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H1N1 Influenza and Schools.ppt

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					   H1N1 Influenza
    and Schools

Information from CDC, U.S. Dept.of
 Education, ODE, Oregon Dept. of
Human Services, Clackamas County
           Public Health
H1N1 Influenza


   Background
What is the H1N1 InfluenzaVirus?

   Novel influenza A
    (H1N1) is a new flu
    virus of swine origin
    that first caused illness
    in Mexico and the
    United States in March
    and April, 2009.
Why was is called the Swine Flu?

   This virus was originally referred to as
    “swine flu” because laboratory testing
    showed that many of the genes in this new
    virus were very similar to influenza viruses
    that normally occur in pigs in North
    America. But further study has shown that
    this new virus is very different. It has two
    genes from flu viruses that normally
    circulate in pigs in Europe and Asia and
    avian genes and human genes. Scientists
    call this a "quadruple reassortant" virus.
                             How does H1N1 flu spread?

                                   H1N1 flu spreads in the same way that regular
                                    seasonal flu spreads, mainly through the
                                    droplets in coughs and sneezes of people who
A cough. Garry Settles/Penn State
                                    are sick with the virus. It may also be spread by
                                    touching infected objects and then touching
                                    your nose or mouth. The flu virus can survive on
                                    objects/surfaces for about 2-8 hours.




                                                          Gary Settles, Penn State
What are the signs and symptoms?

   H1N1 infection has been reported to cause a
    wide range of flu-like symptoms, including:
    –    fever (some people do not get a fever)
    –    cough
    –    sore throat
    –    headache and body aches
    –    chills
    –    fatigue
    –    many people also have reported nausea,
        vomiting and/or diarrhea.
What are the incubation/contagious
periods?
 Incubation period: Unknown, thought to be
  1-7 days.
 Contagious period: At the current time,
  CDC believes that this virus has the same
  properties in terms of spread as seasonal
  flu viruses. With seasonal flu, studies have
  shown that people may be contagious
  from:
  1 day before symptoms develop to
     up to 7 days after they get sick.
How severe is the illness from H1N1?
   It’s not known at this time how severe the H1N1
    flu virus will be in the general population. As with
    seasonal flu, there are certain people that are at
    higher risk of serious flu-related complications:
     – Children younger than five years old
     – Pregnant women
     – People of any age with certain chronic
        medical conditions, such as diabetes and
        asthma
     – Unlike seasonal flu, adults older than 64 years
        do not yet appear to be at increased risk
How do you control the spread of
H1N1?
   Get an H1N1 flu shot, when available.
   Everyday actions that can help prevent the spread of
    influenza:
     – Respiratory Etiquette: Cover your nose/ mouth with a
        tissue/sleeve when you cough or sneeze.
     – Hand Hygiene: Wash your hands often with soap and
        water, especially after you cough or sneeze. Wash for at
        least 20 seconds. Alcohol-based hand cleaners (with 60%
        or more alcohol) may be used.
     – Avoid touching your eyes, nose or mouth.
     – Try to avoid close contact with sick people.
     – Stay home if you are sick until you have been symptom-
        free for 24 hours.
What is the H1N1 influenza vaccine?
   An H1N1 vaccine is currently in production and
    may be ready for the public in mid-October. The
    H1N1 vaccine is not intended to replace the
    seasonal flu vaccine – it is intended to be used
    along-side seasonal flu vaccine.
   Types of H1N1 vaccine:
    – Inactivated subunit (pieces of dead virus) vaccine injection
      (with and without thimerosal preservative). Some doctors
      recommend that pregnant women receive preservative-free
      vaccinations.
    – Live attenuated (weakened virus) vaccine in inhaler
      sprayers (flu mist). No preservative. Used for low risk,
      healthy people.
    – NOTE: May need 2 doses of the vaccine, about 3-4 weeks
      apart. Cannot take vaccine if allergic to eggs.
Who would be recommended to
receive the vaccine?
   Pregnant women because they are at higher risk of complications
    and can potentially provide protection to infants who cannot be
    vaccinated
   Household contacts and caregivers for children younger than 6
    months of age because younger infants are at higher risk of flu-
    related complications and cannot be vaccinated
   Healthcare and emergency medical services personnel
   Children from 6 months through 18 years of age because we have
    seen many cases of H1N1 influenza in children and they are in close
    contact with each other in school
   Young adults 19 through 24 years of age because we have seen
    many cases of H1N1 influenza in these healthy young adults and they
    often live, work, and study in close proximity
   Persons aged 25 through 64 years who have health conditions
    associated with higher risk of medical complications from
    influenza
Exclusion from school?
   Those with flu-like illness should stay home for at least 24
    after they no longer have a fever, without the use of fever-
    reducing medicines. They should stay home even if they are
    using antiviral drugs.
   Physicians have been advised not to test every person who
    has flu symptoms. They will just be testing severe cases for
    possible H1N1. So, we may not know who has H1N1 in our
    schools and we will not be reporting to parents if
    someone has been diagnosed with H1N1.
   Decisions about extending the school exclusion period should
    be made at the community level, in conjunction with local and
    state health officials.
Exclusion from school?
   General Communicable Disease Guidelines for Exclusion
     (Information from ODE based on OAR 581-022-0705)
   Students should be excluded from school if they exhibit:
     – Fever greater than 100.5 (currently 100 for possible H1N1)
     – Vomiting
     – Stiff neck or headache with fever
     – Any rash with or without fever
     – Unusual behavior change, such as irritability, lethargy, or somnolence
     – Jaundice (yellow color or skin or eyes)
     – Diarrhea (3 watery or loose stools in one day with or without fever)
     – Skin lesions that are “weepy” (fluid or pus-filled)
     – Colored drainage from eyes
     – Brown/green drainage from nose with fever of greater than 100.5 F
     – Difficulty breathing or shortness of breath; serious, sustained cough
     – Symptoms or complaints that prevent the student from participating
       in his/her usual school activities, such as persistent cough, with or
       without presence of fever
     – Student requires more care that the school staff can safely provide
H1N1 Influenza


