November 25, Sincerely, Ralph Marino, Jr., Ed.D. Superintendent of Schools

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1 November 25, 2009 Dear Parents/Guardians of Students in grades 5-12: The Chemung County Health Department will be holding an H1N1 vaccination clinic Wednesday, December 2 for students in grades 5-12 who have returned signed parental consent forms. The clinic will be held at the Horseheads Intermediate/Middle School complex on Sing Sing Road from 4 to 8 p.m. If you ve seen any national news coverage of vaccination clinics, you ve seen the long lines, so please be prepared to wait. In order to attempt to avoid lengthy wait times, we ask that you bring your child(ren) according to the following schedule. We simply felt this might help alleviate long lines: Horseheads Intermediate School: Horseheads Middle School: Horseheads High School: 4pm 5pm 6pm Please note that if you are unable to bring your child at the designated time, you may bring him/her at any time that evening. Note: Please do not bring your child(ren) to the school prior to 4 p.m. so that our buses may leave the complex at the scheduled time. Please use the front entrance to the complex (not the Fieldhouse/delivery entrance). You will be entering the complex through the Intermediate School side. This is the entrance further away from Sing Sing Road. PLEASE NOTE: Both the nasal spray and the injection (shot) will be available. Students who are 18 or older may choose for themselves, but if your child is under 18, please accompany your child to the clinic so that you may tell the Health Department which form of the vaccine you d like your child to receive. The nasal spray is a weakened form of the live virus, while the injection is a dead form of the virus. The Centers for Disease Control have told us that both are effective, and neither has proven to have serious side effects. At this time, the Health Department has enough vaccine to vaccinate only those children in grades 5-12 who have returned signed parental consent forms. Those children who have not already returned consent forms who come to the clinic will have to wait until the last half hour of the clinic to be sure there is enough vaccine. Please be sure your child wears a sleeveless or short-sleeved shirt to the clinic (underneath a sweater for warmth) so that the nurses will be able to easily access your child s upper arm for the vaccination. We have more than 1200 students to vaccinate that evening, so your cooperation is appreciated. We vaccinated more than 1000 children at our PreK-4 clinic last week. The process went quite smoothly, with wait times of less than one hour. We hope this clinic goes just as smoothly, and we appreciate your patience and understanding as we waited for the vaccine to arrive. If you have any questions regarding H1N1 or the vaccination, please call the Chemung County Health Department at Thank you. Sincerely, Ralph Marino, Jr., Ed.D. Superintendent of Schools

2 November 16, 2009 Dear Parents/Guardians of Students in Grades PreK-4: The Chemung County Health Department will be holding an H1N1 vaccination clinic Wednesday, November 18 for students in grades PreK-4 who have returned signed parental consent forms. The clinic will be held at the Horseheads Intermediate/Middle School complex on Sing Sing Road from 3:30 to 9 p.m. If you ve seen any national news coverage of vaccination clinics, you ve seen the long lines, so please be prepared to wait. In order to attempt to avoid lengthy wait times, we ask that you bring your child(ren) according to the following schedule. We simply felt this might help alleviate long lines: Gardner Road Elementary School: Big Flats Elementary School: Center Street Elementary School: Ridge Road Elementary School: 3:30pm 5 p.m. 6 p.m. 7 p.m. Please note that if you are unable to bring your child at this time, you may bring him/her at any time that evening. Note: Please do not bring your child(ren) to the school prior to 3:30 p.m. so that our buses may leave the complex at the scheduled time. Please use the front entrance to the complex (not the Fieldhouse/delivery entrance). You will be entering the complex through the Intermediate School side. This is the entrance further away from Sing Sing Road. At this time, the Health Department has enough vaccine to vaccinate only those children in grades PreK-4 who have returned signed parental consent forms, so if you did not submit a consent form for your child prior to this time, your child will not be vaccinated. No walk-ins will be permitted. Additionally, if you have older children, please do not ask for them to be vaccinated at this clinic. When the Health Department receives more of the vaccine, we will schedule additional clinics for our older students. We thank you for your understanding. Please be sure your child wears a sleeveless or short-sleeved shirt to the clinic (underneath a sweater for warmth) so that the nurses will be able to easily access your child s upper arm for the vaccination. We have some 1100 students to vaccinate that evening, so your cooperation is appreciated. We understand that the H1N1 virus and vaccine have caused anxiety for parents and students. We ve been working on our vaccination plan for many months, so we hope that the process will go as smoothly as possible, and we appreciate your cooperation and patience as we ve all been waiting for enough vaccine to arrive. If your child is age 9 or younger, please note that a second vaccination is necessary four weeks after the initial vaccination to help boost immunity. The district will provide information on this second booster vaccination once it becomes available. If you have any questions regarding H1N1 or the vaccination, please call the Chemung County Health Department at Thank you. Sincerely, Ralph Marino, Jr., Ed.D. Superintendent of Schools

