H1N1 Influenza A Updates: Schools & Fall Flu Season

1. H1N1 Influenza A Updates: Schools & Fall Flu Season Washtenaw County Public Health Diana Torres-Burgos, Medical Director Richard Fleece, Interim Health Officer Cindra James, EP Coordinator WISD 8/5/09

2. What is Novel Influenza A H1N1? • Pandemic Influenza A H1N1 is a new strain of the flu that contains genetic fragments from birds, pigs, and humans and was first detected in April, 2009.

3. Signs and Symptoms • Fever • Cough • Sore Throat • Vomiting • Body ache • Diarrhea • Lethargy

4. How does it spread? • Thought to be spread in the same way that seasonal flu spreads • Mainly from person to person when an infected person coughs or sneezes and spreads tiny particles into the air • Sometimes by touching contaminated surfaces with flu viruses, and then touching one’s mouth, nose or eyes

5. How long is a person infectious and can spread to others? • Up to 7 days after they become sick • Children, especially infants, may be contagious for longer periods • Viruses can live 2 - 8 hours on surfaces like tables, desks, and doorknobs • On hard non porous surfaces may live up to 48-72 hours - like metal/stainless steel products.

6. Influenza A H1N1 and Seasonal Flu • H1N1 influenza A is different from seasonal flu because: • It is a new strain of the virus • Most people do not have immunity to it • Immunizations received last fall or this winter do not offer protection against the H1N1 swine flu • Children and young adults at higher risk for disease and complications from H1N1

7. H1N1:What We Know-Cont’d • Novel H1N1 transmission ongoing • Majority of deaths in individuals with underlying medical conditions such as Asthma, Diabetes and immune disorders • Fourfold hospitalization in pregnant women

8. H1N1: What We Know-Cont’d • Most reported cases: • Highest in 5-24 years old, • Lowest reported cases in 65+ years old • Note: Usually 90% of seasonal influenza-related deaths occur in people aged 65 and older. Seasonal flu still has a higher death rate then the H1N1 virus.

9. Public Health Authorized Intervention Options • To help contain or limit the spread of infections as effectively as possible The Health Department has the authority to: • Treat sick and exposed individuals with antivirals • Isolate sick people in hospitals, homes or other facilities • Identify and quarantine exposed people • Close schools and workplaces only as needed • Cancel public events - Athletic / Social • Restrict Travel - Field Trips/ Overnight Trips

10. H1N1 Vaccine • Available earliest by mid-October • Vaccines remains the single best means for protection • Vaccines clinics at schools for students/staff/families. We are still working on details of when and where with Public Health. • Permission / Consent forms for vaccine

11. H1N1 Vaccine Priority Groups • Pregnant women • People who live with or care for children younger than 6 months age • Persons between the ages of 6 months – 24 years of age - The School Age Group • People from ages 25 – 64 years who are at higher risk for H1N1 complications due to chronic health diseases or compromised immune systems

12. Promote Respiratory Hygiene • Allow for regular handwashing for students and staff using soap and water • Waterless hand gels sanitizers provided to classrooms without sinks • Ensure custodial staff is checking sink locations and restrooms regularly to ensure they are stocked with soap, paper towels or working hand dryers • Cough etiquette education posters throughout school will be distributed

13. Disinfecting Facilities • Viruses commonly live on surfaces from 2-8 hours • Commonly hand touched surfaces such as stairways, railings, elevator buttons should be kept clean by wiping with detergent-based cleaners or EPA registered disinfectants used in the school settings • Bringing in additional cleaning services is not warranted.

14. CDC Revised Recommendations for Schools K-12 • “CDC recommends that people with influenza-like illness remain at home until at least 24 hours after they are free of fever (100 degrees F), or signs of a fever without the use of fever-reducing medications.” • It is recommended that staff and students stay home for at least 5 days or until they are fever free for 24 hours.

15. CDC Recommendations for Schools • Isolate those with flu like symptoms promptly in a room separate from other students while waiting to be sent home • Each school needs to identify an isolation room • Ill students should not attend alternative child care or congregate in the community

16. CDC Recommendations for Schools • Key messages: • Keep ill students and staff at home • At least 5 days or until fever is gone for 24 hours • Wash hands frequently • Using sinks/soap and hand sanitizer • Cover cough and sneezes

17. AAPS Plan • Send letter home week before start of school • It will emphasize the importance of keeping ill children at home for 5 days per CDC • It will ask parents to come up with plan to keep children at home. • Provide hand sanitizers in classrooms without sinks • We may institute alcohol based products and ask for parent donations • Allow time for hand washing during school day • Cleaning protocol has been initiated by custodial staff • Immunization Sites - locations - consent - staffing

18. AAPS Plan • Develop website of info with updates linked to each school site • Allocate one school nurse to be dedicated to H1N1 plan for district • Distribute H1N1 posters for all schools/classrooms • Develop protocol for student & staff to remain home when ill • Develop education plan for extended illness/school closing • Ask each school to identify isolation area to hold student when ill • Masks for ill students/staff per recommendation by Public Health -?

19. Resources • The Centers of Disease Control and Prevention • www.flu.gov • www.cdc.gov/h1n1flu/schools/schoolguidance.htm • www.cdc.gov/h1n1flu/schools/toolkit • The Department of Education • www.ed.gov • Michigan Department of Community Health • www.michigan.gov/h1n1 • Washtenaw County Public Health • http://publichealth.ewashtenaw.org • Public Health - School Portal