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 Guidance for primary and post-primary day schools in preparing for and managing Pandemic (H1N1) 2009 (Swine Flu)

27th August 2009 Version 1.0

These recommendations are based on current information and are subject to change based on ongoing surveillance and continuous risk assessment.

Background

This document provides interim public health guidance for primary and secondary day schools on preparing for Pandemic (H1N1) 2009 influenza. This guidance includes recommendations on hygiene measures that should be put in place now in order to prevent the spread of respiratory illness, and planning activities that should occur in preparation for the possibility of cases of Pandemic (H1N1) 2009 occurring in schools.

Schools play a critical role in protecting the health of their students, staff, and the community from contagious diseases such as Pandemic (H1N1) 2009. Children and young adults are very susceptible to getting this new virus and schools may be locations where spread of this new virus can happen quickly. Schools can help prevent the spread of Pandemic (H1N1) 2009 by implementing good health practices now and preparing for activities that need to occur in the event of cases of Pandemic (H1N1) 2009 occurring there.

1. Preparation

1.       Identify who in your school/college should plan and prepare for Pandemic (H1N1) 2009, ensuring backup support as required.

2.       Develop a flu plan containing but not limited to the guidance in this document.

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2. Infection control:

Prevent the spread of respiratory illness through knowledge of Pandemic (H1N1) 2009 influenza and practice of good respiratory and hand hygiene.

a. Display information (available for download at www.education.ie)

i. What to do to prevent spread of respiratory illness

ii. Respiratory Hygiene and Cough Etiquette

iii. Hand hygiene

 

b. Key Messages

Preventing the spread of germs is the single most effective way to slow the spread of influenza. Ensure that all staff and students are aware of and practice the following good health practices.

i. Wash your hands often with soap and water and especially after coughing, sneezing, using the bathroom and before eating.

ii. Avoid touching your eyes, nose or mouth with your hands – germs spread this way.

iii. Cover your mouth and nose with a tissue when you cough or sneeze and put your used tissue in a waste bin. Wash your hands after.

iv. If you do not have a tissue, cough or sneeze into your sleeve (not into your hand). Wash your hands after.

v. Stay home from school if sick with a flu-like illness for seven days from onset of illness.

vi. Avoid unnecessary close contact with people who have influenza.

vii. Do not share wind instruments.

viii. Avoid sharing pencils, crayons and pens toys/objects where possible and if sharing them clean them before passing them between students.

 

c. Infection prevention supplies and policies

i. Ensure that hand hygiene facilities are adequate and working properly. Minimum standards required at all times are soap, water and a method of drying that is not shared between students (paper towels, pull down towels or automatic hand dryers are preferred; if not available students may bring in their own towels from home for their own personal use).

ii. In the absence of hand-washing facilities, alcohol-based hand rub may be used as an alternative.

iii. Schools should provide the time needed for all students and staff to wash their hands whenever necessary, especially after coughing or sneezing into their hands, before eating, and after using the toilet.

iv. Younger children and children with special needs may require extra attention with regards to hand-hygiene and respiratory etiquette.

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d. Environmental cleaning procedures

i. Ensure that adequate supplies of normal household cleaning materials are readily available.

ii. Ensure there are procedures for regular cleaning of hard surfaces. Particular attention should be on cleaning items that are more likely to have frequent hand contact (for example, keyboards, desks, doorhandles).

iii. Ensure there are procedures for immediate cleaning of areas when visibly soiled.

 

e. Procedures for isolating and caring for sick students/staff

Students and staff who are ill with a flu-like illness at arrival or become ill during the day should be promptly separated from other students and staff while waiting to be sent home. The student should be placed in a suitable area, such as a small office, away from other students, but where an eye can be kept on them to ensure that they are all right.

 

f. Access to information on Pandemic (H1N1) 2009 (available at www.education.ie)

All teachers and other staff should have access to information:

i. Information and medical guidance for the public on Pandemic (H1N1) 2009 infection

ii. Hand hygiene and respiratory etiquette poster

iii. Advice for Parents of Children at High Risk for Flu Complications

iv. Advice for Parents of Children with Special Needs

v. Information and medical advice about Pandemic (H1N1) 2009 for pregnant women and women who are breastfeeding

vi. Advice for parents if school is closed or children are sick and must stay at home because of flu

vii. How students can prevent the spread of flu at school

viii. How teachers and other school staff can prevent the spread of flu at school

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3. Communications

Schools should develop a communications plan that will include informing staff and parents of what may happen in the event of cases of Pandemic (H1N1) 2009 influenza occurring in the school. It should include:

a. Communications plan:

i. The school may wish to advise parents and guardians that in the event of a child or number of children becoming ill with Pandemic (H1N1) 2009 there is a possibility of students being sent home from the school and that the parent/guardian must ensure they or their nominated guardian will be contactable and available to take care of the child. The school should also consider taking this opportunity to provide information to parents on Pandemic (H1N1) 2009 (available at www.education.ie).

ii. The school should develop a plan for communicating with parents in the event of a case or cases of Pandemic (H1N1) 2009 influenza occurring in the school. Schools should bear in mind that parents from other countries have may have difficulties reading communications in English. Information in different languages is available at www.hse.ie.

b. Contact details for:

i. The school’s board of management and trustees (who should have up to date information on Pandemic (H1N1) 2009 and recommended school actions).

ii. The student’s guardian (the school should ensure that the identified guardian has provided current contact number and emergency contact number).

iii. The Department of Public Health in the region (See Appendix 3).

iv. Review contact details regularly to ensure they are up to date.

