Influenza & Early Childhood Education

1. Influenza & Early Childhood Education Ashante Butcher PUBH: 6165-1 Environmental Health Instructor Dr. Shana Morrell

2. Learning Goals • Review universal precautions. • Review procedures that prevent illness and promote children’s health in early care and learning environments. • Identification of resources for effective activities that promote health. • Overview of regulatory systems which guide Colorado’s early childhood programs. • Procedure for planning, developing, and evaluating health practices in an early childhood program. Colorado Office of Professional Development. (2008). Colorado core knowledge and standards: A guide for early childhood professional development. Denver, CO.

3. Learning Outcomes • Awareness of health practices that can be promoted in early care and education environments. • Examination of recommendations for routine cleaning, sterilizing, and maintaining learning materials and equipment. • Procedures to formulate a training plan for pandemic flu prevention and preparedness. • Essential safety management procedures, including a plan for tracking pandemic flu. Colorado Office of Professional Development. (2008). Colorado core knowledge and standards: A guide for early childhood professional development. Denver, CO.

4. Pandemic Influenza Merriam-Webseter. Definition of pandemic. Retrieved from http://www.merriam-webster.com/dictionary/pandemic.

5. Flu Terms Defined Seasonal (or common) flu - is a respiratory illness that can be transmitted person to person. U.S. Department of Health and Human Services (2006). Pandemic influenza pre-event message maps. Retrieved from www.flu.gov/news/pre_event_maps.pdf - 2006-02-01.

6. Flu Terms Defined Pandemic Influenza – a global outbreak caused by a new influenza virus. • The virus may spread easily, possibly causing serious illness and death. • Because so many people are at risk, serious consequences are possible. • Historically, pandemic influenza has caused widespread harm and death. U.S. Department of Health and Human Services (2006). Pandemic influenza pre-event message maps. Retrieved from www.flu.gov/news/pre_event_maps.pdf - 2006-02-01.

7. Historical Overview • 1918: H1N1 “Spanish Flu” • 1957: H2N2 “Asian Flu” • 1968: H3N2 “Hong Kong Flu” Taubenberger, J.K., & Morens, D.M., (2006). 1918 influenza: The mother of all pandemics. Emerging Infectious Diseases, 12, 1, 15 – 22. U. S. Department of Health and Human Services. Pandemic Influenza. Retrieved from: http://www.hhs.gov/nvpo/pandemics/index.html

8. Pandemics Do Happen! Pandemics have naturally occurred throughout the 20th century H9* 1998 1999 H5* 2003 Historical analysis can assist in effective planning for a pandemic 1997 2003-2006 H7* 1980 1996 2002 2003 2004 H1 H3 H2 H1 1977 1915 1925 1935 1945 1955 1965 1975 1985 1995 2005 1918 Spanish Influenza H1N1 1957 Asian Influenza H2N2 1968 Hong Kong Influenza H3N2 *Avian (or Bird) Flu U.S. Department of Health and Human Services (2006). Pandemic influenza pre-event message maps. Retrieved from www.flu.gov/news/pre_event_maps.pdf - 2006-02-01.

9. History - Influenza Pandemics • Historical records since the 16th century suggest that new influenza pandemics may appear at any time of the year. • All influenza A pandemics have been caused by descendants of the 1918 virus, including “drifted” H1N1 viruses and reassorted H2N2 and H3N2 viruses. • Before and after 1918, most influenza pandemics developed in Asia and spread from there to the rest of the world. • 1918 virus was novel to humans in 1918 and was not a reassortment virus produced from old existing strains, such as those causing the 1957 and 1968 pandemics. Taubenberger, J. K., & Morens, D. M., (2006). 1918 Influenza: the mother of all pandemics. Emerging Infectious Diseases, 12, 1, 15 – 22.

10. History - Influenza Pandemics • Most pandemic influenza cases in 1918 (>95% in most locales in industrialized nations) were mild and essentially indistinguishable from influenza cases today. • High death rates appear to be the result of several factors including higher proportion of severe and complicated infections of the respiratory tract. • Protective immunity to influenza? Taubenberger, J. K., & Morens, D. M., (2006). 1918 Influenza: the mother of all pandemics. Emerging Infectious Diseases, 12, 1, 15 – 22.

11. History - Influenza Pandemics • Even with modern antiviral and antibacterial drugs, vaccines, and prevention knowledge, the return of a pandemic virus equivalent in pathogenicity to the virus of 1918 would likely kill > 100 million people worldwide. Taubenberger, J. K., & Morens, D. M., (2006). 1918 Influenza: the mother of all pandemics. Emerging Infectious Diseases, 12, 1, 15 – 22.

12. Young Children and the Flu Centers for Disease Control and Prevention. 2007 – 2008 U.S. Influenza Summary. Retrieved from http://www.cdc.gov/flu/weekly/weeklyarchives2007-2008/07-08summary.htm.

13. Influenza in Mountain States Centers for Disease Control and Prevention. 2007 – 2008 U.S. Influenza Summary. Retrieved from http://www.cdc.gov/flu/weekly/weeklyarchives2007-2008/07-08summary.htm.