3 September 15, 2009 Dear Parents/Guardians: As we enter the new school year, we are all becoming more and more concerned about the H1N1 swine flu. I m writing to let you know the preparations we ve made, and will continue to make, in order to keep all of our children as safe and healthy as possible. We have been meeting with officials from the Chemung County Health Department and our county s other school districts, and we participated in a state-wide teleconference with state health and educational officials during the summer. Local health officials are in constant contact with national health officials such as the Centers for Disease Control. Please be assured that we are making sure we have the most up-to-date information and planning resources. The H1N1 or swine influenza (flu) is a new virus that has not been identified in people until this year. It is thought to be spread through person-to-person contact and air droplets. The virus is not spread through food, including pork or pork products. Symptoms of the H1N1 swine flu are similar to the symptoms of seasonal flu: fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people have reported additional symptoms including nausea, vomiting, and diarrhea. As you may know, the H1N1 flu affects younger age groups than seasonal flu, and of course, this is a large part of our shared concern. To that end, federal and local health officials are asking school districts to assist in any potential immunization efforts. No plans have been confirmed at this point; if and when they do, we will get information to you as soon as possible. Please note that researchers believe the seasonal flu vaccine does not provide protection against H1N1. We can all work together right now to prevent the spread of the H1N1 and seasonal influenza. Please help by taking the following precautions, and by encouraging your children and others to do the same: - Cover all coughs and sneezes with a tissue and dispose of all tissues in waste containers. Cough or sneeze into your shirt sleeve if a tissue is not available. - Wash hands frequently with soap and water, especially after coughing, sneezing, or blowing your nose and before eating. Use a hand sanitizer if soap and water are not available. Please note that soap and water are more effective at stopping the spread of germs than sanitizer products. - If your child is ill, especially if a fever is present, keep your child at home. Ill students should stay out of school for at least 24 hours after fever is gone without the use of fever reducers such as acetaminophen or ibuprofen. - If your child is ill, tell your school s nurse about your child s symptoms so they can watch for other students and staff with the same symptoms. - Avoid touching nose, mouth, and eyes to reduce the spread of germs. - Do not share eating utensils, water bottles, beverage containers, or other personal items. Contact with these items can expose people to viruses that exist on their surfaces. (continued)

4 If your child or someone in your home has a compromised immune system, chronic respiratory or cardiac disease, or is pregnant, please contact your health care provider for recommendations on using antiviral medications, and about immunization. Please note that if your child is ill in school, we will send your child home, so you may want to make alternate arrangements in the event you work or are unable to pick up your child during the day. Per our procedures and health department advice, we will separate ill children and adults from others in the school. Each nurse s office has a separate room for children and adults with illnesses we believe to be infectious. I would also like to share a word about hand sanitizers. We provide non-alcohol sanitizers in all our schools. We chose the non-alcohol variety because the fire inspector told us that having a large amount of alcohol-based sanitizer, which is flammable, is in violation of fire codes. We also understand that the FDA website says non-alcohol sanitizers are not effective at killing some viruses, but we don t believe that is definitive. Research also shows that the compound used in our sanitizers is effective in killing a large number of viruses. We will continue to look into this, and we will do what s best for children, in accordance with health codes and laws. Again, be aware that washing with soap and water is more effective than using hand sanitizers alone. Sanitizers are meant to be a supplement to hand-washing. To that end, we are working to place hand sanitizers in each district classroom and in more places throughout the buildings. As you can imagine, with the increased concern about the flu, the sanitizer we use is on back order, but as soon as we can get the product, we will increase its presence in our schools. Please be assured that our cleaners are diligent in their cleaning of our schools and buildings. Prior to the start of the year, supervisors reinforced with each cleaner the daily cleaning protocols. Our cleaners are paying special attention to the cleaning and disinfecting of certain areas such as nurse s offices, eating areas, and door knobs. We use a hospital-grade disinfectant. The H1N1 virus is a situation that concerns us all, and I promise you that we are doing everything we can to learn more about the situation, prepare for any possibility, and protect the health of our children and community. Your children s health and safety are as important to us as their academic success, and we will continue to be vigilant regarding this public health concern. For more information on the H1N1 flu, you may visit the Centers for Disease Control web site at or the New York State Department of Health web site at The New York State Department of Health has also set up a 24-hour H1N1 hotline at If you have questions or concerns about your child, please contact your child s school principal. Thank you for helping us battle the H1N1 virus. Sincerely, Ralph Marino, Jr., Ed.D. Superintendent of Schools

