October 14, Parents and Guardians:

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1 October 14, 2016 Parents and Guardians: As we approach the end of the first nine weeks of school and move into what is typically the time of the year where we see an increase of Colds, Strep Throat and the Flu, I want to remind you how important it is that you reinforce healthy habits with your children. Colds, Strep Throat, Flu and even Mumps are viral infections which mean they are passed to others by sneezing, coughing, contact with saliva and sharing of food and drink. The best way we can stop these illnesses from spreading throughout our student body is for the home and the school to reinforce healthy habits. I hope you will join with your school in reinforcing the practice of good hand washing with soap and water to prevent the spread of illness, by covering your mouth and nose when you cough or sneeze, preferably with a tissue, and then disposing the tissue in a trash can, and reinforce to your child to avoid sharing food and drink with others. It is also very important that you do not send your child to school when they are sick, especially if they are running a fever. Fact sheets included with this letter will help you identify the common illnesses that affect students in school. If you have any health questions, please contact your health care provider or the Kay County Health Department at Sincerely, DP/bj David Pennington, Ed.D. Superintendent of Schools 613 East Grand Ponca City, OK Fax:

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3 Public Health Fact Sheet Staphylococcal Skin Infections in Schools Public Health Fact Sheet What is Staphylococcus aureus (Staph)? Staphylococcus aureus is a bacteria that can cause skin infections and other more severe infections such as pneumonia and bloodstream infections. Methicillin-resistant Staphylococcus aureus (MRSA) is a form of the Staphylococcus bacteria that has become resistant to commonly used antibiotics, such as methicillin which is related to penicillin. There are other antibiotics that can treat MRSA infections, if necessary. What does a skin infection look like? Symptoms of a skin infection can include swelling, redness, tenderness and pus. Skin infections sometimes look like spider bites, pimples or boils. How serious are skin infections? Skin infections that only involve the skin are usually mild and easily treated. Although it is rare, sometimes the bacteria can cause severe illnesses such as bloodstream infections which may be fatal. Therefore, it is very important to see your healthcare provider if you have a skin infection that is not improving. How are Staph germs spread? Any drainage from a skin wound should be considered infectious. Staph is primarily spread through contact with the bacteria, either by direct person-to-person contact or indirectly through shared equipment, personal items or contaminated surfaces. Examples of shared objects include towels, soap, razors, clothing and athletic equipment. Frequent hand washing is the best way to prevent the spread of MRSA. How are Staph infections treated? Most uncomplicated skin infections can be treated by a healthcare provider without the use of antibiotics. A quick office procedure called Incision and Drainage should be performed to drain the pus, then it is important to keep the area clean and covered until it is healed. In certain circumstances the healthcare provider may prescribe an antibiotic, but they usually are not needed. What are your responsibilities as a teacher, school nurse or school official? Instruct students to report all suspected skin infections to the teacher or school nurse. Completely cover all wounds with a bandage sufficient to contain the drainage. If wounds cannot be covered completely, students with skin infections should be excluded from school until the lesions can be covered adequately or are healed. Bandages that become wet, loose or saturated with drainage should be removed immediately and replaced with fresh bandage. Always discard used bandages immediately into appropriate trash receptacles, and wash hands after touching or treating a skin infection. Report clusters or outbreaks of illness (more than three cases in a school, classroom or sports team) to your local health department. Individuals with skin infections do NOT need to be reported. Teach and support frequent hand hygiene practices. Wipe down shared desks, keyboards, phones, and light switches regularly What should students do to prevent the spread of Staph germs? Wash your hands often with warm, soapy water. Use 60-95% alcohol-based hand gel to disinfect hands that are not visibly soiled. Report skin infections to the teacher or school nurse. Avoid contact with other people s skin infections. Cover all wounds with a clean, dry bandage, and replace immediately if the bandage becomes wet, loose or saturated. Stay home from school if wound drainage cannot be contained by a bandage. Shower immediately after physical education class or sports activities. Do not share personal hygiene items (bar soap, towels, razors) or clothing. Revised 11/07 For further information call or visit us on the World Wide Web Acute Disease Service Oklahoma State Department of Health Phone (405)

