Are our educators now the sentinels for widespread community outbreaks of novel influenza A (H1N1) in the US?

[Farmer]

We have discussed for years how health care worker illnesses can serve as sentinel events for evidence of increased human to human transmission of H5N1. I wonder if now our educators are the sentinels for community outbreaks of novel influenza A (H1N1). They have multiple opportunities for exposure to the young people who comprise the most severely affected age categories; 2/3rds of confirmed H1N1 cases occur among those less than 18 years of age.
http://www.cdc.gov/media/transcripts/2009/t090512.htm

As has been previously suggested, novel influenza A (H1N1) appears to present as afebrile illness among some of those infected.
http://www.flutrackers.com/forum/showthread.php?p=231936

This presents difficulties for parents during the decision-making process of whether to keep children home due to illness. Many people do not receive paid sick leave in this country, and may use the presence of fever as a major criterion for severe illness requiring home care. These children have a high probability of attending activities outside the home - certainly during the incubation period or prodrome - and potentially during a course of relatively mild illnesses.

It strikes me that one novel influenza A (H1N1) death- Judy Trunnell, the 33 year old Texan was a special education teacher, http://www.flutrackers.com/forum/showthread.php?p=229287

and one severe illness - a NYC school staff member, is now hospitalized in critical condition.
http://www.flutrackers.com/forum/showthread.php?t=104203

Both of these individuals were both potentially exposed to large numbers of children.

Soon in the US, schools will be out for the summer. Children will still congregate at retail outlets, summer camps, community recreational facilities, etc. Many of these facilities are staffed by teenagers and college-age students working summer jobs. Due to their age, these older children and young adults appear to be at higher risk for infection. They may also have underlying illnesses and potential risk factors for severe novel influenza A (H1N1) infection.

Will we start seeing more illness in this new sentinel population of younger but significantly exposed people, or will novel influenza A (H1N1) transmission be reduced during the warm summer months?

I believe that we must increase surveillance for novel influenza A (H1N1) at this time. We must continue to count individual cases of confirmed illness and to analyze them not only by age, but also by occupation and behavioral risk factors. We need this information to understand how best to intervene to minimize the public health effects of this outbreak. Time is short, as we expect opportunities for transmission or viral pathogenicity to potentially increase in the autumn.

As a society, we must consider and seriously weigh the immediate economic impacts of cancelling gatherings of children versus the potential longer term health consequences of ‘business as usual’ as this novel influenza A (H1N1) epidemic continues in the US.

 

[Skatman]

Re: Are our educators now the sentinels for widespread community outbreaks of novel influenza A (H1N1) in the US?

Farmer,

Great point!!!

I would add that where Summer Camp (with a lot of close contact) is involved take Scouts for example usually several hundred to a couple of thousand kids along with adult leaders (usually between 30 and 50) rotate in an out of camps in remote areas each week. If an outbreak were to occur you could easily see what is considered as a "mild illness" become a major health threat.

I have already contacted the Boy Scout Council in Houston and expressed my concern and they told me that they will follow CDC's recommendation. Which was a round about way of saying they would keep them open.

I think this a very dangerous plan but since they earn most of their revenue from summer camp they will do everything they can to keep them open.

 

[Dark Horse]

Re: Are our educators now the sentinels for widespread community outbreaks of novel influenza A (H1N1) in the US?

Judy Trunnel, the 33-year-old pregnant woman who died in Texas, was a special education teacher.

This whole thing of protecting the economy by not letting border guards wear masks, letting the state health boards off the hook for testing, and no longer having the CDC/DHS daily briefings is a scandal. If this is a dress rehearsal for the fall, then we have a public health disaster waiting with public health departments being a key part of the problem.

As a Georgia resident, I wonder if the state will ever get their act together to tell its taxpayers what is going on.

 

[Diane Morin]

Re: Are our educators now the sentinels for widespread community outbreaks of novel influenza A (H1N1) in the US?

The authorities of public health of Quebec confirmed only one another case of influenza A (H1N1), which changes to 17 the number of people contaminated in the province. It is about an employee of the Charlemagne college, where three pupils are carrying the virus.