5 H1N1 Swine Flu Information What is H1N1 (swine) influenza (flu)? Swine flu is a viral infection of the nose, throat, windpipe, and bronchi. The main symptoms are a fever, cough, sore throat, and runny nose. If you don t have a fever, you don t have swine flu. Usually there s more muscle pain, headache, fever and chills than seen with the common cold. Some people are also experiencing nausea and diarrhea, but this is much less usual. What is a pandemic? The term pandemic refers to the number and distribution of cases around the world, not to the severity of the disease. That is, there are a lot of cases in many countries all over the world, but the cases are not necessarily all severe. Flu is caused by the H1N1 virus. It started in March 2009 and by June had spread to most of the world (a pandemic). After exposure (close contact), 20% of people come down with symptoms in 4 to 6 days. It is anticipated that this fall/ winter season, we will see more cases of seasonal flu due to the emergence of swine flu. Some experts estimate that up to 30-50% of the U.S. population will get the swine flu. What are the signs and symptoms of H1N1 flu? Most cases of H1N1 influenza in the USA at this time involve only mild illness. Your child may exhibit the following symptoms: fever (over 100 degrees F), feverishness, cough, sore throat, congestion or runny nose. Some additional symptoms may be experienced, including muscle pain, fatigue, and sometimes vomiting and diarrhea. Children who are getting ill may exhibit different behavior than usual, such as eating less or being irritable. Children with the above signs and symptoms should not be sent to school. Children at school with these signs and symptoms will be sent home. How do I protect my family and myself? The virus is spread by sneezing, coughing, and hand contact. 1. Cover the nose and mouth with a tissue when coughing or sneezing, and discard the tissue in the trash immediately. If no tissue is available, cough or sneeze into the bend of your elbow (into your sleeve); do not cough into your hands. Set a good example for your children by following these practices yourself. 2. Clean hands with soap and water or a hand sanitizer often. Soap and water works very well; better, in fact, than hand sanitizer. Lather and rub hands for seconds, or as long as it takes to sing the happy birthday song twice. Hand sanitizers are a good alternative when soap and water are not immediately available. 3. Clean frequently-touched surfaces often: faucets, doorknobs, tele phones, TV remote, computer keyboards, etc. 4. Don t touch your face or eyes with your hands if you have not recently washed them. Keep children out of school when sick. Your child may return to school after the fever is gone for at least 24 hours without the use of fever-reducing medicine. (CDC) Stay away from others if you are ill; if you are well, stay away from those who are ill. Swine flu shots: The swine flu vaccine is anticipated to be available by mid-october. When the swine flu vaccine becomes available, get all family members protected. Children need to be over 6 months old. A note on the seasonal flu shot: This year s seasonal flu shot does not protect against the swine flu. All children 6 months to 18 years of age are advised to get the seasonal flu shot. This means that to get protection for both the seasonal and swine flu, your children will need to get two different vaccinations. You should NOT see your doctor or go to the Emergency Room if your child has mild illness stay at home! If you or your children do not have swine flu, they are likely to be exposed to it in the waiting room of a doctor s office or the Emergency Room. How to know that your child has swine flu If swine flu becomes widespread in our community and your child has flu symptoms with a fever, then he or she likely has swine flu. You don t need to get any special tests. You don t need to call or see your child s doctor, unless your child is HIGH-RISK (see section below What Care Does My Child Need? ) or develops a possible complication of the flu (see the Call your child s doctor section).