4 Oklahoma State Department of Health Acute Disease Service Public Health Fact Sheet Seasonal Flu Facts What is influenza? Influenza, also called the flu, is caused by a virus that mainly affects the nose, throat, air passages, and lungs. There are two main types of flu that affect humans, types A and B. Either or both types can circulate in the United States each year during the fall and winter months, which is why it is called seasonal flu. Each type of flu virus has different strains, which change from year to year. On average each year, seasonal flu infects between 5 20% of the U. S. population, and more than 200,000 hospitalizations and 36,000 deaths can be attributed to influenzarelated complications each year. What are the symptoms of flu? Flu can range from a very mild to serious, sometimes fatal illness. Symptoms of the flu usually come on suddenly. Symptoms may include fever of 100 F to 103 F (possibly higher in children), cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, and extreme tiredness. Less often nausea, vomiting, or diarrhea can also occur, especially in children, however these symptoms are usually not the main problem. The term stomach flu is sometimes used to describe a different type of stomach illness (with symptoms of diarrhea, nausea, and vomiting), but this is not the same as seasonal flu. How is flu spread? Flu is spread from person to person by respiratory (nose and throat) droplets released into the air by talking, coughing, sneezing, laughing, or singing. Touching an object that has flu virus on it, and then touching one s own eyes, nose, or mouth can also spread flu. Most healthy adults can infect others from one day before symptoms are present and up to seven days after becoming sick. Some people, especially young children and people with weakened immune systems, might be able to infect others for an even longer time. How soon after exposure do symptoms start? How long will symptoms last? The time from being exposed to the flu to the first sign of symptoms can be from one to five days. Most people who have flu recover completely in one to two weeks, but sometimes the illness can cause other infections like pneumonia. How do you know if you have flu? The only way to know for sure is to visit your healthcare provider. They may do a rapid lab test for flu, or they may diagnose flu based on your symptoms with evidence that flu virus has been found in your surrounding area. A rapid test for flu may be performed in an outpatient clinic. Is there any treatment for flu? Most people who get the flu usually recover by drinking plenty of fluids and getting plenty of rest. Prescriptions (called flu antiviral drugs) are available through your healthcare provider to help prevent or reduce the severity of flu, but some only work against type A flu virus. Antiviral drugs work best when started within 48 hours of getting sick; however, starting them later can still be helpful, especially if the sick person has a high-risk health condition or is very sick from the flu. Antibiotics do not work against the flu virus. Who should get vaccinated this year in Oklahoma? All persons aged 6 months and older are recommended to receive the flu vaccine. People in certain categories are strongly encouraged to receive the flu vaccine due to their high-risk for flurelated complications or exposure to others. These categories are persons who: are ages 6 months 4 years; are ages 65 years and older; have chronic disorders such as asthma, chronic lung disease, heart disease, kidney disorders, liver disorders, neurological and neurodevelopment conditions, blood disorders, endocrine disorders (such as diabetes mellitus), or metabolic disorders; Continued on next page

5 Continued from previous page People in certain categories are strongly encouraged to receive the flu vaccine due to their high-risk for flurelated complications or exposure to others. These categories are persons who: have a weakened immune system due to disease or medication (such as people with HIV or AIDS, or cancer, or those on chronic steroids); are or will be pregnant during the flu season; are aged 6 months 18 years and receiving long-term aspirin therapy, and may be at risk for Reye syndrome after flu infection; are residents of nursing homes and other chronic-care facilities; are American Indian / Alaskan Native; are morbidly obese (Body Mass Index or BMI of 40 or greater); are healthcare personnel; are household contacts and caregivers to children younger than 5 years of age and adults aged 65 years and older, especially contacts of children aged younger than 6 months; and are household contacts and caregivers of persons with any of the above medical conditions that put them at higher risk for severe complications from flu. How can people get a flu vaccination? Flu vaccines are offered every flu season through healthcare providers, local county health departments, outpatient clinics, and many pharmacies. Call first to see if the vaccine is available and to find out what times the vaccine is being given. When should people get the flu vaccination? It is never too late to get the flu vaccine during the flu season. Flu starts spreading as early as the beginning of October, but flu illnesses are usually highest in January or February in Oklahoma and can continue to occur into mid-may. It is recommended to get the flu vaccine as soon as it s available to you, rather than wait until flu is circulating in your community. Once a you are vaccinated against flu, it takes two weeks before you are fully protected from infection. What are the types of flu vaccine available this year? This flu season, there are 2 formulations of the flu vaccine. The trivalent vaccine contains three strains of flu that are most likely to spread in the United States this flu season. These are A/California/7/2009 (H1N1)-like, A/Switzerland/ /2013 (H3N2)-like, and B/Phuket/3073/2013-like (Yamagata lineage) virus. The quadrivalent vaccine contains B/Brisbane/60/2008-like (Victoria lineage) virus in addition to the trivalent strains. There are seven types of flu vaccine available*: Trivalent Protects against 3 strains of influenza: 1. Standard dose, inactivated influenza vaccine, which is the traditional inactivated seasonal flu vaccine. This is given as an injection into the muscle, and is recommended for people aged 6 months and older. This vaccine is approved for pregnant women. 2. High-Dose, inactivated influenza vaccine, Trivalent only, which is licensed only for persons of ages 65 years and older. This vaccine is also an injection into the muscle. 3. Cell culture-based (cciiv3), Trivalent only, vaccines are developed by growing flu viruses in animal cells rather than the traditional egg-based process. This vaccine is licensed for persons age 18 years and is recommended for persons with egg allergies. It is given in the same way as traditional inactivated seasonal flu vaccine. 4. Recombinant influenza vaccine (RIV3), Trivalent only, which is a recombinant hemagglutinin (HA) vaccine, is indicated for persons 18 years and older. It is given in the same way as traditional inactivated seasonal flu vaccine. This vaccine can be given to someone with a reported allergy to eggs. Continued on next page