************************

Les autorit?s de sant? publique du Qu?bec ont confirm? un seul autre cas de grippe A (H1N1), ce qui porte ? 17 le nombre de personnes contamin?es dans la province. Il s'agit d'un employ? du coll?ge Charlemagne, o? trois ?l?ves sont porteurs du virus.<?xml:namespace prefix = o ns = "urn:schemas-microsoft-comfficeffice" /><o></o>
<o> </o>
http://www.flutrackers.com/forum/showpost.php?p=231755&postcount=40

 

[Farmer]

Re: Are our educators now the sentinels for widespread community outbreaks of novel influenza A (H1N1) in the US?

I searched on the novel influenza A (H1N1)-associated deaths in the US. I was only able to find occupational information for the adult Texas case.

I hope that the information is being collected and analyzed, even if it is not publicized.

 

[Laidback Al]

Re: Are our educators now the sentinels for widespread community outbreaks of novel influenza A (H1N1) in the US?

Farmer, an insightful observation. I wonder how many school teachers and educators are among the dead in Mexico?

 

[GermTheory]

Re: Are our educators now the sentinels for widespread community outbreaks of novel influenza A (H1N1) in the US?

We have discussed for years how health care worker illnesses can serve as sentinel events for evidence of increased human to human transmission of H5N1. I wonder if now our educators are the sentinels for community outbreaks of novel influenza A (H1N1). They have multiple opportunities for exposure to the young people who comprise the most severely affected age categories; 2/3rds of confirmed H1N1 cases occur among those less than 18 years of age.
http://www.cdc.gov/media/transcripts/2009/t090512.htm

As has been previously suggested, novel influenza A (H1N1) appears to present as afebrile illness among some of those infected.
http://www.flutrackers.com/forum/showthread.php?p=231936

This presents difficulties for parents during the decision-making process of whether to keep children home due to illness. Many people do not receive paid sick leave in this country, and may use the presence of fever as a major criterion for severe illness requiring home care. These children have a high probability of attending activities outside the home - certainly during the incubation period or prodrome - and potentially during a course of relatively mild illnesses.

It strikes me that one novel influenza A (H1N1) death- Judy Trunnell, the 33 year old Texan was a special education teacher, http://www.flutrackers.com/forum/showthread.php?p=229287

and one severe illness - a NYC school staff member, is now hospitalized in critical condition.
http://www.flutrackers.com/forum/showthread.php?t=104203

Both of these individuals were both potentially exposed to large numbers of children.

Soon in the US, schools will be out for the summer. Children will still congregate at retail outlets, summer camps, community recreational facilities, etc. Many of these facilities are staffed by teenagers and college-age students working summer jobs. Due to their age, these older children and young adults appear to be at higher risk for infection. They may also have underlying illnesses and potential risk factors for severe novel influenza A (H1N1) infection.

Will we start seeing more illness in this new sentinel population of younger but significantly exposed people, or will novel influenza A (H1N1) transmission be reduced during the warm summer months?

I believe that we must increase surveillance for novel influenza A (H1N1) at this time. We must continue to count individual cases of confirmed illness and to analyze them not only by age, but also by occupation and behavioral risk factors. We need this information to understand how best to intervene to minimize the public health effects of this outbreak. Time is short, as we expect opportunities for transmission or viral pathogenicity to potentially increase in the autumn.

As a society, we must consider and seriously weigh the immediate economic impacts of cancelling gatherings of children versus the potential longer term health consequences of ?business as usual? as this novel influenza A (H1N1) epidemic continues in the US.

Excellent point, applicable to influenza in general. Children with influenza infections are infectious for a longer period of time than most adults, up to several weeks, are not careful with their secretions, do not observe physical distance norms, and are not likely to wash their hands. For these reasons, they are especially effective infection transmitters.

Establishing an illness reporting site for teachers might be an idea their unions could get behind. The site could include a simple screening questionaire so the reports coudl be better interpreted.

There are conflicting reports about the length of time the H1N1 strain was circulating in Mexico, ranging from 1-6 + months before the official April announcement. By April 23, 400 health care workers had been infected in one area, apparently Mexico City. See ProMED http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,77182

 

[LSU2001]

Re: Are our educators now the sentinels for widespread community outbreaks of novel influenza A (H1N1) in the US?

