COLUMBIA — With two confirmed cases of swine flu in Boone County and a little more than two weeks until the start of school, Columbia Public Schools officials are working with city and county health officials to devise a plan for dealing with the issue once students return on Aug. 24.
“Consistency is key,” said Eddie Hedrick, emerging infections coordinator for the Missouri Department of Health and Senior Services. “You don’t want the school across the street doing something different than you are,” Hedrick told school administrators at a Missouri School Board Association safety conference on July 31.
Geni Alexander, public information officer for the Columbia/Boone County Health Department, said the department has been working with the school district for several years to develop a plan for dealing with a pandemic flu outbreak.
Alexander said county health officials have met with school nurses throughout the district to inform them what symptoms to look for in those infected with swine flu or H1N1, the official name. Symptoms include: sudden fever, muscle aches, headache and lack of energy.
Mary Laffey, assistant superintendent for human resources, said she hopes the district would have informational packets about how to deal with swine flu ready for parents by back-to-school nights, which begin Aug. 17, but they are not yet available.
Laffey also said the district has not determined any specific protocol for when it might become necessary to close schools because of a swine flu outbreak.
Alexander said that decision would be left up to health department director Stephanie Browning and emphasized that district officials are taking their cues from the health department.
“If there are gaps in the information that schools have, that’s because we don’t have that information, and that’s because the (Centers for Disease Control and Prevention) has not released it,” she said.
Nick Boren, chief operations officer for the district, said it is difficult to provide up-to-date information about how to deal with H1N1 because it is constantly changing. He said he hopes to have the information packets Laffey spoke of ready by this coming week.
Marjorie Cole, school health services coordinator for the state Department of Health and Senior Services, said the department is recommending that sick children be kept away from other students and that parents keep their children home from school if they are feeling ill.
Recent information released by CDC, which advises all local, state and national health organizations about H1N1, indicates that children exhibiting flu-like symptoms should stay home for 24 hours after their fever has gone down without the use of fever-reducing medicines.
Hedrick made clear that children who stay home from school because they are feeling ill should not attend alternative care centers or congregate with other community members. He said that infection rates are particularly high “in places were kids congregate.”
An earlier recommendation by the CDC that schools close if there is even one case of swine flu has been repealed, Cole said.
“We know if we send children home from school, they will re-congregate in our malls,” Cole said. “Are we really stopping the spread of flu by sending them out into the community?”
Although much of the advice being given to schools, parents and students about how to deal with swine flu is almost identical to guidelines used to deal with seasonal flu, Hedrick said the danger of H1N1 is that there is not yet a vaccine available.
He said CDC is predicting a flu outbreak two times higher than normal and that lab tests indicate about 99 percent of all flu cases in the country right now are swine flu.
Government officials are predicting the vaccine to be ready by mid-October, Hedrick said, but because of production problems, he does not anticipate the vaccine to be widely available until as late as November or December.
Hedrick said two doses of vaccine are required to inoculate for H1N1, and a third vaccination is required to protect against the seasonal flu.
Health professionals think H1N1 is similar to a virus to which older generations have already been exposed and built a resistance, which they say explains why the infection has been less prevalent among older people and why children are most at risk.
“In schools, I anticipate we’re going to see a lot of flu, and we’re going to see it early,” Hedrick said.
David Luther, director of school-community relations for Jefferson City Public Schools, said his district has an emergency plan in place for dealing with health issues, and officials are putting a strong emphasis on good hygiene.
For the most part, though, he said the Jefferson City Public School District is not taking any precautions too out of the ordinary.
“We’re cognoscent of the importance of this particular flu,” Luther said. “But we don’t want to fall into a situation where we are creating undue anxiety.”
Hedrick said schools should take necessary precautions but not overreact. “(By overreacting) you create unintended consequences that may be worse than the actual disease,” he said.
One of these consequences, he said, is that students who depend on school meals for lunch and breakfast may not get to eat if schools are closed. This issue is particularly important for urban school districts such as Kansas City Public Schools, whose students rely heavily on such services, district spokesman Andre Riley said.
Riley said the Kansas City district has not yet come up with a plan for how it would deal with that issue should it be necessary to close schools. However, the district is slightly further along than the Columbia district in developing protocol for deciding whether to close schools because of a flu outbreak.
He defined an outbreak as three or more cases in a school within a short period of time.
“When you get to three, you have to acknowledge this issue might be more serious than a few random instances,” Riley said.
Hedrick said health officials will continue to update schools about how to best deal with H1N1, but, for now, the best thing to do is keep sick children out of school.
“If you’re sick, stay home,” he said. “That will slow this down more than anything else we can do.”