What Schools Need to Know
About Preventing the Spread of the Flu

About Flu

Influenza, commonly called "the flu,” is a contagious respiratory illness caused by influenza viruses. Infection with influenza viruses can result in illness ranging from mild to severe and to life-threatening complications. Five hundred out of 100,000 children with high-risk conditions (such as heart disease or asthma) and 100 out of 100,000 otherwise healthy children aged 0 to 4 years who are infected with the flu will be hospitalized for complications each season.

Symptoms of Flu

Symptoms of flu include fever (usually high), headache, extreme tiredness, dry cough, sore throat, runny or stuffy nose, and muscle aches. Other symptoms, such as nausea, vomiting, and diarrhea, are much more common among children than adults.

Spread of the Flu

The flu is spread when a person who has the flu coughs, sneezes, or speaks and sends the flu virus into the air. The virus enters the nose, throat or lungs of a person and multiplies.

Treatment of the Flu

Antibiotics like penicillin will not cure the flu. The best way to prevent the flu is to get a flu shot. Over-the-counter medications may relieve symptoms of flu. Acetaminophen (Tylenol) for children is recommended for both children and adults. Decongestants, cough suppressants, and use of a humidifier can provide symptomatic relief. In addition to flu shots, three antiviral medicines are available by prescription that will help treat the flu and its symptoms, and help prevent the flu from spreading in your body. The three antiviral medicines are: Tamiflu, Flumadine and Symmetrel.

Preventing the Spread of the Flu in Schools

While vaccination against the flu each fall remains the primary way to prevent this disease, the following measures may help prevent flu in school settings.

Remind students and staff to clean their hands, and make sure they have the supplies to do so.

• Wash hands several times a day using soap and warm water for 15-20 seconds (this is generally around the time it takes to sing the ABC's).  Alcohol-based hand rubs also may be used. Dry hands with paper towels or automatic hand dryers if possible.  In school, allow regular breaks for the students and teachers to wash hands.  Young children should be instructed and assisted to ensure proper hand washing. Restrooms should be checked regularly to ensure that soap and paper towels are always available.

Encourage sick students and staff to stay at home.

• Sick students and staff should stay home from school until they have been without fever for 24 hours to help prevent spreading illness to others.

Work closely with your local health department, especially if making plans regarding school closure.

• Schools can assist the local health department with reporting outbreaks or unusually large numbers of flu absences as a way to help understand the impact of the disease on the community. Any decisions about closing a school due to increased flu activity should be made in consultation with local and state health departments. It is unknown whether school closings are beneficial in controlling the spread of flu.

Good Health Habits

The following steps may help prevent the spread of respiratory illnesses like flu:

• Avoid close contact with people who are sick.
• Stay home when you are sick.
• Cover your mouth and nose with a tissue when coughing or sneezing.
• Wash your hands to protect you from germs.
• Avoid touching your eyes, nose or mouth.

Quick Tidbits

• Do NOT give aspirin to a child or teenager who has the flu.
• Encourage children to cover coughs and sneezes, wash hands frequently, and keep hands away from eyes, nose and mouth.
• A sick child is advised to stay at home during the first days of illness when symptoms are most severe and the infection is most contagious. Children can return to school when symptoms are improving and no fever has been detected for 24 hours.
• Any employee, student, teacher, or staff suspected of having the flu should not attend school.
• Staff and students (especially those with medical conditions and anyone else who wants to lower their risk of getting the flu) should get the flu shot. Remember, it is never too late in the flu season to be vaccinated.
• Schools should be extra-vigilant that ill students be excluded from sports activities, choir or any activities that may involve close contact, since transmission of the flu may be easier in these situations. All students and staff should avoid sharing glasses, water bottles, drinks, spoons/forks, etc.
• School buses, because of the enclosed space, may allow for easy spread of the flu. Tissues should be available on the buses, and student s should be encouraged to cover nose and mouth while coughing or sneezing. Disinfect commonly handled interior surfaces (i.e. door handles, hand rails, etc.) between loads of students, if possible.
• In the school, clean commonly used surfaces such as door handles, handrails, eating surfaces, desks, etc frequently with disinfectant. (Bleach solutions or commercial disinfectants are appropriate.)

About the Flu Vaccine

The flu vaccine prevents the flu, a common and highly contagious infection that can cause serious illness, and even death, in young children, older adults, and certain vulnerable people of all ages. The vaccine protects between 45 percent and 90 percent of healthy children from getting the flu. Children and adults should ideally get a flu shot is in October.

References and Resources

• www.immnunizenc.com - Immunization Branch, N.C. Department of Health and Human Services
• www.edc.gov/flu - Centers for Disease Control and Prevention Flu Home Page
• www.irnrnunizationinfo.org - National Network for Immunization Information

What You Need to Know About…
Meningococcal Meningitis

What is meningococcal meningitis? What causes it?
Meningococcal meningitis is a form of bacterial meningitis. People sometimes refer to it as spinal meningitis. It is a rare, but potentially fatal bacterial infection that can cause severe swelling of the fluid around the brain and spinal cord, or a serious blood infection.

How is the disease spread?
The disease is spread from person to person through the air or by contact with saliva usually through close, personal contact with an infected person. The disease can be spread through coughing, sneezing, kissing, or shared items like a drinking glass, utensils or cigarettes.

What are the symptoms?
Symptoms can progress rapidly and may resemble the flu. They can include fever, headache, stiff neck, nausea, vomiting, confusion, sleepiness and sensitivity to light. Some people also develop a rash mainly on their arms and legs.

How many people contract or die from m. meningitis?
About 3,000 cases of meningococcal meningitis are diagnosed in the United States each year. One in 10 cases is fatal. Because meningococcal meningitis can progress rapidly, often within hours, about 20 percent of those who survive suffer long-term effects that can include brain damage, seizures or limb amputations.

Why are college students at risk?
Studies show certain college students, especially freshmen living in dormitories, are at an increased risk for meningococcal meningitis compared to other persons in the same age group. Certain social behaviors, including drinking, smoking (both active and passive) and being in crowded situations like a dormitory may put college students at greater risk.

Can meningococcal meningitis be prevented?
Yes. A safe and effective vaccine is available to protect against four of the five most common types of meningitis. Studies show that up to 80 percent of cases that occur among college students can be prevented with vaccination. The vaccine protects for approximately three to five years.

What do health officials recommend?
Both the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) recommend that college students, especially those living in dormitories, be educated about meningitis and the benefits of vaccination.

Where can I get more information on the disease and the vaccine?
Visit the web sites of the Centers for Disease Control and Prevention at: www.cdc.gov, the American College Health Association at: www.acha.org, or for North Carolina, the Immunization Branch at: www.immunizenc.com. Talk to your physician or someone at your local health department for more information.