Novel Influenza A (H1N1) Virus: Review of Current School Guidance-Fairfax County Public Schools

1. Novel Influenza A (H1N1) Virus: Review of Current School Guidance-Fairfax County Public Schools Presentation to AISGW September 29, 2009 Esther M. Walker RN, BSN, MSA Assistant Director of Patient Care Services Fairfax County Health Department

2. Recommendations for Schools: Outbreak similar to the Spring • Hand Hygiene/Respiratory etiquette • Work with school administrators to make access hand washing, hand sanitizers, tissues available • Reinforce the classroom based instruction with the student and staff • Getting seasonal flu vaccine • All children aged 6 months to 19th birthday should get seasonal flu vaccine • H1N1 Vaccine when available for persons in priority group • Keeping ill students home

3. Current Planning • Ongoing meetings with Fairfax Count Public Schools (FCPS) • Education to community • General messaging about H1N1 and prevention measures • High risk individuals should begin dialogue with primary care provider • Town Hall Meeting for general public • If severity increases guidance will come through Fairfax County Health Department and FCPS if other interventions are needed • Number of strategies available

4. Preventive Measures • Communication to principals before start of school • HD SIMS daily absentee monitoring • Front load hand washing and respiratory etiquette in first 2 weeks • Use of posters • Notification of high risk groups for anticipatory guidance from PMD

5. Respiratory/Cough Etiquette and Hand Washing Posters

6. Recommendations for Schools: Separating Ill Students and Staff • If students present to health room with Influenza Like Illness -ILI (fever plus cough/sore throat) they should be sent to a room separate from other students while waiting for parent pick-up • School staff should immediately go home • Staff providing direct care need to use PPE (N95) • Student with ILI wears surgical mask if they tolerate it while waiting for parent pick-up • Reinforce the exclusion period with the families when they are called and again when they pick up the child • Children do not necessarily need to seek medical care unless the severity of their illness requires that

7. Recommendations for Schools: Exclusion period • Staff and students with ILI should stay home for at least 24 hours after fever (most contagious period) without the use of fever reducing medications • 3-5 days in most cases • Avoid close contact with others • Medical note not required to return to school • When they return to school after fever resolves, they should continue to wash hands and cover coughs and sneezes

8. Recommendations for Schools: School Closures • Widespread school closures not anticipated • Will use strategies based on the severity of the illness and local flu activity • Alternatives to school closures • Stepping up basic good hygiene practices • Keeping sick students and staff away from school • Helping families identify their children who are at high-risk for flu complications • Benefit from early evaluation from their physician if they develop the flu • Review your medical flag lists and discuss these kids with their parents in advance • Routine Cleaning

9. Individual and Family Preparedness • Encourage students, staff and school community • Get an emergency kit • Make a family plan • Stay informed • Stop germs from spreading • Wash hands often • Cover coughs and sneezes • Stay home when sick