Fall 2009 Influenza Updates

By Dr. John Urkevich, Executive Director

As the new school year has begun, concerns about Influenza A and H1N1 are high amongst schools, families and communities. Cooperating School Districts is monitoring the situation closely, communicating regularly with our member districts as well as the St. Louis County, Jefferson County, St. Charles County Departments of Health.

As you can see on the charts below from St. Louis County Department of Health for the month of September, influenza cases are increasing each week, and students in K-12 schools are most affected. According to Dr. Dolores Gunn, Director of the St. Louis County Department of Health, this number of flu cases is unusually high for this time of year; usually flu season starts mid-October In addition, the distribution of reported flu cases to date is concentrated more highly in younger age groups than would typically be the case.

According to the St. Louis County Department of Health, surveillance sites (which includes all hospitals located in the county, pediatric practices, ambulatory care facilities, and a university student health center) reported 215 cases of influenza A for the week ending September 27, including 6 cases of 2009 H1N1 influenza. It should be noted that very few influenza A cases are being tested for the 2009 H1N1 (which is a type A infuenza), and that the actual number of cases may be much higher.

Many agencies are working to get up to date information to the community on the flu and H1N1. For example, Missouri’s Department of Health & Human Services created a flu campaign called WHACK The Flu! that teaches school children to help protect themselves and others from illness by using effective hygiene habits:

W: Wash your hands often;
H:  Home is where you stay when you are sick;
A:  Avoid touching your eyes, nose and mouth;
C:  Cover your coughs and sneezes;
K:  Keep your distance from people who are coughing or sneezing.

For more information and to access free materials, please visit http://www.dhss.mo.gov/WHACK/.

When visiting http://flu.gov, you can find information for “individuals and families” that includes tips on vaccination, prevention and treatment, and care giving. Under the section “for professionals,” there are links for community planning, school planning, and hospital planning.

Over a dozen resources can be found on CSD’s H1N1 webpage. In addition, information is being added to Education Today’s side bar (see upper right).

H1N1 Flu and St. Louis area schools

By Dr. John Urkevich, Executive Director

Earlier this week, Dr. Dolores Gunn, Director of the Saint Louis County Health Department, met with Cooperating School Districts member districts to discuss issues surrounding the H1N1 virus (commonly known as Swine Flu).

Dr. Gunn stated that the Saint Louis County Health Department is prepared to close down a school if a probable or confirmed case of H1N1 is identified (99 percent of probable cases are confirmed positive within 72 hours, so they are treated just as seriously as confirmed cases).

While she spoke, reports were surfacing that the US is advising against closing schools at the present time. Dr. Gunn responded by indicating that the ultimate decision lies on the local level, and her recommendation would still be to close a school if a probable or confirmed case is identified.

Dr. Gunn also told meeting attendees that the Health Department is monitoring the situation and is in constant communication with the Centers for Disease Control (CDC).

However, because 61 percent of the people who get the H1N1 virus are under the age of 18, it is very possible that a student in a St. Louis area K-12 school could come down with it. The following is information that will be critical in case school closure becomes a possibility:

• Public health officials will give the best advice possible for public health and will work closely with school administrators.
• Schools can be closed for even one probable or confirmed case.
• School closures can last for up to 14 days.
• In districts where multiple schools are located on the same campus, more than one school may be closed with one case because of that proximity.
• When schools are closed, all extracurricular school-based activities will also be shut down.
• If a child has a confirmed case and has siblings who attend other schools, everyone in that family will be tested before any of those children return to school.  It may or may not be necessary to close the school a sibling attends.

Since every case and school district is different, districts will need to be flexible when dealing with an H1N1 case and the investigation that follows. Dr. Gunn noted that public health investigations involving schools are very detailed and take some time to follow the trail of the virus through a school community.

Dr. Gunn also said that if a school nurse treats a student with a temperature over 100 degrees, a sore throat and other signs of the flu, that student should be sent home. If a school wishes to require a doctor’s note for that student to return to school, the Health Department would stand behind that requirement.

The good news was that this virus is flawed and having trouble replicating itself. Although it is still a threat, the flu is not spreading as quickly as initially thought. There is a chance, however, that the H1N1 virus could come back much stronger when flu season comes in the fall, just as school is starting again.

Remember, prevention is key. According to the CDC website, “serious respiratory illnesses like influenza, respiratory syncytial virus (RSV), whooping cough, and severe acute respiratory syndrome (SARS) are spread by:

• Coughing or sneezing
• Unclean hands

To help stop the spread of germs,

• Cover your mouth and nose with a tissue when you cough or sneeze.
• Put your used tissue in the wastebasket.
• If you don’t have a tissue, cough or sneeze into your upper sleeve, not your hands.

Clean your hands after coughing or sneezing

• Wash with soap and water  or
• Clean with alcohol-based hand cleaner.”

For more resources on H1N1, please visit these websites:
http://www.cdc.gov/H1N1FLU/

http://www.stlouisco.com/doh/Flu/New_H1N1.htm

http://www.education.com/topic/swine-flu/

If requested by the Health Department to do so, CSD will share any changes with districts on how schools should approach the H1N1 virus. For a fall 2009 update, click here.