6 What care does my child need? The treatment of swine flu depends on your child s main symptoms. It s no different from treating symptoms of the common cold. So far, the rate of complications is no higher than with regular seasonal flu. Bed rest is not necessary. Antibiotics are not helpful. Fever or aches - Give acetaminophen (Tylenol) or ibuprofen (Advil) for fever over 102 F (39 C) or for any pain. Children and adolescents who have influenza should never take aspirin. Cough - For children over age 6, give cough drops. If your child is over 1 year of age, give honey (1/2 to 1 teaspoon as needed). Never give honey to babies. If honey is not available, you can use corn syrup. Drugstore cough medicines are not as helpful as honey. Also, they are not approved for children under 4 years old (FDA). Sore throat - Tylenol or Ibuprofen is very helpful for throat pain. Chil dren over 6 years old can suck on hard candy. Children over 1 year old can sip warm chicken broth or other warm liquids. Stuffy or blocked nose - Saline (or warm-water) nose drops followed by suction (or nose blowing) will open most blocked noses. Use these nasal washes whenever your child can t breathe through the nose. You can buy saline spray without a prescription. Saline nose drops can also be made by adding 1/2 teaspoon (2 ml) of table salt to 1 cup (8 oz or 240ml) of warm water. Use 2 or 3 drops at a time. Antiviral medicine (such as Tamiflu) - Most LOW-RISK children with swine flu do not need antiviral medicine unless they develop serious symptoms (such as pneumonia). Antiviral medicines must be started within 48 hours of the start of flu symptoms to have an effect. They usually only reduce the time your child is sick by 1 or 2 days. They improve the symptoms but do not eliminate them. HIGH-RISK children for complications - The following children are at higher risk for complications from swine flu: lung disease (such as asthma), heart disease (such as a congenital heart disease), weak immune system (such as cancer), diabetes, sickle cell disease, kidney disease, diseases requiring long-term aspirin therapy, other chronic diseases, pregnant teens, or children less than 5 years old. Expected course - The fever lasts 2 to 3 days, runny or stuffy nose 1 to 2 weeks, and cough 2 to 3 weeks. When does my child need to see the doctor? Call your child s doctor NOW (night or day) if: Your child looks or acts very sick Breathing becomes difficult or fast Bluish or gray skin color Not waking up or interacting Dehydration occurs (no urine in 12 hours, dry mouth, no tears) Being so irritable that the child does not want to be held Call your child s doctor during the day if: Your think your child needs to be seen Earache or sinus pain occurs Your child is in the HIGH RISK group and has flu symptoms Fever lasts more than 3 days Your child becomes worse Cough lasts more than 3 weeks What about school closures? School closures, which were recommended in the spring of last school year, were not helpful in halting the spread of swine flu. The CDC, federal and state governments are currently not recommending any routine school closures for swine flu during the fall/winter of this school season. Any decision to close our schools would result from collaboration between the school district and the county health department. In the unlikely event of school closings due to swine flu, you would be notified in the same ways that we announce school closings due to inclement weather. That is, via the local media (TV and radio stations) and on our district s web site ( It is important to plan ahead. Have a family discussion now to develop options in advance of the unlikely event of a school closing. Arrange for child care in other than a group setting.

7 Where can I get more information? Stay informed: Develop a plan - individual/family/business: Based (and modified for school use) on advice sheet by Barton D. Schmitt MD, Denver, CO ; Authors: Kim Holden, RN, FNP, Nurse Practitioner, Elmira School District; Linda Swarthout, RN, BSN, MS, Public Health Educator, Chemung County Health Dept.; Kenneth A. Sobel, MD, School Physician, Horseheads and Elmira School Districts,

