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H1N1 Virus Series Part Two

With the new H1N1 virus or swine flu predicted to affect half the U.S. population this flu season, health AND school officials are working to prepare. In part two of our series on the H1N1 virus, KSMU’s Michele Skalicky reports on preparations in Southwest Missouri for a potentially widespread illness…

Schools are the perfect place for germs to spread. When one child sneezes and doesn’t cover his or her mouth, many others around them could get sick. That’s why school nurses are working hard this fall to educate students about illness prevention. Jean Grabeel, coordinator of health services with Springfield Public Schools, says the health and safety of students is always a top priority. The concern about the potentially large number of cases this fall of the new H1N1 virus has just added an additional concern for them this year. She says prevention will be stressed to students AND parents…

"Well, certainly this fall we'll be having the nurses going into the classrooms, as they normally do, to reinforce good handwashing practices, and we're putting together some information for parents, too, and hopefully we'll get that posted on our website very soon, but they'll be reminding the students and staff about good handwashing practices 'cause that's the number one way to prevent the spread of disease is handwashing frequently, and, in between times, to use the no-rinse hand sanitizer, so that's number one."

She says they’ll also talk with kids and staff about proper etiquette when coughing or sneezing…

"If they don't have a tissue available, they need to cough or sneeze into their sleeve, otherwise use a tissue and then go wash your hands immediately after that. You know, when we sneeze, there's a 100,000 droplets that go into the air, 200 miles per hour at a distance of three feet, so that's the way colds and flu are spread oftentimes, and so it's important for kids and for staff and for the public, as well, using those safe practices."

There will be information about swine flu and prevention for parents and staff on the Springfield Public Schools website, and information may be sent home with students. Nurses will be watching for signs of illness as they normally do and reporting to Grabeel if more than 10% of staff and students at any one school are home sick. Grabeel will then update the Springfield-Greene County Health Department.She says they will rely on recommendations from the health department when deciding if a school should be closed down…

"The current recommendations from the CDC, the Centers for Disease Control, is that you not automatically close a school system down or even a particular school site, and they want to leave that up to local health departments and school districts working conjointly to make the decision about school closures."

Parents are advised to keep kids home if they have a temperature of 100 or greater until they’re fever-free for 24 hours without the use of fever-reducing medicine.A vaccine for the H1N1 influenza virus is expected to be available sometime in October, and those 6 months to age 25 will be among the first to receive the shots. Grabeel says they’re in a “wait and see” mode in deciding whether or not vaccination clinics will be available at schools…

"We're not sure if the vaccine is going to be available, how much is going to be available, and then, of course, we'll go with the CDC guidelines as far as what those high need populations are for administering the vaccine, and, again, we'll be working with the health department, and, if that recommendation comes through, then we would work with the health department to provide those onsite clinics at the school sites."

She says students would not receive a vaccination unless parents sign a consent form allowing them to do so.Grabeel feels Springfield schools will be prepared to respond should a large number of flu cases occur in schools. And she says Springfield is fortunate to have school nurses in most buildings…

"We're very very fortunate as compared to other school districts in the area who may not have a health professional there who is that key person for early intervention, and that is a key."

Meanwhile, local hospitals are doing what they can to prepare for a large demand for H1N1 vaccines and for a potentially large number of patients reporting with flu-like symptoms…

"I think it's going to be a tremendous strain on all of our healthcare resources, honestly, and employers and everybody."

Dr. Dan Sontheimer is a physician and vice-president of medical affairs at Cox Health. He says they’re prepared to give vaccines to a large percentage of the population if needed…

"The clinics and Cox, and I'll say St. John's in coordination with our health department--we are coordinating all of our efforts for the H1N1 vaccination, so we have an infection prevention department so if it's determined, you know, this release of the vaccine will go to healthcare workers, we have a place where they can go and get it or they can go out to certain outpatient clinics and things like that, and I know St. John's has that capacity. Also, Greene County Medical Society has been very active in flu distribution, in getting flu vaccine out in the community, and they're going to play a role along with the health department."

He says patients who go to Cox with flu-like symptoms will be put in rooms away from other patients to prevent the spread of the illness. He suggests calling your physician right away if you have any flu-like symptoms because anti-viral medications work best if administered early in the illness. According to Dr. Sontheimer, Cox has a supply of the anti-viral Tamiflu as does its vendor.

Cox plans to set up a phone line for people with questions about H1N1. He feels they will be well-prepared should there be a large number of flu cases here this season.

At St. John’s Dr. Will Sistrunk, medical director of the infection prevention program and an infectious diseases physician says they’ve begun educating co-workers and administration on how to properly care for patients with influenza and they’re working to prepare them to potentially see a large number of cases.They’re meeting with different groups to decide how they’ll receive the H1N1 vaccine from state authorities and how to distribute it.He says, should the swine flu hit hard here, they’ll be prepared…

"We feel that we are going to be very prepared to care for patients with influenza. I don't think any organization can be totally prepared because we don't know what we're going to be faced with. We want to try to be prepared for everything that we can be prepared for, but the problems is that we don't know what's going to happen. Hopefully our preparations that we have done will all not have to be used, but we're going to be ready if our community needs us to help."

According to Dr. Sistrunk, over the last few years, they’ve worked to prepare St. John’s for rapidly immunizing its healthcare workers by using vaccination drills with the season flu vaccine. He says the preparations to deal with the H1N1 virus are a team effort...

"We're working within our organization, which involves a lot of clinics in Southwest Missouri, but also we're working very closely with the other healthcare organizations in our community and with the Greene County Health Department and the State Health Department to make sure that we're all working as a team to better care for our community. We feel that, and we've felt this for a long time that we can better care for our communities if we're all working with the same goals and we all know what our expectations are going to be of each other if it comes time of a pandemic or another emergency."

The Springfield- Greene County Health Department is also working to prepare for flu season this year. Health Department director Kevin Gipson says they’re planning for the worst and hoping for the best. But he says they’ll be prepared should the H1N1 virus hit the community hard. The series on swine flu is available on the web at ksmu.org.For KSMU News, I’m Michele Skalicky.