     LOSD School
Planning, Prevention, and
       Response
School planning, prevention, and response
to H1N1 influenza infection

   Update emergency plans and ensure all contact lists are up
    to date (LOSD new emergency calling system).
   Collaborate with the public health department (track
    student and staff absence and flu-like illness rates).
   Promote good hand hygiene and respiratory etiquette
    through teaching (Flu Fighter curriculum available from the
    state at www.flu.oregon.gov), posters, etc. Provide
    opportunities and appropriate supplies for handwashing.
    (Hand sanitizer dispensers are being installed in secondary
    school lunchrooms).
   Plan for regular cleaning and disinfection of surfaces in
    schools and other infection control measures.
   Minimize the use of shared classroom supplies (e.g.
    buckets of markers or scissors).
School planning, prevention, and response
to H1N1 influenza infection

   Provide H1N1 information to the staff and parents via
    website, newsletters, listserve, etc. Advise parents to develop
    contingency plans should their children become sick and need
    to stay home.
   What can parents do to help? (letter home to parents)
     – Teach your children to wash their hands.
     – Teach your children not to share personal items.
     – Know the signs and symptoms of the flu.
     – Keep your sick children home for at least 24 hours after they no
       longer have a fever.
     – Do not send children to school if they are sick.
     – If you call the school to report that your child is ill, please tell the
       school staff what symptoms your child is experiencing.
School planning, prevention, and response
to H1N1 influenza infection

   Identify high-risk students/staff and encourage
    early treatment of symptoms. People at high risk
    include; for example, those who are pregnant, have
    asthma, diabetes, have compromised immune
    systems, or have neuromuscular diseases.
   Develop response plans to ensure that students
    or staff with fever or flu-like symptoms do not
    come to school or are sent home. Separate
    students who may have flu-like symptoms from
    other students who are ill, until they can be sent
    home.
School planning, prevention, and response
to H1N1 influenza infection

   Plan for possible vaccine distribution request
    from the county health department. A school or
    multiple schools may be designated by the county
    as a POD (point of dispensing) site for the H1N1 flu
    vaccine.
   Consider selective school dismissal depending
    on the amount of illness, the ability of a school to
    function, and the number of students and staff at
    high risk. This decision would be made with
    recommendations from the county health
    department.
Under conditions of increased severity
   The CDC may recommend additional measures
    to help protect students and staff if it is found
    that H1N1 is causing more severe disease. The
    local health and education officials may elect to
    implement some of these measures:
    – Active screening: Check students and staff for flu
      symptoms when they get to school in the morning.
    – Permit high-risk students and staff to stay home.
    – Students with ill household members instructed to stay
      home.
    – Increase distance between people at schools.
    – Extend the exclusion period for ill persons to stay home.
    – School dismissals (selective, reactive, preemptive).
Resources

   Clackamas County Public Health:
    – http://www.clackamas.us/swineflu/
   Oregon Department of Human Services:
    – http://www.flu.oregon.gov/
   Updated federal guidelines for 2009 H1N1
    Influenza in Schools, includes the
    Communication Toolkit for Schools
    (Grades K-12):
    – http://www.flu.gov/plan/school/index.html

				
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