Friday, November 13, 2009
School nurses talk about flu
Last week saw an uptick in student illness at the Concord-Carlisle Regional High School (CCHS), but the absentee rate for students at the Carlisle School remains normal. Both schools are monitoring student health and pro-actively working to reduce the spread of illness among students and faculty in light of the global appearance of H1N1 influenza.
According to CCHS School Nurse Chris DeBruzzi, normally between 2% to 5% of the high school students will call in sick on any given day. However, she said “Last week it popped up to 8% to 10%. We hit a high last Wednesday of 10%.” Fewer were sick by Monday, November 9, when the percent ill dropped back to 6%.
She noted that the data does not track how many students have contracted H1N1, the seasonal flu, or other illnesses such as colds, strep, mononucleosis or tonsillitis. The state is not requiring testing for H1N1 and is grouping people with flu symptoms under the umbrella term: influenza-like-illness (ILI). DeBruzzi only knows of flu cases when someone calls in and describes the symptoms, or if she sends them home sick during the school day and observes the symptoms. She says she’s “definitely seeing ILI. It’s here.” She said that flu cases are “probably higher this year than last year” and last week’s illness rate was “probably a flu-like spike. I have to make that assumption.”
Faculty illness rates have been lower, DeBruzzi says. “The adult population is fine. We are watching that as well. Their percentages are up slightly, but today [Monday] they were back to normal.” She added that, “They’ve been really good about washing their hands, educating the students and taking care of their classroom.” Strategies to reduce flu transmission were discussed at a faculty meeting, DeBruzzi said. “Because of the flu we’ve been able to drive home infection control procedures that are so important for keeping all contagious illness down.”
How to avoid the flu? In a high school newsletter DeBruzzi recommends: vaccination for H1N1 and seasonal flu; frequent handwashing; using hand sanitizer containing at least 60% alcohol; and covering coughs and sneezes with tissues or by coughing into the inside of one’s elbow. To avoid spreading illness, she said that students should stay home from school at least 24 hours after their temperature is normal without using fever-reducing medicines such as acetamenophen or ibuprofen.
Flu has not been a major factor at the Carlisle School this fall, according to Carlisle School Nurse Kathy Horan. On a recent day there were 40 students absent, about 5.7%, but she noted that some were due to routine doctor or dentist appointments. The average daily rate is between 4% and 5%. Of those calling in sick, she said, “The majority have colds with no fevers.” The school shares student illness data with the BOH and so far there have been one or two presumed cases of flu reported. Faculty absences have been at or below normal levels, Horan said.
Typically, the highest rates of student illness occur between Christmas and February vacations. During this interval Horan sometimes sees spikes with up to 60 or 80 children out sick.
Both school nurses agreed that it was important for sick students to stay at home until they are well. Horan said they are trying to get the word out to middle school students that “it’s okay to stay home until you’re really well.” Some return as soon as they are fever-free for 24 hours and “not allegedly contagious, but may still have a cough and do not feel great.” Often, Horan sees kids who return too soon feel like “a dishrag by noontime.”
Horan’s advice echoed DeBruzzi’s. While admitting that it can be hard for working parents, she added, “Please, if kids are sick, keep them home.”
If student absentee rates rise significantly in the coming months, the schools would likely stay open, following recent Centers for Disease Control (CDC) guidelines.
If an outbreak were noticed in Carlisle, Horan said the school would consult with the state flu line and epidemiology office. However, Horan said that in schools that experienced flu outbreaks last spring, closing middle schools did not slow the outbreak, because the children socialized outside of school for sports, sleepovers or to attend church or temple. “They’re exposed lots of places.”
CCHS Principal Peter Badalament explained that for the high school “the decision to close school would be made between the [Concord-Carlisle Regional School District] CCRSD and the Concord [Department of Public Health] DPH. The latest CDC guidelines focus on maintaining the appropriate number of adults to safely staff the building and do not take into consideration the rate of student absenteeism.” He concluded “In other words, while we are closely monitoring both student and staff absence, the decision to close would be largely based on whether or not we had enough teachers to function safely.”
For more information about H1N1 and the seasonal flu, visit: www.flu.gov. ∆
© 2009 The