DISTRICT 113A PREPARED FOR H1N1 WITH PRECAUTIONS

by Sandra Larek

As school students begin coming back to school this fall, District 113A has readied itself for a possible outbreak of the H1N1 flu. As was the case last spring, the district is taking extra precautions with hand washing, cleaning of facilities and general precautions suggested by the Department of Education and the Center for Disease Control as the flu season begins this fall. See a copy of the letter sent home with students on the first day of school. H1N1 Parent Letter

In a letter to all school districts in the country, the Center for Disease Control sent new guidelines on August 8, 2009. District 113A immediately took action to put in place these new guidelines. The letter reads as follows:

CDC Updates Recommendations for the Amount of Time Persons with

Influenza-Like Illness should be Away from Others

On August 5, 2009, Center for Disease Control changed its recommendation related to the amount of time people with influenza-like illness should stay away from others (the exclusion period). New guidance indicates that people with influenza-like illness should stay home for at least 24 hours after their fever is gone (without the use of fever-reducing medicine).

A fever is defined as having a temperature of 100° Fahrenheit or 37.8° Celsius or greater. This is a change from the previous recommendation that ill persons stay home for 7 days after illness onset or until 24 hours after the resolution of symptoms, whichever was longer.

The new recommendation applies to camps, schools, businesses, mass gatherings, and other community settings

where the majority of people are not at increased risk for influenza complications. CDC recommends this exclusion

period regardless of whether or not antiviral medications are used. This guidance does not apply to health care

settings where the exclusion period continues to be for 7 days from symptom onset or until 24 hours after the

resolution of symptoms, whichever is longer.

Decisions about extending the exclusion period should be made at the community level, in conjunction with local

and state health officials. More stringent guidelines and longer periods of exclusion – for example, until complete

resolution of all symptoms – may be considered for people returning to a setting where high numbers of high-risk

people may be exposed.

This exclusion period guidance for the community setting is based on epidemiologic data about the overall risk of

severe illness and death. The new recommendation attempts to balance the risks of acquiring illness from influenza

and the potential benefits of decreasing transmission through the exclusion of ill persons with the goal of minimizing

social disruption. This guidance will continue to be updated as more information becomes available.

To read the complete revised guidance please go to the following web pages:

http://www.cdc.gov/h1n1flu/guidance/exclusion.htm

For more general information on H1N1, go to

http://www.cdc.gov/h1n1flu/.

This change in our recommendation has affected content on a number of other pages, including the following:

www.cdc.gov/h1n1flu/guidelines_infection_control.htm for guidance on infection control in health care settings.

www.cdc.gov/h1n1flu/guidance_homecare.htm

for more information on caring for sick persons in the home.

www.cdc.gov/h1n1flu/qa.htm questions and answers about H1N1 influenza.

Take the following steps to help keep students, teachers, and staff from getting sick with flu.

These steps should be followed ALL the time and not only during a flu pandemic.

Educate and encourage students and staff to cover their mouth and nosewith a tissue when they cough or sneeze. Also, provide them with easy access to tissues and running water and soap. Remind them to cover coughs or sneezes using their elbow instead of their hand when a tissue is not available.
Remind teachers, staff, and students to practice good hand hygieneand provide the time for them to wash their hands as often as necessary.
Send sick students, teachers, and staff homeand advise them and their 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 (without the use of fever-reducing medicine).
Clean surfaces and itemsthat are more likely to have frequent hand contact such as desks, door knobs, keyboards, or pens, with cleaning agents that are usually used in these areas.
Move students, teachers, and staff to a separate roomif they become sick at school 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.
Encourage early medical evaluation for sick students and staffat higher risk of complications from flu. People at high risk of flu complications who get sick will benefit from early treatment with antiviral medicines.
Stay in regular communication with local public health officials.

If the flu conditions become MORE severe, schools may consider adding the following steps:

Extend the time sick students, teachers, or staff stay hometo at least 7 days, even if they feel better sooner. Those who are still sick after 7 days should continue to stay home until at least 24 hours after symptoms have gone away.
Allow high-risk students, teachers, and staff to stay home. These students, teachers, and staff should make this decision in consultation with their physician and/or health professional.
Conduct active fever and symptom screeningof students, teachers, and staff upon arrival at school. Any sick students, teachers, or staff should be separated from others, offered a surgical mask, and sent home.
Find ways to increase social distances(the space between people) at school such as rotating teachers between classrooms while keeping the same group of students in one classroom, moving desks farther apart, or postponing class trips.
Consider how and when to dismiss studentsby working closely with your local and state public health officials. If you decide to dismiss all students, notify CDC and your state health and education agency by reporting a school or school district dismissal at www.cdc.gov/FluSchoolDismissal.

These steps have been taken to prepare for the flu during the 2009-2010 school year:

Reviewed existing pandemic plans and focus on protecting high-risk students, teachers, and staff.
Update student, teacher, and staff contact information as well as emergency contact lists.
Identify and establish points of contact with the local public health and education agencies.
Develop a plan to cover key staff positions, such as the school nurse, when staff any stay home because they are sick.
Develop communication tools (e.g., letters to parents, Web site postings) that can be used to send sick students home, dismiss students, and to remind parents and staff how long sick students and staff should remain at home.
Review school policies and awards criteria to encourage social distancing and avoiding any incentives for students or staff to go to school when 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.
Collaborate with the local health department, community organizations, local businesses, and social services on a plan for flu response.
Help families and communities understand the important roles they can play in reducing the spread of flu in schools.