Well about the only good thing is that schools will be closing for the summer within the next month for most of the country. With schools closed for summer vacation there will be fewer opportunities for infection spread and fewer opportunities for educators to catch this flu from their charges.

I am a middle school assistant principal and I can promise you it has crossed my mind a thousand times that I am directly exposed all day everyday to whatever the kids are carrying.
TIm

 

[sharon sanders]

Re: Are our educators now the sentinels for widespread community outbreaks of novel influenza A (H1N1) in the US?

WelcomeLSU2001!

 

[Laidback Al]

Re: Are our educators now the sentinels for widespread community outbreaks of novel influenza A (H1N1) in the US?

. . . There are conflicting reports about the length of time the H1N1 strain was circulating in Mexico, ranging from 1-6 + months before the official April announcement. By April 23, 400 health care workers had been infected in one area, apparently Mexico City. See ProMED
http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,77182

Actually, there were reports of HCWs being infected in Oaxaca by an unknown respiratory illness in mid April which raised suspicions here at FT. http://www.flutrackers.com/forum/showpost.php?p=220200&postcount=12

 

[SagamoreJames]

Re: Are our educators now the sentinels for widespread community outbreaks of novel influenza A (H1N1) in the US?

I am also an educator in a Massachusetts high school. I have been on flutrackers for a while now (about 2 years). I have hand sanitizer in the room. I spray and clean the desks. I use red cross spray sometimes between classes if I have noticeably sick students. Not many other teachers seem to be paying attention though after the initial burst of news . I am really looking forward to the summer and I do hope they make the vaccine. It would be good timing for us in the schools.

 

[SagamoreJames]

Re: Are our educators now the sentinels for widespread community outbreaks of novel influenza A (H1N1) in the US?

I also have a question. A loved one of mine (also a teacher) has asthma. If he has a pneumonia vaccine could that help him with the pneumonia coming with the swine flu?

 

[Snicklefritz]

Re: Are our educators now the sentinels for widespread community outbreaks of novel influenza A (H1N1) in the US?

Wow, Farmer! I wished I'd thought of that. Keen insight... Maybe is we called teachers 'canary's' we'd pay them what they're really worth.

 

[The Mountains Voice]

Re: Are our educators now the sentinels for widespread community outbreaks of novel influenza A (H1N1) in the US?

I also have a question. A loved one of mine (also a teacher) has asthma. If he has a pneumonia vaccine could that help him with the pneumonia coming with the swine flu?

Hi SJ,
My personal experience and research is a resounding YES! I'm 47 - with asthma, and had a shot 3 years ago. I got the pneumonia shot primarily because of a few bad bouts with lung infections, one of which devolved into Pneumonia. ANY flu / lung / sinus infection can weaken the system of someone like your friend, or myself, and cause pretty bad problems if pneumonia sets in, and in the case of this specific swine flu - MY view of things says it is causing more damage than the "Mild" seasonal flu in many cases. And I also think it's a safe, inexpensive hedge against a larger bird flu pandemic (or any pandemic) - because once something like that starts - even pneumovax shots might be in short supply. The downside of getting a pneumonia shot is absolutely minimal / non-existant compared to the upside benefits. Here's a good read on the subject - ttp://www.vaccineinformation.org/pneumchild/qandavax.asp

So, My Opinion is to have your friend get one - and get it now. It lasts a lifetime for the most part. My Opinion is that pretty much everyone should consider it, regardless of health/age - if of course you believe a pandemic is in your future.

 

[WTB]

Re: Are our educators now the sentinels for widespread community outbreaks of novel influenza A (H1N1) in the US?

The clinical picture we have now is that sometimes the patient do get secondary pneumonia like the "usual" flu but we also see ARDS wich is acute lung failure. But getting vaccinated is always a good idea. Asthma with the flu is no fun at all. So better to prevent as Mountains Voice said.

WTB

 

[SagamoreJames]

Re: Are our educators now the sentinels for widespread community outbreaks of novel influenza A (H1N1) in the US?

Thank you so much for the advice. He going to try to get one.