HEALTH ALERT: Conference Call on H1N1 School Closings; Funds Available for Vaccination Clinics; Additional H1N1 Guidance

HEALTH ISSUE ALERT

TO: Superintendents of Schools
FROM: Susan A. Gendron, Commissioner, and Dora Anne Mills, MD, MPH, Director, Maine CDC
DATE: October 28, 2009
RE: HEALTH ALERT: Conference Call on H1N1 School Closings; Funds Available for Vaccination Clinics; Additional H1N1 Guidance

Purpose of this letter

This Health Issue Alert addresses the following:

Conference call scheduled for Thursday, October 29, 12:30 p.m. on H1N1 school closure guidance
Update on the increased presence of H1N1 in Maine schools
Monitoring and reporting absenteeism above 15 percent due to illness
Funds available for schools conducting H1N1 virus and seasonal flu vaccination clinics
Refresher information on preventing and responding to H1N1

Conference call on school closure guidance

We will hold a conference call this Thursday, October 29, at 12:30 p.m. to discuss the current U.S. CDC guidance on school closures due to H1N1 and seasonal flu. The guidance has shifted since last spring and now considers whether to close more of a local operational decision (are there enough staff to teach and students to learn) rather than a public health decision. Dr. Dora Anne Mills of the Maine Center for Disease Control and Prevention (Maine CDC) will be on the call, as well as Deputy Education Commissioner Angela Faherty and Nancy Dube, the Department’s school nurse consultant.

This conference call is for superintendents and school nurses.

Call-in information:
Dial: 1-800-914-3396
Enter passcode: 473623

Update on the Increased Presence of H1N1 in Maine Schools

Following the H1N1 outbreaks at Bowdoin College and Bates College, there are now several private and public K-12 schools in Maine that are seeing increased incidence of H1N1, including several in the Midcoast area. Gould Academy in Bethel and Maine Central Institute in Pittsfield have outbreaks. Wiscasset High School and one of the elementary schools in RSU 12 are also seeing absentee rates of over 30 percent.

It is important to understand that the U.S. CDC guidance on school closures is significantly different than it was in the spring. The U.S. CDC and Maine CDC are advising that schools remain open, except when the normal functioning of schools is threatened by the high absenteeism of staff and/or students. In short, it is a local decision whether or not to close a school. The reasoning is that when schools are closed, students generally interact with each other and the community. By the time there is an outbreak of H1N1 in a school there is little or no benefit to closure.

It is also extremely important that schools have plans in place for continued learning in the case of a closure. This could include online learning opportunities, reading assignments, and other tools that help minimize the impact of lost school days.

See “Refresher” below for guidance and link to additional information.

Monitoring and Reporting Absenteeism Above 15 Percent Due to Illness

Suspected infectious disease outbreaks are reportable to the state. An outbreak in a school setting is defined as a student absentee rate greater than 15 percent.

What to do when you reach this rate:

Document daily absenteeism rate.
Consider reason for high absenteeism – is it illness related? (Non-illness related reasons might include busy travel days).
If absenteeism is likely due to illness, complete the Absentee Reporting Form.
Return to Maine CDC by e-mail (disease.reporting@maine.gov ), fax (800-293-7534) (both e-mail and fax are monitored M-F 8-5), or by calling 800-821-5821 (available 24 hours).
An epidemiologist will contact you to follow-up and provide additional guidance.
In order to facilitate documentation once elevated absenteeism has been identified, the Absenteeism Tracking Form may be used by school personnel to help track symptoms. Find the Absentee Tracking Form at: http://www.maine.gov/dhhs/boh/maineflu/h1n1/absenteeism-tracking-form.pdf .

If you have questions or concerns about reporting absenteeism, call Maine CDC at 800-821-5821.

Funds Available for H1N1 Virus and Seasonal Flu Vaccination Clinics

The Maine CDC is now able to provide funding to school administrative units that offer seasonal influenza and H1N1 influenza vaccines in K-12 schools.

This partnership between the Maine CDC and schools sets the foundation not only to protect the health of school children and the school community, but also to protect the health of the entire community, including siblings, parents, and the elderly.

Since children are major transmitters of influenza, vaccinating them provides protection throughout the community. Additionally, offering vaccines in schools will help reduce the impact of large scale vaccination clinics on the health care system.

Eligible Schools: K-12 school districts, or a public or private school not part of a school district that serves some portion of K-12 students, are eligible for funding.

Purpose of Funds: To help offset some costs of building the infrastructure and systems needed to offer influenza vaccine to students.

School Enrollment (09-10)                            Funding
50 - 99                                                             $ 1,000
100 – 249                                                         $ 2,000
250 - 499                                                          $ 3,500
500 – 799                                                         $ 5,000
800 – 1,499                                                      $ 6,500
1,500 – 1,799                                                    $ 8,000
1,800 – 2,999                                                    $ 9,500
3,000 – 4,000                                                    $10,500
> 4,000                                                             $12,000

To receive funds, schools must complete the school agreement form, which can be found at:
http://www.maine.gov/dhhs/boh/maineflu/h1n1/H1N1-School-Funding-Agreement-10-23-09.pdf

Refresher Information on Preventing and Responding to H1N1

It is more important than ever for schools to take steps to prevent and respond to H1N1. More information and technical information is provided on each of these at the link below.

Assure the school community has access to seasonal flu vaccine and H1N1 flu vaccine when it arrives
Report elevated absenteeism or school closure due to illness
Stay home when sick for at least 24 hours after fever ends
Separate ill students and staff
Stress hand hygiene and respiratory etiquette

Bolster routine cleaning
Treat high-risk students and staff early
Consider selective school dismissal for high-risk student populations or schools with high-risk student populations

Additional measures such as active screening and increasing social distancing
Stay informed

Please review the more detailed information and links to resources on each of the steps above here:
http://www.maine.gov/dhhs/boh/maineflu/h1n1/educators.shtml

For More Information

If you have questions regarding any of the items in this Health Alert, please contact the Maine CDC at 888-257-0990 or flu.questions@maine.gov or Nancy Dube, the Department’s school nurse consultant, at 207-624-6688 or nancy.dube@Maine.gov .

NOTE: This Health Issue Alert is being archived as Informational Letter #40 and can be found on the Informational Letters web page: http://www.maine.gov/education/edletrs/ilethome.shtml