6 Continued from previous page What are the types of flu vaccine available this year? (Continued) Quadrivalent Protects against 4 strains of influenza: 1. Standard dose, inactivated influenza vaccine. There are several different flu shots of this type available, and they are approved for people of different ages. Some are approved for use in people as young as 6 months of age. 2. Intradermal, Inactivated influenza vaccine is indicated for persons aged years. This vaccine is given by injection into the dermal layer of the skin, compared to the traditional flu shot which is injected into the muscle. This vaccine uses less antigen than the traditional flu shot, but produces a comparable immune response. This vaccine is administered using a 90% smaller needle than is used for traditional flu shots, which may be appealing to needle-averse adults. 3. Live, attenuated influenza vaccine (LAIV), Quadrivalent only, which is a nasal mist instead of an injection. This is a weakened form of a live flu virus which does not cause flu illness. It is approved for healthy people 2 49 years of age who are not pregnant and do not have certain health conditions. Recent studies suggest that the nasal spray flu vaccine may work better than the flu shot in children 2 to 8 years of age. Your flu vaccine provider will determine if you are recommended to receive the LAIV. Because the LAIV contains the live virus, it should not be used by anyone in close contact with someone who has a condition that affects their immune system. What can be done to control or prevent flu? We join the CDC s Take 3 campaign to fight the flu. These three actions are: 1. Take time to get the flu vaccine. The single best way to prevent the flu is get a flu vaccine. Flu vaccination can reduce flu illnesses, doctor s visits, and missed work and school due to flu, as well as prevent flurelated complications, such as hospitalization and death. 2. Take everyday preventative actions to stop the spread of germs. These include: Covering your mouth and nose with a disposable tissue when sneezing or coughing and disposing those used tissues immediately into trash containers Washing your hands often with soap and water, especially after coughing, sneezing or using a tissue Using alcohol-based hand sanitizers if your hands are not visibly soiled Staying home if you have a fever, and not returning to work or school until you are fever free for 24 hours. 3. Take antiviral flu medications if prescribed by your healthcare provider. These medications can make your flu illness milder and shorten the time you are sick. They can also help prevent serious complications from flu. You are still contagious, so follow the advice above regarding staying home when sick. *For more information about the flu vaccine, see these documents: Centers for Disease Control and Prevention. Prevention and Control of Influenza with Vaccines Recommendations of the Advisory Committee on Immunization Practices (ACIP), United State, Influenza Season., at Inactivated Influenza Vaccine (Vaccine Information Statement): Live, Intranasal Influenza Vaccine (Vaccine Information Statement): For more information call or visit us on the web: Phone: OSDH 10/15

