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H1N1 Infuenza A & Virginia Public Schools

VDOE works closely with the Virginia Department of Health (VDH) and other state and federal authorities to provide the latest information and guidance on H1N1 Influenza A to the commonwealth’s public schools.

This Web page provides division and building-level administrators, school health coordinators and educators with ready access to up-to-date resources and information about H1N1 Flu and the steps schools should take to safeguard the health of students and staff.

Virginia public schools, in turn, communicate information to staff, students and parents. School divisions are directed to routinely review their Pandemic Influenza Plans and ensure that communication channels are in place among educators, local health department officials and community leaders.

VDOE Guidance & Resources

Guidance to Schools & School Divisions

• August 21, 2009 (VDOE & VDH) – School divisions are expected to submit student and faculty absentee data to the Virginia Department of Health (VDH) to gauge levels of H1N1 within the community. Information collected and sent to VDH will be transmitted in aggregate form by school and no individual-level information will be shared. The information will be used to increase the ability to detect and monitor changes in the health of Virginia school-age children and those working in schools. Reporting program specifications outline collection and transmission requirements.
• August 7, 2009 (VDOE & VDH) – VDH has confirmed novel influenza A H1N1 virus in all regions of Virginia. The virus continues to affect the young disproportionately, resulting in outbreaks in group settings involving children. The current severity of illness resulting from this virus is similar to that of the seasonal flu strains. It is anticipated that the virus will continue to circulate into the fall; however, it remains uncertain as to how widespread and how severe influenza illness will be during the fall and winter seasons. 

  There are a number of effective measures divisions should consider taking now to help schools lessen the impact of this disease on students and staff, as well as local communities. The CDC and VDH do not consider school closure an effective means of controlling influenza in either a school or a community, given the rapid pace of infection spread from person to person. School closure is unlikely to be recommended unless absenteeism levels interfere with the school’s ability to function (i.e., not enough teachers) or the school is comprised of a large majority of individuals at high risk of flu complications.

• School officials are advised to continue preparations and planning to respond to potential changes in the number of affected people or severity of illness. The CDC continues to emphasize personal responsibility (cover cough, stay home if you are sick) to limit the transmission of the virus. In addition, anyone with an underlying health condition or children under the age of two who experiences flu-like symptoms or measured fever of 100 or greater, cough and body aches should contact their health care provider immediately. The CDC reports a disproportionate amount of illness and hospitalization of younger people between the ages of five and 24, with the highest hospitalization rates for children under five. The virus seems to spread faster, at least in school-aged children. School division personnel should:
  • Make sure there is a plan and that the plan has been reviewed.
  • Update the plan based upon “lessons learned” from the initial April/May 2009 outbreak.
  • Determine the most feasible social-distancing strategies for your locality.
  • Determine the most feasible methods for continuing instruction in the event schools are closed.
  • Continue discussions with local stakeholders for the purpose of a coordinated community response.
• Read August 7 recommendations to school divisions from state superintendent and health commissioner (PDF).
• Read CDC Guidance for State and Local Public Health Officials and School Administrators for School (K-12) Responses to Influenza during the 2009-2010 School Year, which provides information to help decrease the spread of flu among students and school staff and expands upon earlier school guidance documents by providing a menu of tools that school and health officials can choose from based on conditions in their area.

In the Event of School Closure

The CDC and USED have established a School Dismissal Monitoring System to report on novel influenza A (H1N1)-related school or school division closings. The form may be completed and submitted electronically to the CDC or may printed out and faxed to the CDC at (770) 488-6156.

If schools are closed because of a state of emergency declared by the Governor or by officials in a locality (pursuant to § 44-146.21 of the Code), the local school board may request a waiver for the missed days so that no reduction in Basic Aid occurs. The Virginia Board of Education has authorized the Superintendent of Public Instruction to act on its behalf in approving the waiver requests.

Board regulations require that the waiver request include evidence of efforts that have been made by the school division to reschedule as much instructional time as possible. The division superintendent and the chair of the local school board must certify that every reasonable effort for making up lost instructional time was exhausted before requesting a waiver of the requirement.

If the waiver is denied, or if schools are closed because of a threat to the health or safety of students, but there is no declared state of emergency, the provisions for making up lost time are the same as for severe weather conditions or other emergency situations.

