1. Family and Community Forum on H1N1 Flu Welcome Tuesday, October 6, 2009

2. Presenters Valerie Hon, RN, BSN District Nurse for Portage Community Schools Susan Lorenz, RN, MS Columbia County Health Officer

3. Overview of H1N1 In April 2009, a novel strain of Influenza A surfaced in Mexico and spread into the US Wisconsin 6432 confirmed cases as of 08/29/09 239 hospitalizations (slightly higher than seasonal influenza) 8 deaths (lower than seasonal influenza)

4. Current information New data collection cycle started 08/30/09 Wisconsin’s weekly report Wisconsin’s Pandemic Flu Resource

5. What have we learned? The novel H1N1 flu strain is affecting well students and the young disproportionately The seasonal flu generally affects older adults or people with underlying health conditions, especially those with lung disease or altered immune systems

6. Some data from the CDC As of 7/31/09 the median age of persons with lab confirmed infections in the US was 12 years the highest infection incidence was among persons aged 5–24 years the median age of hospitalized persons with laboratory-confirmed novel influenza A (H1N1) virus infection was 20 years

7. Data continued The incidence of hospitalization was highest among young children aged <4 years The median age among persons who died with novel H1N1 infection is 37 years

8. General population information 2% of the total population for the US are teachers Approximately 95% of children ages 3-19 years are enrolled in schools

9. Know the Symptoms of Influenza Sudden onset of illness Fever higher than 100.4° F (38° C)* Chills Cough Headache Sore throat Stuffy nose Muscle aches Feeling of weakness and/or exhaustion Diarrhea, vomiting, and/or abdominal pain (occur more commonly in children) *It’s important to note that not everyone with flu will have a fever.

10. What to do Stay home Distance yourself from others Contact your family doctor if you are concerned about your illness or have underlying health concerns

11. What to do Wash your hands often with soap and water, especially after coughing or sneezing. Alcohol-based hands cleaners are also effective Stay home when sick or have flu like illness at least 24 hours after they no longer have a fever, or signs of a fever, without the use of fever-reducing medicines.

12. What to do Stay away from people who are sick Cover nose and mouth with a tissue when coughing or sneezing (or use shirt sleeve or elbow if no tissue is available) Avoid touching your eyes, nose or mouth. Germs spread that way Frequently wash common surfaces Eat nutritious meals, get plenty of rest and do not smoke

13. This is why we need to catch a sneeze.

14. If the ill person is a child in school Notify school of child’s absence Follow Student Health GuidelinesStudent Health Guidelines Share the symptoms s/he is having Follow up with school if a diagnosis is given by a health care provider Follow the recommendations about social isolation and staying home from school until fever is gone and feeling better

15. Family preparation for sick children Start thinking about how you will handle your child being ill for 2 to 5 days and needing to be out of school and or child care Consider options for child care if an extended school closure occurred Consider speaking with your employer about alternative work schedules

16. Family Preparedness Plan ahead for medications Plan ahead for food A great resource for families to use Wisconsin Pandemic Influenza Toolkit for Families Wisconsin Pandemic Influenza Toolkit for Families

17. School preparedness Education about non-pharmaceutical interventions across the grades Cover your cough Catch a sneeze in your sleeve Throw your own used tissues in the garbage Wash hands often Use hand sanitizer correctly Keep hands away from mouth, eyes, nose

18. School preparedness Sharing posters on non-pharmaceutical interventionsposters Sending communications home to families Posting information and resources on the individual school web pages and the Daily Bulletin on Power School. individual school web pages Pandemic Plan proposal to Board 10/26/09

19. School preparedness Answering questions as they arise Educating adults on prevention Actively involved in school based vaccination clinic planning Assuring access to either soap and water or hand sanitizer in or near each classroom

20. School preparedness Reviewing cleaning procedures The H1N1 virus is thought to live 2 to 8 hours on inanimate objects. This is still under investigation by CDC. Schools wouldn’t be closed for cleaning as that is done daily in all buildings School closures would be to decrease the close proximity and disease spread or inability to function due to high numbers of ill individuals

21. School-based vaccination clinics Columbia and Marquette County Health Departments H1N1 flu vaccination only children K through 12th grade and Transition program In each school building During the regular school day By parental consent Each child will bring home a parent letter, vaccine information statement, and a consent form

22. School-based vaccination clinics Dates are not set Vaccine has not arrived at either health department yet Volunteers will be needed

23. Questions A list of tonight’s questions will be added to the web pages with the answers

24. Q and A How will the district decide when to close a school? This is based upon operability of a school or district, the rise in the number of ill students, and is collaborative. Is the information on the paperwork being provided to parents enough to make a decision? Yes. It gives information and also includes links to further resources. Parents may find a variety of information on the Internet to aid in making his/her decision. Vaccination is voluntary and requires parental consent.

25. Q and A Will another family and community forum be presented since attendance was so low? No. Instead the district has plans to post this forum information on the H1N1 Influenza web link and run the video on the Charter Cable channel 97. What else is the district doing to promote healthy immune systems versus the vaccinations? Not directly tied to H1N1 interventions is the wellness movement in the district in which healthy eating, fruit and vegetable consumption are all happening. Sleep hygiene and water are also promoted. Additionally, frequent hand washing.

26. Q and A Where can parents find the ingredient lists for the vaccines? The FDA website would be one resource. http://www.fda.gov Another site is http://www.immunize.org/packageinserts/pi_h1n1.asp This link will take you to 4 different package inserts for the H1N1 vaccine.http://www.fda.gov http://www.immunize.org/packageinserts/pi_h1n1.asp If the packaging says it is not safe for less than 4 year olds and pregnant women, why would it be given? Different vaccine manufacturers have their particular vaccine licensed with slight variations. Specific vaccine indications are followed and a vaccine not licensed for a particular age or population will not be given in an off label use by Columbia or Marquette County Health Departments. The FDA or the Immunization Action Coalition web sites are places people may locate further detailed information about vaccine components.

27. Q and A What vaccine will be made available to students during the school based vaccination clinics? Nasal spray and injectable vaccine will be available. The nurse giving the vaccination will make a decision based upon information provided by the parent/guardian on the consent form completed by the parent/guardian. The local health department will get multiple manufacturers’ vaccine and the supply at any given time is not guaranteed. Some may or may not contain Thimerosal.

28. Q and A If a school or district closes because of H1N1, does that time need to be made up? The 180 day requirement is waived by DPI if the local health officer closes a school (a collaborative effort between administration, local health officer, Wisconsin Department of Health Services, school nurse and Board of Education), but the minutes of instruction are not changed.

29. This program will be placed on the Charter Cable channel 97 for future reference and for those unable to attend

30. Thank you for joining us. Stay well.