14. Prepare for flu • 2009 H1N1 in the United States – as of August 6, 2009: • 6506 hospitalized cases • 436 deaths • Higher rates of pandemic influenza when schools are open and children congregate. • Influenza in Colorado. Campos-Outcalt, D. (2009). Pandemic and seasonal flu: What you need to know. The Journal of Family Practice, 58, 9, 481 – 484. Centers for Disease Control and Prevention (CDC). (2009). Novel H1N1 flu situation update: August 6, 2009. Retrieved from http://www.cdc.gov.h1n1flu/update.htm Colorado Department of Public Health and Environment (CDPHE). Disease Control and Environmental Epidemiology Division. (2009c). Colorado weekly flu report for the week ending October 17, 2009. Retrieved from http://www.cdphe.state.co.us/dc/Influenza/.

15. What Can You Do to Protect Yourself During a Pandemic Influenza Event?

16. What You Can Do… • Be Prepared • Maintain Hand Hygiene & Personal Health • Prepare Work Environments • Respond

17. Pandemic Influenza – Prevention Examples of educational materials and posters are available at: http://www.cdc.gov/h1n1flu/flyers.htm Centers for Disease Control and Prevention. Cover your cough. Retrieved from http://www.cdc.gov/flu/protect/covercough.htm

18. Vaccination • Recommendations for Adults: • Persons aged ≥ 50 years • Pregnant women • Health care personnel • Care givers of children or those with medical conditions • Those who have chronic diseases • Those with any respiratory condition • Recommendations for Children and Adolescents at High Risk for Complications: • Aged 6 months to 4 years • Those who have chronic diseases • Those with any respiratory condition • Those receiving long term aspirin therapy • Those in chronic-care facilities • Live attenuated influenza vaccine (LAIV): • Runny nose • Nasal congestion • Headache • Fever Centers for Disease Control and Prevention. (2008, July 17). Prevention and control of influenza: Recommendations of the advisory committee on immunization practices (ACIP). Morbidity and Mortality Weekly Report, 57, 1 – 60.

19. Influenza: Prevention & Preparedness Colorado Department of Public Health and Environment. Consumer Protection Division. Guidelines for the use of sanitizers and disinfectants in child care centers. Retrieved from http://www.cdphe.state.co.us/cp/. International Child Resource Institute. Healthy Child Care: Clean and Sanitize. Retrieved from http://www.globalhealthychildcare.org/.

20. Symptoms of Flu Seasonal Flu H1N1 Pandemic Flu • All types of flu can cause: • Fever • Coughing and/or sore throat • Runny or stuffy nose • Headaches and/or body aches • Chills • Fatigue • Same as seasonal flu, but symptoms may be more severe. • Fever • Coughing and/or sore throat • Runny or stuffy nose • Headaches and/or body aches • Chills • Fatigue In addition to the above symptoms, a number of H1N1 cases reported: • Vomiting • Diarrhea U.S. Department of Health and Human Services (2009). Flu.gov. Retrieved from http://www.flu.gov/individualfamily/about/symptoms/

21. Recommendations for Tracking & Surveillance Colorado Department of Public Health and Environment - Consumer Protection Division 303.692.3645 or http://www.cdphe.state.co.us/cp/ Colorado Department of Human Services – Division of Child Care 303.866.5700 or http://www.cdhs.state.co.us/childcare/index.htm Colorado Department of Public Health and Environment. Consumer Protection Division. Gastrointestinal illness in children’s resident camps: Outbreak prevention and control measures. Retrieved from http://www.cdphe.state.co.us/cp/.

22. Pandemic (H1N1) 2009 • The pandemic (H1N1) 2009 virus lives in some people for at least eight days after symptoms develop. • Individuals working with vulnerable populations (e.g., health care workers, those caring for young children, etc.) should stay home until the risk of transmission has passed. • Members of the general public should consider whether they are still coughing and sneezing and could spread the virus easily. Eggerston, L. (2009). Pandemic (H1N1) 2009 lives in some people for at least eight days after symptoms develop. Canadian Medical Association Journal, 181,9, E203.

23. Pandemic Influenza

24. Community strategies • Community strategies may delay or reduce the impact of pandemic influenza and reduce the spread of disease. • Business (child care provider) plans should consider the following recommendations: • Identify a workplace coordinator • Examine policies for leave and employee compensation • Share pandemic plans with employees and clearly communicate expectations • Prepare business continuity plans • Establish an emergency communication plan U. S. Department of Homeland Security. (2009). Planning for 2009 H1N1 influenza: A preparedness guide for small business. Retrieved from www.flu.gov/professional/business/smallbiz.pdf.