The Code of Virginia, in § 22.1-98, and the Virginia Board of Education’s regulations, in 8 VAC 20-521-10 through 8 VAC 20-521-60, address the requirements for making up instructional time when there is a declared state of emergency, or when there are other emergency situations presenting a threat to the health or safety of students, that result in the closing of schools.

School Closure: Special Education

• May 4, 2009 (VDOE) – ALERT: LEA’s FAPE Responsibilities During H1N1 Influenza Outbreak (Word)

Immunization Information

• List of Vaccination Sites
• H1N1 Immunization Updates from the Commissioner of Health, Dr. Karen Remley
• H1N1 Get1 Campaign
• General H1N1 Immunization Information
• CDC H1N1 Flu Vaccination Resources
• CDC Vaccine Safety Information
• 2009 H1N1 Inactivated Influenza Vaccine (“the shot”) Information Sheet (PDF)
• 2009 H1N1 Live, Attenuated Influenza Vaccine (“the nasal spray”) Information Sheet (PDF)
• CDC Vaccine Information Statements (in languages other than English)
• Information About the Preservative Thimerosal

Resources for Schools & School Divisions

• May 2008 – Pandemic Influenza Plan Guidelines for Virginia Public Schools (PDF)
• November 2008 – Pandemic Influenza Planning for Schools: Social Distancing Strategies by Pandemic Phase (PDF)
  

Sample Letter to Parents
This sample letter may be used by school divisions to inform parents of the H1N1 Influenza A (swine flu) outbreak, signs and symptoms of the flu, what they can do to protect themselves and prevent the spread of the virus. Please note that the letter needs to be personalized at the division level before being distributed.

• Sample School Advisory Letter to Parents (Word) - Revised August 7, 2009, based on CDC guidance

Virginia Department of Health (VDH)

VDH is urging parents of school-age children to prepare now for the possibility of increased flu activity this fall. While most reports of the H1N1 virus indicate that its impact is moderate, viruses are highly unpredictable and can mutate into a more serious form in a short period of time. Parents should ensure that children receive all recommended immunizations and plan for situations when children may be home ill for several days.

With reports of influenza-like illness in the commonwealth continuing, all Virginians and especially those with influenza-like symptoms that include fever, cough, sore throat, headache, chills, fatigue and body aches should:

• Stay home from work and school and limit their contact with others to keep from spreading the virus
• Cover their nose and mouth when they cough or sneeze and throw the tissue in the trash
• Wash their hands often with soap and water, especially after they cough or sneeze. Use of alcohol-based hand cleaners also is effective.
• Limit close contact with sick people
• Prevent the spread of germs by not touching their eyes, nose or mouth
• Call their health care provider if they have questions or concerns

September 10, 2009 (VDOE & VDH) – Guidance letter (PDF) to administrators of private schools

August 24, 2009 (VDH) – VDH offers an electronic toolkit to provide schools with information and resources on a variety of topics relevant to both H1N1 and seasonal influenza. As new links become available, updates will be added to the VDH website.

August 17, 2009 (Office of the Governor) –VDH has expanded its call center to handle H1N1 questions. The toll-free number is 1-877-275-8343 and will be answered during state business hours. As necessary, the hours will be adjusted to accommodate call volume. The call center is part of a federally-funded program developed by the health department to prepare for and respond to the novel H1N1 virus.  More information is available in the governor’s office news release.

July 21, 2009 (VDH) – Parents Should Prepare Students Now for Increased Flu Activity news release.

Flu.gov (CDC, USED & HHS)

Flu.gov provides one-stop access to official U.S. government information on H1N1, avian and pandemic flu

November 5, 2009 (USED) – Guidance under the Family Educational Rights and Privacy Act (FERPA) concerning the disclosure of personally identifiable information from students’ education records when addressing an H1N1 outbreak.

October 23, 2009 (VDOE & CDC) – A school closure course of action checklist and other guidance is available in the Technical Report for State & Local Public Health Officials & School Administrators on CDC Guidance for School (k-12) Responses to Influenza During the 2009-2010 School Year.

September 8, 2009 (CDC) – Resources for the deaf and hard of hearing are available from the Centers for Disease Control and Prevention.

August 25, 2009 (USED & HHS) – Continuity of learning recommendations in the event of absences or school closures. Recommendations (PDF) and Questions & Answers for Schools (PDF)

August 7, 2009 (Flu.gov) — CDC, USED and HHS announced recommended school responses for the 2009-2010 school year.
See the Technical Report for State and Local Public Health Officials and School Administrators.