8 2009 H1N1 and Seasonal Flu: What To Do If You Get Sick This flu season CDC expects the new 2009 H1N1 flu to cause illness, hospital stays, and deaths in the United States along with seasonal flu. This flyer has information about what to do if you get sick with the flu this season. How do I know if I have the flu? You may have the flu if you have some or all of these symptoms: fever * headache cough sore throat runny or stuffy nose body aches *Not everyone with flu will have a fever. What should I do if I get sick? chills fatigue sometimes diarrhea and vomiting If you get sick with flu-like symptoms this flu season, you should stay home and avoid contact with other people except to get medical care. Most people with 2009 H1N1 have had mild illness and have not needed medical care or antiviral drugs and the same is true of seasonal flu. However, some people are more likely to get flu complications and they should talk to a health care provider about whether they need to be examined if they get flu symptoms this season. They are: ychildren younger than 5, but especially children younger than 2 years old ypeople 65 and older ypregnant women ypeople who have: Cancer Blood disorders (including sickle cell disease) Chronic lung disease [including asthma or chronic obstructive pulmonary disease (COPD)] Diabetes Heart disease Kidney disorders Liver disorders Neurological disorders (including nervous system, brain or spinal cord) Neuromuscular disorders (including muscular dystrophy and multiple sclerosis) Weakened immune systems (including people with AIDS) Also, it s possible for healthy people to develop severe illness from the flu so anyone concerned about their illness should consult a health care provider. There are emergency warning signs. Anyone who has them should get medical care right away.

9 What are the emergency warning signs? In children yfast breathing or trouble breathing ybluish skin color ynot drinking enough fluids ynot waking up or not interacting ybeing so irritable that the child does not want to be held yflu-like symptoms improve but then return with fever and worse cough yfever with a rash In adults ydifficulty breathing or shortness of breath ypain or pressure in the chest or abdomen ysudden dizziness yconfusion ysevere or persistent vomiting Do I need to go the emergency room if I am only a little sick? No. The emergency room should be used for people who are very sick. You should not go to the emergency room if you are only mildly ill. If you have the emergency warning signs of flu sickness, you should go to the emergency room. If you get sick with flu symptoms and are at high risk of flu complications or you are concerned about your illness, call your health care provider for advice. If you go to the emergency room and you are not sick with the flu, you may catch it from people who do have it Are there medicines to treat 2009 H1N1? Yes. There are drugs your doctor may prescribe for treating both seasonal and 2009 H1N1 called antivirals. These drugs can make you better faster and may also prevent serious complications. This flu season, antiviral drugs are being used mainly to treat people who are very sick, such as people who need to be hospitalized, and to treat sick people who are more likely to get serious flu complications. Your health care provider will decide whether antiviral drugs are needed to treat your illness. Remember, most people with 2009 H1N1 have had mild illness and have not needed medical care or antiviral drugs and the same is true of seasonal flu. How long should I stay home if I m sick? CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other things you have to do and no one else can do for you. (Your fever should be gone without the use of a fever-reducing medicine, such as Tylenol.) You should stay home from work, school, travel, shopping, social events, and public gatherings. What should I do while I m sick? Stay away from others as much as possible to keep from making them sick. If you must leave home, for example to get medical care, wear a facemask if you have one, or cover coughs and sneezes with a tissue. And wash your hands often to keep from spreading flu to others. CDC has information on Taking Care of a Sick Person in Your Home on its website. For more information, visit or or call CDC-INFO. CS A 09/24/2009

