Schools and H1N1: What You Need to Know
What causes swine flu and how can you stop the spread? NEA's Health Information Network has answers.
With the start of the school year, there's been a lot of media attention surrounding a new wave of H1N1, or swine flu, and how it will impact our schools. In response to quetions and concerns, the The Department of Education has provided an updated list of frequently asked questions for educators:
Q. How does CDC’s new flu guidance for schools differ from the previous school guidance documents?
Q. Why should we be concerned about the spread of flu in schools?
Q. Which students and staff are at higher risk for complications from flu?
Q. How will schools and communities decide what steps to take?
CDC and other public health agencies will be monitoring national data on the number of people who seek care for flu-like illness, as well as the number of hospitalizations and deaths. CDC will also look at the geographic spread of flu-like illness and will look for changes in the characteristics of the virus. By comparing data on a weekly basis with seasonal flu trends and trends from the 2009 H1N1 flu during the spring, CDC will be able to provide advice to state and local agencies on appropriate steps to take. States and local communities can expect the impact of flu in their communities to be different from that seen in other parts of the country. States, communities, and schools should consider: who needs to be involved in the decision-making process and include those people in regular communications, the severity of flu and the impact in the community and in the schools, and the goals, feasibility, and community’s acceptability of the action steps being considered.
Q. What can families, students, and school personnel do to keep from getting sick and spreading flu?Families, students, and school staff can keep from getting sick with flu in three ways:
- Practicing good hand hygiene. Students and staff members should wash their hands often with soap and water, especially after coughing or sneezing. Alcohol-based hand cleaners are also effective.
- Practicing respiratory etiquette. The main way that the flu spreads is from person to person in the droplets produced by coughs and sneezes, so it’s important to cover your mouth and nose with a tissue when you cough or sneeze. If you don’t have a tissue, cough or sneeze into your elbow or shoulder, not into your hands.
- Staying home if you’re sick. Keeping sick students at home means that they keep their viruses to themselves rather than sharing them with others.
Students, staff, and their families must take personal responsibility for helping to slow the spread of the virus by practicing these steps to keep from getting sick with flu and protecting others from getting the flu.
Q. What is the best way to practice good hand hygiene?
Washing your hands with soap and water for at least 20 seconds (the time it takes to sing “Happy Birthday” twice) is the best way to keep your hands from spreading the virus.
Alcohol-based hand cleaners containing at least 60% alcohol are also effective.
If soap and water are not available and alcohol-based products are not allowed in the school, other hand sanitizers that do not contain alcohol may be useful for cleaning hands. However, they may not be as effective as alcohol-based sanitizers.
Q. What steps can schools take to keep students and staff from getting sick?
Schools should take the following steps to help keep students and staff from getting sick with flu. These steps should be followed ALL the time, and not only during a flu pandemic.
- Encourage respiratory etiquette by providing staff and students education and reminders about covering coughs and sneezes, and easy access to tissues and running water and soap or alcohol-based hand cleaners.
- Remind staff and students to practice good hand hygiene and provide the time and supplies for students and staff to wash their hands when needed.
- Send sick students and staff home. Advise students, staff, and families that sick people should stay at home until at least 24 hours after they no longer have a fever or signs of a fever. This should be determined without the use of fever-reducing medicines (any medicine that contains ibuprofen or acetaminophen). They should stay home until at least 24 hours after they no longer have a fever even if they are using antiviral medicines. Schools should revise their policies and incentives to avoid unknowingly penalizing students who stay home when they are sick (e.g., perfect attendance awards).
- Clean surfaces and items that are more likely to have frequent hand contact with cleaning agents that are usually used in these areas. Additional disinfection beyond routine cleaning is not recommended. Some states and localities have laws about specific cleaning products used in schools. School officials should contact their state health department and department of environmental protection for additional guidance.
- Move students and staff who become sick at school to a separate room until they can be sent home. Limit the number of staff who take care of the sick person and provide a surgical mask for the sick person to wear if they can tolerate it.
- Have Personal Protective Equipment (PPE) such as masks available and ensure it is worn by school nurses and other staff caring for sick people at school.
- Encourage sick students and staff at higher risk of complications from flu to get a medical evaluation as soon as possible. Taking antiviral medicines early might prevent severe complications from the flu, such as hospitalization or death.
- Consider dismissing students if a large proportion of staff are at higher risk of flu-related complications. This strategy would be applicable to very few schools nationwide. Settings where this strategy might be appropriate are in schools for pregnant women and schools with many medically fragile children.
Q. What should I do if I’m pregnant and I work or attend a K-12 school?
Pregnant women working in or attending schools should follow the same guidance as the general public about staying home when sick, hand hygiene, respiratory etiquette, and routine cleaning. Pregnant women are at higher risk of complications from flu and should speak with their doctor as soon as possible if they develop a flu-like illness to find out whether they should take antiviral flu medicines. Any person at high risk for flu complications should do the same. Early treatment with antiviral flu medicines is recommended for pregnant women who have the flu. Pregnant women and their doctors should know that they are part of the first priority group to receive the 2009 H1N1 flu vaccine.
