Student Flu Drills

By Karen Murphy-Kimber

Preparedness Activist

Member of the Milwaukee/Waukesha County Consortium for Emergency Public Health Preparedness Pandemic Influenza Planning Task Force

"We are in a race. We are in a race against a fast moving virulent virus with the potential to cause an influenza pandemic...We are in a race, against a changing virus, for H5N1 has not only spread, it has evolved. There are now two main variants, or clads, of H5N1 and it is this second, newer clad that is spreading across western Asia into Europe, the Middle East and Africa. This second clade has killed over 60 percent of those it is known to have infected. Let me be very clear. It is only a matter of time before we discover H5N1 in birds in America." Secretary Michael Leavitt, HHS

INTRODUCTION
A pandemic is a widespread epidemic outbreak of a new virus that humans have little or no immunity too. There were three pandemics in the last century in 1918, 1957, and 1968. The Spanish Flu caused 500,000 U.S. deaths and up to 40 - 50 million deaths worldwide. The world is currently on pandemic alert in response to the threat of the H5N1 virus. The H5N1 virus is now causing widespread illness and death to poultry in the Middle East, Asia, and some parts of Europe.

So far, about 218 cases of H5N1 have occurred in humans and 124 deaths, usually through close contact with sick poultry. (Updated - 5/24/06) The virus has not developed the ability to spread easily from human to human. Several changes would need to occur with the virus for the virus to spread this way. If the virus does develop the ability to spread easily among humans, and it keeps it's ability to cause a very serious illness and (the A H5N1 Avian Influenza (bird flu) , "looks and acts a like lot like the 1918 Spanish Flu, rather than the 1957 and 1968 cousin flus," according to Alex Azar, II, Deputy Secretary of the U.S. Department of Health and Human Services) and it spreads to the United States, each of us will need to be prepared.

The estimated number of U.S. deaths associated with a moderate (1958/68-like) influenza pandemic could be 209,000, an estimated number of U.S. deaths associated with a (1918-like) influenza pandemic could be 1,903,000.

Illness rates could be high among school-aged children (about 40%). Viral shedding and risk of transmission will be greatest during the first 2 days of illness. Children usually shed the greatest amount of virus and therefore are likely to post the greatest risk for transmission.

Children can be taught common-sense steps that limit the spread of germs: washing hands frequently with soap and water, covering their mouth and nose with a tissue when they cough or sneeze, putting the tissue in a waste basket, sneezing into their sleeve, and using alcohol-based hand sanitizer when soap or water isn't available.

Sources-

U.S. Department of Health and Human Services (HHS) and the U.S. Centers for Disease Control and Prevention (CDC), "School District (K - 12) Pandemic Influenza Planning Checklist"

U.S. Department of Health and Human Services (HHS), "Pandemic Influenza Planning: A Guide for Individuals and Families"

U.S. Department of Health and Human Services (HHS), "Pandemic Planning Update: A Report from Secretary Michael O. Leavitt, March 13, 2006"

U.S. Department of Health and Human Services (HHS), "What Is An Influenza Pandemic?"

U.S. Department of Health and Human Services (HHS), "How Does Seasonal Flu Differ From Pandemic Flu?"

U.S. Department of Health and Human Services (HHS), "Planning Assumptions"

U.S. Department of Education, "Practical Information on Crisis Planning: A Guide For Schools and Communities"

INFLUENZA DRILL GOALS -

1) To make hand hygiene a habit among school children.

2) To make cough/sneeze etiquette a habit among school children.

3) To establish infection transmission prevention school procedures.

INFLUENZA DRILL HHS and CDC Components -

Implement and exercise /drill to test pandemic plans and revise it periodically.

Work with the local health department to implement effective infection prevention policies and procedures that help limit the spread of influenza at schools in the district (e.g. promotion of hand hygiene cough/sneeze etiquette).

Make good hygiene a habit now in order to help protect children from many infectious diseases such as flu.

Provide sufficient and accessible infection prevention supplies (e.g. soap, alcohol-based/waterless hand hygiene products, tissues and receptacles for their disposal).

INFLUENZA DRILL ELEMENTS -

TEACHERS/STAFF provided with surgical masks, personal bottles of alcohol-based hand sanitizer, gloves, tissues, paper towels, spray disinfectant, and garbage receptacles at their work stations

ENVIRONMENTAL SERVICE STAFF provided with Personal Protective Equipment (PPE)

PARENTS will be assured that they will be notified in a timely manner if their children are ill, and that if one of their children's classmates gets sick - - that procedures are in place to lessen the spread of cold or flu.

STUDENTS will be provided with an alcohol-based hand sanitizer towelette at each meal, tissues and garbage receptacles in each room, access to a nurse's office or AIDE Room, and access to AIDE Stations equipped with surgical masks (children and adult sizes), disposable thermometers, tissues, alcohol-based hand sanitizer, a flip chart of signs, symptoms and emergency information.

Nurse's Office or AIDE Room (If no nurse's office is available, then consult with health department or medical experts for specifications and design)

AIDE Stations mounted on walls throughout the school building that is equipped with surgical masks (children and adult sizes), disposable thermometers, tissues, alcohol-based hand sanitizer in mounted containers, a flip chart of signs, symptoms and emergency information.

POSTERING about hand hygiene, cough/sneeze etiquette, Who To Tell When You Don't Feel Well

CURRICULUM about cough/sneeze etiquette, hand hygiene, germs/viruses, epidemics/pandemics, and avian influenza (age appropriate activities, instruction, assemblies)

FUNDING IS NEEDED FOR

PPEs

Disposable Thermometers

Bottles of Alcohol-based Hand Sanitizer

Hand Sanitizer Wall Holders

Alcohol-based Hand Sanitizer Towelettes

Personal bottles of Alcohol-based Hand Sanitizer

Paper Towels

Facial Tissues

Spray Disinfectant

Surgical Masks (children and adult sizes)

Gloves

Waste Receptacles

Information Materials

Posters

Copying

INFLUENZA /FLU DRILL

1. If a student informs a staff member in the class, that he is ill or if a student appears to be feverish or has a persistent cough; a staff member will ask all students in the room to put their heads down on their desk or surface, (and not to lift them until instructed to do so).

2. The staff member in the class, will call the office to notify the nurse (if available) or chaperon that a student may be ill and needs escorting to the nearest AIDE Station for triage.

3. The staff member in the class, will put on a surgical mask and walk the student to the door when the chaperon who also is wearing a surgical mask, arrives. Once an all clear is signaled. [All clear means - the student has been triaged, was found to have a temperature of 100.1 or more and is on the way to the nurse's office or AIDE room to wait for parents to pick him up; or the student is all right and will be returning to class.]

4. If the student was found to be ill the staff member in the class, will disinfect the desk or surface where the ill student sat. If not the Influenza drill is over.

5. The staff member in the class, will go with depending on grade, or send students (one student at a time) to the nearest AIDE station to blow their nose, throw away the tissue, and sanitize their hands with the alcohol-based hand sanitizer.

6. Each student's desk or surface in the class, is disinfected before they can sit back down and put their heads back down on their desk or surface, until every student has gone to the AIDE station and has had their desk or surface disinfected.

7. At the AIDE station the chaperone takes the student's temperature with a disposable thermometer. If the student has a fever the chaperone will help or have (depending on the age), the student put on a surgical mask and will help or have the student wash his hands with the alcohol-based hand sanitizer, and finally escort him to the nurse's office or AIDE room and call his parents.

8. In the nurse's office or AIDE room, the ill student waits for his parents to come. The chaperone waits with him.

#END OF DRILL#