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4. Actions in the event of a case/cases of Pandemic (H1N1) 2009 influenza occurring in a school

Schools need to be prepared to recognise and respond if one or a number of students/staff members develop symptoms consistent with Pandemic (H1N1) 2009 influenza.

a. Early recognition of influenza like symptoms.

All staff (and older students) should be able to recognise symptoms of Pandemic (H1N1) 2009 influenza.

b. Taking care of a student/staff member with flu like illness

In the event of a staff member thinking that a student may have Pandemic (H1N1) 2009 influenza there should be procedures in place which facilitate them to:

i. Separate students with flu-like symptoms from other students while they are waiting for their parent/guardian to collect them.

ii. Staff at risk of complications if infected (pregnant women or those with an underlying condition with increased risk of influenza related complications), if possible, should not look after students with flu-like symptoms. However, if this is unavoidable they should ensure that they practice rigorous hand hygiene and respiratory etiquette and remain at a distance of 1 meter from the ill child if possible.

iii. The school should have prior permission from parents to enable urgent medical assessment of students with flu-like symptoms if parent is uncontactable.

iv. Encourage parents to seek early medical assessment for students with flu-like symptoms at higher risk of complications from flu. Staff with flu-like symptoms at higher risk of complications from flu should do the same (see Appendix 2 for list of those at higher risk).

c. Actions in the event of an unusual number of people presenting with influenza like illness

There should be a policy for notifying the school’s principal/deputy principal who should inform the local Department of Public Health by phone.

d. Exclusion policy

i. There is no need for any staff member or student (including those at risk of complications and those who are pregnant) to stay at home from school if they are well.

ii. Schools should have clear policies on exclusion of staff and students with flu-like illness.

iii. Schools should remind parents and carers that children displaying flu-like symptoms while at home (weekends and holidays) should stay at home and not return to school for seven days from onset of symptoms.

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5. Preparing for school closures

At the current stage of the Pandemic (i.e. moderate as per WHO) schools are unlikely to be closed on public health advice, even if there are cases of Pandemic (H1N1) 2009 influenza in the school, but may close for ‘business continuity’ reasons such as staff absenteeism. In certain exceptional circumstances there may be advice to close on public health grounds for a short period of time (usually 7 days). Schools must develop plans for partial and total closure.

• Each school should have a governance structure for implementation of school closures.

• Schools need to have business continuity plans in place to deal with school closures due to public health recommendation or due to teacher absences. These should include:

a. Staff working arrangements in event of school being closed.

b. Teachers/schools should provide students with sufficient course work and exercises to cover the duration of the closure.

c. Criteria for lifting school closure (in event of closure due to public health recommendation the local Department of Public Health will give advice on criteria for lifting school closure).

d. Plans for the partial re-opening of the school as well as full re-opening of the educational institution.

e. Plans for managing staff absenteeism due to Pandemic (H1N1) 2009.

f. In respect of State examinations there may be a need to contact the State Examinations Commission to put alternative arrangements in place.

g. Refer to the up-to-date information on the Department of Education and Science’s website regarding school closures and staff absenteeism.

 

Appendix 1: Website addresses

Health Protection Surveillance Centre

http://www.hpsc.ie/hpsc/A-Z/EmergencyPlanning/AvianPandemicInfluenza/SwineInfluenza/

Health Service Executive

http://www.hse.ie/eng/swineflu/

Department of Education and Science

http://www.education.ie/home/home.jsp?pcategory=27173&ecategory=27173&language=EN

Appendix 2: Who are those considered to be in high-risk groups for complications of Pandemic (H1N1) 2009 infection.

Patients with: chronic lung, heart, kidney, liver, or neurological disease; immunosuppression (whether caused by disease or treatment); diabetes mellitus; people aged 65 years and older; children <5 years (children <2 years are at higher risk severe complications); people on medication for asthma, severely obese people (BMI ≥40), pregnant women and people with haemoglobinopathies. - 7 -

Appendix 3: Contact Details for HSE Departments of Public Health (and counties they cover) HSE North West

Tel 071‐9852900

Donegal

Leitrim

Sligo

HSE Midlands

Tel 057‐9359891

Longford

Westmeath

Offaly

Laois

HSE South

Tel 021‐4927601

Cork

Kerry

HSE MidWest

Tel 061‐483337 Clare

Limerick

Tipperary North

HSE North East

Tel 046‐9076412

Cavan

Monaghan

Louth

Meath

HSE SouthEast

Tel 056‐7784124 Tipperary South

Waterford

Kilkenny

Carlow

Wexford

HSE East

Tel 01‐635 2000 Kildare

Dublin

Wicklow

HSE West

Tel 091‐775 200

Mayo

Roscommon

Galway