle echoes Stanwick’s advice. “A pandemic plan has to be part of a larger disaster plan,” says Doyle, who chairs her district’s pandemic committee in Spanaway, Washington. Taking charge can lower your family’s risk of injury or illness in any emergency.

Where do you begin?

To help manage your fears of a pandemic, learn all you can, advises Stanwick. To start, go to www.pandemicflu.gov. There, you’ll find safety checklists and guidelines to follow for your home. You’ll learn about national plans for public safety and can monitor national and international updates on avian flu. Also review www.who.int/topics/avian_influenza/en/.

Can you take practical steps?

Yes, because good, old-fashioned common sense may be your family’s best defense. Ask yourself, “Could I lock my door for three weeks and be okay?” says Nancy Kass, a bioethics professor at Johns Hopkins University. Work out issues such as: Where do young children turn for help if parents are ill?  What supplies—food, medicine, cash, water—would you need in the event of a quarantine? What could you do to help elderly or disabled family members or neighbors if you were needed?

Can prevention help?

Basic hygiene habits are also a good way to protect your health. Hand washing and shielding coughs are two of the best ways to avoid the spread of influenza and other viruses. “We are attracted to the exotic, such as bird flu,” Schaffner says, “but the regular flu costs lives every year. Get your flu shots.”

Do you have the heart of a hero?

Because education workers are often willing to help others, gather your inner circle of colleagues and identify what Kass calls “lay heroes,” people willing or able to be first responders and stand in for others in critical jobs.

As you consider plans for your family and school community, remember that “if an outbreak occurs in the United States, we will have distant, early warning from the CDC and local health departments,” says  Schaffner. Taking steps to protect yourself now simply means that whether avian flu H5N1 goes down in history as a crisis or a scare, you and your loved ones will be better prepared to weather any storm.

Be Prepared  NEA Member Tip

Nurse Janice Doyle gives a tip on being prepared.Janice Doyle, a nurse at Bethel School in Spanaway, Washington, knew her way around a crisis long before anyone heard the words “avian flu.” Doyle is the author of Disaster Preparedness Guidelines for School Nurses, published by the National Association of School Nurses. She says that everyone can turn their classrooms or schools into healthier spaces by teaching and reinforcing the basics of cold and flu prevention.

Schedule your own healthy classroom day, says Doyle, encouraging kids to make posters and other reminders of important—but easy to forget—behaviors such as hand washing and covering up when they sneeze or cough.  Stock up on hand sanitizer and tissues for the classroom.

In the event of a flu outbreak, Doyle says, “Remember, children pick up stress from adults. Try to stay calm.” Make note of any students that may be dependent on school resources such as meals for their health. Consider children with special physical needs as well.  Share the information with your school nurse and administrators.

Illustration: Photodisc

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20-Sep-06