25. URL: http://www.flu.gov/ URL: http://www.cdc.gov/flu/ Training and Resources:

26. Suggested Reading: • American Lung Association’s Influenza Prevention Program. URL: http://www.facesofinfluenza.org • American Red Cross. Pandemic Flu. http://www.redcross.org/pandemicflu • Butler, J. (2009). Flu still spreading in US, CDC says. Clinical Infectious Diseases, 49,8, i. • Centers for Disease Control and Prevention (CDCa). CDC’s Advisory Committee Recommends Influenza Vaccination for Children 6 months through 18 years of age [press release]. URL: http://www.cdc.gov/media/pressrel/2008/r080227.htm • Centers for Disease Control and Prevention (CDCb). Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). URL: http://www.cdc.gov/mmwr/pdf/rr/rr57e717.pdf. • Centers for Disease Control and Prevention (CDC). (2009). CDC Guidance on helping child care and early childhood programs respond to influenza during the 2009 – 2010 influenza season. Retrieved from http://www.cdc.gov/H1N1flu/childcare/guidance.htm.

27. Suggested Reading: • Campos-Outcalt, D. Pandemic and seasonal flu: What you need to know. Journal of Family Practice, 58, 9, 481-484. • Eggerston, L. (2009). Pandemic (H1N1) 2009 lives in some people for at least eight days after symptoms develop. Canadian Medical Association Journal, 181,9, E203. • Flu.gov: What to do about the Flu. URL: http://www.pandemicflu.gov/ • Glass, R., Glass, L., Beyeler, W., & Min, H. (2006). Targeted social distancing design for pandemic influenza. Emerging Infectious Diseases, 12, 11, 1671-1681. • Petit, D. A., and Bailie, J (2008). A cruel wind: Pandemic flu in America, 1918 – 1920. Murfreesboro, TN: Timberlane Books. • Sick days could cost employers $10 billion [press release]. URL: http://money.cnn.com/2006/11/27/news/companies/flu_season/index.htm • Taubenberger, J.K., & Morens, D.M., (2006). 1918 influenza: The mother of all pandemics. Emerging Infectious Diseases, 12, 1, 15-22. Retrieved from http://www.cdc.gov/ncidod/eid/vol12no01/05-0979.htm#cit

28. References: • Barnett, D. J., (2006 September - October). Disasters are always local. The Futurist, 57. • Campos-Outcalt, D. (2009). Pandemic and seasonal flu: What you need to know. The Journal of Family Practice, 58, 9, 481 – 484. • Centers for Disease Control and Prevention. 2007 – 2008 U.S. Influenza Summary. Retrieved from http://www.cdc.gov/flu/weekly/weeklyarchives2007-2008/07-08summary.htm. • Centers for Disease Control and Prevention. Cover your cough. Retrieved from http://www.cdc.gov/flu/protect/covercough.htm • Centers for Disease Control and Prevention (CDC). (2009). CDC Guidance on helping child care and early childhood programs respond to influenza during the 2009 – 2010 influenza season. Retrieved from http://www.cdc.gov/H1N1flu/childcare/guidance.htm.   • Centers for Disease Control and Prevention. (2009). Novel H1N1 flu situation update: August 6, 2009. Retrieved from http://www.cdc.gov.h1n1flu/update.htm • Centers for Disease Control and Prevention. (2008, July 17). Prevention and control of influenza: Recommendations of the advisory committee on immunization practices (ACIP). Morbidity and Mortality Weekly Report, 57, 1 – 60.

29. References: • Colorado Department of Public Health and Environment. Consumer Protection Division. (2009a). Gastrointestinal illness in children’s resident camps: Outbreak prevention and control measures. Retrieved from http://www.cdphe.state.co.us/cp/. • Colorado Department of Public Health and Environment. Consumer Protection Division. (2009b). Guidelines for the use of sanitizers and disinfectants in child care centers. Retrieved from http://www.cdphe.state.co.us/cp/. • Colorado Department of Public Health and Environment. Disease Control and Environmental Epidemiology Division. (2009c). Colorado weekly flu report for the week ending October 17, 2009. Retrieved from http://www.cdphe.state.co.us/dc/Influenza/. • Colorado Office of Professional Development. (2008). Colorado core knowledge and standards: A guide for early childhood professional development. Denver, CO. • Cowling, B. J., Chan, K, Fang, V., Cheng, C., Fung, R. O., Wai, W., Sin, J., Seto, W. H. (2009). Facemasks and hand hygiene to prevent influenza transmission in households. Annals of Internal Medicine, 151, 7, 437 – 446. • Eggerston, L. (2009). Pandemic (H1N1) 2009 lives in some people for at least eight days after symptoms develop. Canadian Medical Association Journal, 181,9, E203. • International Child Resource Institute. Healthy Child Care: Clean and Sanitize. Retrieved from http://www.globalhealthychildcare.org/.

30. References: • Taubenberger, J. K., & Morens, D. M., (2006). 1918 Influenza: the mother of all pandemics. Emerging Infectious Diseases, 12, 1, 15 – 22. • U.S. Department of Health and Human Services (2009). Flu.gov. Retrieved from http://www.flu.gov/individualfamily/about/symptoms/ • U.S. Department of Health and Human Services (2006). Pandemic influenza pre-event message maps. Retrieved from www.flu.gov/news/pre_event_maps.pdf - 2006-02-01. • U. S. Department of Homeland Security. (2009). Planning for 2009 H1N1 influenza: A preparedness guide for small business. Retrieved from www.flu.gov/professional/business/smallbiz.pdf.

31. Ashante Butcherashante.butcher@waldenu.edu