7 Oklahoma State Department of Health Acute Disease Service Public Health Fact Sheet Cold vs. Flu: Know the Difference Influenza, also called the flu, and the common cold, are both respiratory illnesses, but they are caused by different viruses with different symptoms. Use this chart to learn the difference between them. The term stomach flu is used to describe an illness with symptoms of diarrhea, nausea, and vomiting, but the stomach flu is not the same thing as influenza. Symptoms Common Cold Flu Appearance of Symptoms Symptoms appear gradually Symptoms appear suddenly can appear within 3 6 hours Fever Uncommon Common 100 to 102 F or higher, lasting 3 4 days Chills Uncommon Common Headache Uncommon Common can come on suddenly and be severe Muscle Aches and Pains Feeling Tired and Weak Uncommon or mild Common can be severe Sometimes usually mild Common can be moderate to severe; can last for 2 3 weeks; extreme tiredness can occur suddenly Cough Common mild to moderate hacking Common can become severe and last for several weeks Stuffy Nose Common Sometimes Sneezing Common Sometimes Sore Throat Common Sometimes Chest Discomfort Sometimes can be mild to moderate Common can be severe Treatment Prevention Complications/ Severity Antihistamines Decongestant Pain reliever/fever reducer Rest and plenty of water Use good hand hygiene Avoid close contact with anyone who has a cold Cover your cough and sneezes Clean all surfaces touched by you and others often Stay home when sick Sinus congestion Middle ear infection Asthma Usually does not cause severe health problems Antiviral medicines see a doctor as soon as possible Antihistamines Decongestant Pain reliever/fever reducer Rest and plenty of water Annual vaccination Use good hand hygiene Avoid close contact with anyone who has the flu Cover your cough and sneezes Clean all surfaces touched by you and others often Stay home when sick In certain situations, your doctor may prescribe antiviral medications to prevent you from getting the flu Bronchitis Pneumonia can be life threatening Sinus and ear infections Sepsis Secondary bacterial infections Hospitalization can occur For more information call or visit us on the web: Phone: OSDH 10/15

8 Oklahoma State Department of Health Acute Disease Service Public Health Fact Sheet Mumps What is mumps? Mumps is a contagious disease caused by a virus that can cause swelling and soreness of the salivary glands (the cheek and jaw area) along with fever. What are the symptoms of mumps? Mumps usually causes swelling of the glands under the ears or jaw (called parotitis ). Other symptoms include fever, headache, general aches and muscle pains. Symptoms can last for 7 to 10 days. Some people with mumps may not have any symptoms. Others may feel sick but not have swollen glands. Is mumps serious? In most people, mumps is pretty mild. But in some people it can cause serious, long lasting problems. Mumps can cause meningitis (swelling of the brain and spinal cord), deafness, orchitis (swelling of the testicles) in males who have reached puberty, or oophoritis (swelling of the ovaries) in females who have reached puberty. In rare cases, mumps can cause inflammation of the brain itself, known as encephalitis. Mumps infection during the first 3 months of pregnancy may be linked to miscarriage. Mumps rarely results in death. Who can get mumps? Mumps can affect any person of any age who has not had the disease or been immunized against it. How is mumps spread? The mumps virus is found in the saliva and fluids from the nose and throat of infected persons. It is spread when an infected person coughs or sneezes. It can also be spread by kissing, sharing items, such as cups or eating utensils, and touch objects or surfaces with unwashed hands that are then touched by others. A person can spread the mumps virus 2 days before through 5 days after onset of parotitis. How soon can symptoms start after being infected with mumps? Symptoms usually appear days after infection, but this period can range from days after infection. Is there a treatment for mumps? There is no specific treatment for mumps. Most people with mumps recover completely in a few weeks. Can a person get mumps more than one time? People who have had mumps are usually protected for life. Is there a vaccine for mumps? Yes. Mumps vaccine is give on or after a child s first birthday, and is usually given as the MMR (measles, mumps, rubella) vaccine. A second dose is recommended at 4 to 6 years of age. One dose of MMR vaccine is 78% effective, and two doses of mumps vaccine is 88% effective. While mumps vaccine is effective, it s not perfect. People with two doses of MMR vaccine can still get mumps. All unvaccinated teens and all adults born in or after 1957 should have documentation of vaccination or other evidence of immunity. Adults born before 1957 in the United States are likely to have had mumps as a child are not generally recommended to receive vaccination. Many foreign countries do not routinely advise or require mumps vaccination. How can I prevent the spread of mumps? The best way to prevent mumps is to get the mumps vaccine. Persons exposed to mumps should check their immunization status and call their healthcare provider if they develop symptoms of mumps. Persons with mumps should stay home from child care, school, or work for a total of 5 days starting on the day of parotitis onset until the sixth day after symptoms appear. For more information call or visit us on the web: Phone: OSDH 09/16