See the CDC Guidance for State and Local Public Health Officials and School Administrators for School (K-12) Responses to Influenza during the 2009-2010 School Year, or the summary below:

Under conditions with similar severity as in spring 2009

• Stay home when sick: Those with flu-like illness should stay home for at least 24 hours after they no longer have a fever, or signs of a fever, without the use of fever-reducing medicines. They should stay home even if they are using antiviral drugs. (For more information, visit http://www.cdc.gov/h1n1flu/guidance/exclusion.htm.)
• Separate ill students and staff: Students and staff who appear to have flu-like illness should be sent to a room separate from others until they can be sent home. CDC recommends that they wear a surgical mask, if possible, and that those who care for ill students and staff wear protective gear such as a mask.
• Hand hygiene and respiratory etiquette: The new recommendations emphasize the importance of the basic foundations of influenza prevention: stay home when sick, wash hands frequently with soap and water when possible, and cover noses and mouths with a tissue when coughing or sneezing (or a shirt sleeve or elbow if no tissue is available).
• Routine cleaning: School staff should routinely clean areas that students and staff touch often with the cleaners they typically use. Special cleaning with bleach and other non-detergent-based cleaners is not necessary.
• Early treatment of high-risk students and staff: People at high risk for influenza complications who become ill with influenza-like illness should speak with their health care provider as soon as possible.  Early treatment with antiviral medications is very important for people at high risk because it can prevent hospitalizations and deaths. People at high risk include those who are pregnant, have asthma or diabetes, have compromised immune systems, or have neuromuscular diseases.
• Consideration of selective school dismissal:  Although there are not many schools where all or most students are at high risk (for example, schools for medically fragile children or for pregnant students) a community might decide to dismiss such a school to better protect these high-risk students.

Under conditions of increased severity compared with spring 2009: (The current severity level remains similar to spring 2009)

• CDC may recommend additional measures to help protect students and staff if global and national assessments indicate that influenza is causing more severe disease. In addition, local health and education officials may elect to implement some of these additional measures. Except for school dismissals, these strategies have not been scientifically tested. But CDC wants communities to have tools to use that may be the right measures for their community and circumstances.
• Active screening: Schools should check students and staff for fever and other symptoms of flu when they get to school in the morning, separate those who are ill, and send them home as soon as possible. Throughout the day, staff should be vigilant in identifying students and other staff who appear ill.
• High-risk students and staff members stay home: People at high-risk of flu complications should talk to their doctor about staying home from school when a lot of flu is circulating in the community. Schools should plan now for ways to continue educating students who stay home through instructional phone calls, homework packets, internet lessons, and other approaches.
• Students with ill household members stay home: Students who have an ill household member should stay home for five days from the day the first household member got sick. This is the time period they are most likely to get sick themselves.
• Increase distance between people at schools: CDC encourages schools to try innovative ways of separating students. These can be as simple as moving desks farther apart or canceling classes that bring together children from different classrooms.
• Extend the period for ill persons to stay home: If influenza severity increases, people with flu-like illness should stay home for at least 7 days, even if they have no more symptoms. If people are still sick, they should stay home until 24 hours after they have no symptoms.
• School dismissals: School and health officials should work closely to balance the risks of flu in their community with the disruption dismissals will cause in both education and the wider community. The length of time schools should be dismissed will vary depending on the type of dismissal as well as the severity and extent of illness. Schools that dismiss students should do so for five to seven calendar days and should reassess whether or not to resume classes after that period. Schools that dismiss students should remain open to teachers and staff so they can continue to provide instruction through other means.

  Reactive dismissals might be appropriate when schools are not able to maintain normal functioning for example, when a significant number and proportion of students have documented fever while at school despite recommendations to keep ill children home.

  Preemptive dismissals can be used proactively to decrease the spread of flu. CDC may recommend preemptive school dismissals if the flu starts to cause severe disease in a significantly larger proportion of those affected.

  June 11, 2009 (VDOE) – Secretary of Education Arne Duncan and Secretary of Health & Human Services Kathleen Sebelius jointly distributed a letter to educators advising that the H1N1 flu (Swine Flu) is still active in the United States and that it has been shown to affect school-aged children disproportionately. They noted that the Department of Health and Human Services is taking steps to secure H1N1 flu vaccine for possible use in the fall. Their letter also encourages school officials to begin planning interventions to prevent disease transmission during the next school year, and several recommendations are offered. See Letter to Educators (PDF).

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