Q. What are fever-reducing medications and when would I stop giving them to my child?
Q. Can the virus live on surfaces, such as computer keyboards?
Yes, flu viruses may be spread when a person touches droplets left by coughs and sneezes on hard surfaces (such as desks or door knobs) or objects (such as keyboards or pens) and then touches his or her mouth or nose. However, it is not necessary to disinfect these surfaces beyond routine cleaning. Clean surfaces and items that are more likely to have frequent hand contact with cleaning agents that are usually used in these areas. Some states and localities have laws about specific cleaning products used in schools. School officials should contact their state health department and department of environmental protection for additional guidance.
Q. How do I recognize a fever or signs of a fever?
A fever is a temperature taken with a thermometer that is equal to or greater than 100 degrees Fahrenheit (38 degrees Celsius). If you are not able to measure a temperature, the sick person might have a fever if he or she feels warm, has a flushed appearance, or is sweating or shivering.
Q. How long should a sick student or staff member be kept home?
In the current flu conditions, students and staff with symptoms of flu should stay home for at least 24 hours after they no longer have fever or do not feel feverish, without using fever-reducing drugs. If the flu conditions become more severe, CDC recommends that a sick person stay home for 7 days. A person who is still sick after 7 days should stay home until 24 hours after the symptoms have gone away. In addition, this longer period should be used in healthcare settings and in any place where a high number of high-risk people may be exposed, such as childcare facilities for children less than 5 years of age.
Q. Should family members of sick students stay home too?
Q. What additional steps should schools and families take to keep students and staff from getting sick in the event that the flu is more severe?
- Extend the time sick students or staff stay home to at least 7 days, even if they feel better sooner. People who are still sick after 7 days should continue to stay home until at least 24 hours after symptoms have gone away.
- Schools should allow high risk students and staff to stay home. These students and staff should make this decision in consultation with their doctor.
- Schools should conduct active symptom screening of students and staff upon arrival at school. Any sick students or staff should be separated from others, offered a surgical mask, and sent home. If a household member is sick, parents should keep any school-aged children home for 5 days from the time the first person in the home became sick.
- Parents should monitor the health of their other children for fever and other symptoms of the flu. Schools should find ways to increase social distances (the space between people) at school if possible.
- Schools should work closely with their county and state public health officials to decide how and when to dismiss students. If the decision is made to dismiss students, schools should notify public health and education agencies by submitting a report about the dismissal at www.cdc.gov/FluSchoolDismissal.
- Students should be dismissed for 5 to 7 days and near the end of this period, communities should reassess to determine if students can return to school.
Q. What can schools do to increase social distance during a more severe flu outbreak?
- rotating teachers between classrooms while keeping the same group of students in one classroom,
- canceling classes that bring students together from multiple classrooms,
- holding classes outdoors,
- postponing class trips,
- discouraging use of school buses and public transit,
- dividing classes into smaller groups,
- moving desks farther apart, and
- moving classes to larger spaces to allow more space between students.
Q. What is the difference between a school dismissal and school closure?
Q. What are the different types of school dismissals?
Q. What is a medically fragile child?
Q. How will the decision be made to dismiss schools?
CDC may recommend preemptive dismissals based on information that the outbreak is becoming more severe. An increase in flu spread without an impact on disease outcomes will not lead to the use of preemptive dismissals in most cases.
Q. How will communities know if the flu is more severe and that they need to consider taking additional action steps?
Q. How long will schools have to stay dismissed?
Q. Why would one school dismiss students and another school continue to remain open?
Q. What can a parent do to prepare for flu during the 2009-2010 school year?
Pull together games, books, DVDs and other items to keep your family entertained while at home.
Q. What can a school do to prepare for flu response during the 2009-2010 school year?
- Review and revise existing pandemic plans and focus on protecting high risk students and staff.
- Update student and staff contact information as well as emergency contact lists. Identify and establish a point of contact with the local public health agency.
- Develop a plan to cover key positions, such as the school nurse, when staff stay home because they are sick. Set up a separate room (a sick room) for care of sick students or staff until they can be sent home.
- Purchase Personal Protective Equipment (PPE) such as masks for nurses and other staff providing care for sick people at school. Provide training for this staff about basic infection control and the use of PPE. Develop an education campaign to encourage hand hygiene and respiratory etiquette.
- Develop communication tools (e.g., letters to parents) that can be used to send sick students home, dismiss students, help families identify students who are at high-risk of complications from flu, help staff members self-identify who is at high risk of complications from flu, or cancel mass gatherings.
- Remind parents and staff how long sick students and staff should remain at home.
- Identify ways to increase social distance (the space between people). Review school policies and awards to encourage social distancing and avoiding any incentives for people or staff to go to school when they are sick (e.g., cancel perfect attendance awards).
- Develop a school dismissal plan and options for how school work can be continued at home (e.g., homework packets, web-based lessons, phone calls), if school is dismissed or students are sent home when sick.
- Communicate this plan to all community members who would be affected.
- Collaborate with the local health department, community organizations, local businesses, and social services on a plan for response.
- Help families and communities understand the important roles they can play in reducing the spread of flu in schools.
Q. What can local businesses do to help families and schools during a flu response?
Q. What can community- and faith-based organizations do to help families and schools during a flu response?
Q. How does CDC’s Guidance for School Response apply to my child at boarding school?
Q. How does CDC’s Guidance for School Response apply to my child at college?
Posted August 26, 2009
The first person to call the New York City Health Department and alert them to the first confirmed cases of swine flu in that city wasn’t a hot-shot epidemiologist in a big-city emergency room. It wasn’t even a family doctor. It was a quick-thinking school nurse.