10 Seasonal and 2009 H1N1 Flu: A Guide for Parents What are the symptoms of the flu? Symptoms of seasonal flu and 2009 H1N1 flu can include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, fatigue and sometimes vomiting and diarrhea. Some people sick with the flu will not have a fever. Flu information What is the flu? The flu (influenza) is an infection of the nose, throat, and lungs caused by flu viruses. Flu viruses cause illness, hospital stays and deaths in the United States each year. There are many different flu viruses and sometimes a new flu virus starts spreading among people and making people sick. What is 2009 H1N1 flu? 2009 H1N1 flu (sometimes called swine flu or novel flu) is a new and very different flu virus that is spreading worldwide among people. This flu season, scientists expect both 2009 H1N1 flu and seasonal flu to cause more people to get sick than a regular flu season. More hospital stays and deaths may also occur. How serious is the flu? Most people with 2009 H1N1 have had mild illness and have not needed medical care and the same is true of seasonal flu. However, the flu can be serious, especially for young children (risk is highest in children younger than 2 years) and children of any age who have certain chronic medical conditions. These conditions include asthma or other lung problems, diabetes, weakened immune systems, kidney disease, heart problems and neurological and neuromuscular disorders. Children with these conditions can have more severe illness from any flu, including from the 2009 H1N1 flu virus. How does flu spread? Both 2009 H1N1 flu and seasonal flu are thought to spread mostly from person to person through the coughs and sneezes of people who are sick with flu. People also may get sick by touching something with flu viruses on it and then touching their mouth, nose or eyes. How long can a sick person spread the flu to others? People infected with seasonal and 2009 H1N1 flu shed virus and may be able to infect others from 1 day before getting sick to 5 to 7 days after. However, some people can shed virus for longer, especially children and people with weakened immune systems and people infected with 2009 H1N1 flu. Protect your child How can I protect my child against flu? Get a seasonal flu vaccine for yourself and your child to protect against seasonal flu viruses. Get a 2009 H1N1 vaccine for your child. Ask your doctor about whether you should get one too. Take and encourage your child to take everyday steps that can help prevent the spread of germs. This includes: Cover coughs and sneezes with a tissue. Throw the tissue in the trash after you use it. Stay away from people who are sick. Wash hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub. Avoid touching your eyes, nose and mouth. Germs spread this way. If someone in the household is sick, try to keep the sick person in a separate room from others in the household, if possible. Keep surfaces like bedside tables, surfaces in the bathroom, kitchen counters and toys for children clean by wiping them down with a household disinfectant according to directions on the product label. Throw away tissues and other disposable items used by sick persons in your household in the trash.

11 Is there a vaccine to protect my child from H1N1 flu? A yearly seasonal flu vaccine is the first and most important step in protecting against seasonal flu. This vaccine is recommended for children 6 months through 18 years of age and all people who are close contacts (caregivers) of children younger than 6 months of age. A vaccine against 2009 H1N1 flu also is being made. This vaccine is recommended for all children and young adults 6 months through 24 years of age. Other people, including close contacts of children younger than 6 months of age and adults with certain chronic medical conditions, are recommended for vaccination too. More information about the 2009 H1N1 flu vaccine and the seasonal flu vaccine is available on the CDC Web site. Is there medicine to treat the flu? Antiviral drugs can treat both seasonal flu and 2009 H1N1 flu. The priority use for these drugs this season is to treat people who are seriously ill (hospitalized) or people who are sick with the flu and either have a medical condition or are in an age group that puts them at high risk of serious flu complications. Antiviral drugs can make people feel better and get better sooner and may prevent serious flu complications. These drugs need to be prescribed by a doctor and they work best when started during the first 2 days of illness. These drugs can be given to children. What should I use for hand cleaning? Washing hands with soap and running water (for as long as it takes to sing the Happy Birthday song twice) will help protect against many germs. If soap and water are not available, use an alcohol-based hand rub. If your child is sick What can I do if my child gets sick? If your child is 5 years or older and otherwise healthy and gets flu-like symptoms, including a fever and/or cough, consult your doctor as needed and make sure your child gets plenty of rest and drinks enough fluids. If your child is younger than 5 (and especially younger than 2) or of any age and has a medical condition like asthma, diabetes, or a neurologic problem and develops flu-like symptoms, ask a doctor if your child should be examined. This is because younger children (especially children younger than 2) and children who have chronic medical conditions may be at higher risk of serious complications from flu infection, including 2009 H1N1 flu. Talk to your doctor early if you are worried about your child s illness. What if my child seems very sick? Even children who have always been healthy before or had the flu before can get a severe case of flu. Call or take your child to a doctor right away if your child of any age has: Fast breathing or trouble breathing Bluish or gray skin color Not drinking enough fluids Severe or persistent vomiting Not waking up or not interacting Being so irritable that the child does not want to be held Flu-like symptoms improve but then return with fever and worse cough Has other conditions (like heart or lung disease, diabetes, or asthma) and develops flu symptoms, including a fever and/or cough. Can my child go to school, day care or camp if he or she is sick? No. Your child should stay home to rest and to avoid giving the flu to other children. When can my child go back to school after having the flu? Keep your child home from school, day care or camp for at least 24 hours after their fever is gone. (Fever should be gone without the use of a fever-reducing medicine.) A fever is defined as 100 F or 37.8 C. For more information, visit or or call 800-CDC-INFO CS Sept 29, 2009