Increased illness shows need to keep sick children home

Thursday, May 21, 2009 H1N1 infections primarily among school-aged children

KING COUNTY, WA - As Public Health - Seattle & King County continues to monitor H1N1 influenza (swine flu) in the community, it is finding increasing numbers of school-age children in King County are becoming ill and more flu-like illness at schools. These signs indicate an emerging problem that requires continued work by parents, schools and child cares to reduce the spread of infections.

"In other parts of the country, outbreaks in schools are resulting in multiple school closures, and we want to reduce that possibility here by doing everything possible to keep sick kids and staff out of school and child cares," said Dr. David Fleming, Director and Health Officer for Public Health - Seattle & King County. "These actions not only help to avoid significant disruptions, but also protect children and adults in these places who have risk factors, like chronic medical conditions or pregnancy, that can make them more vulnerable to severe illness from an infection."

In New York City, recent school outbreaks have shown the ability of the virus to spread quickly in the school environment. Large numbers of students became ill, resulting in the closure of several schools. Locally, Public Health is seeing increased disease activity among school-aged children:

• Nearly 70% of confirmed H1N1 cases reported in King County to-date are among school-aged children (5-18 years).
  
  
• Infection with novel influenza A (H1N1) is widespread throughout the county, and reported cases reflect only a fraction of the disease activity in the community now. Even so, Public Health is aware of confirmed cases from 75 public schools and 12 school districts as well as several private schools. As of May 20, there are 335 confirmed cases overall in King County.
  
  
• Emergency department visits for influenza-like-illness among school-aged children remain significantly elevated compared with the period before the outbreak. Although the majority of cases are uncomplicated, there have been 20 persons hospitalized in King County, including 11cases involving school-aged children; all but one of the hospitalized patients have been discharged and are improving.

So far the H1N1 virus appears to cause illness that is no more severe than the typical seasonal flu, resulting in infections without medical complications for most people. However, influenza can be serious and life-threatening for some people. Each year in the United States, seasonal influenza results on average in an estimated 36,000 deaths and more than 200,000 hospitalizations from flu-related causes.

With more widespread illness in the community, Public Health is continuing to work with school districts and child cares to keep ill children at home, and to address outbreaks:

• Ensuring that all parents receive guidance on when to keep their child at home (hand-out available on the Public Health website at www.kingcounty.gov/health/H1N1; go to the "Information for the general public" link).
  
  
• Continuing to identify and send home sick children and staff. If children have flu symptoms of fever and cough or sore throat, they should stay home for seven days. If after seven days they still have symptoms, they should stay at home until symptoms are gone for 24 hours.
  
  
• Reporting higher levels of illness than usual to Public Health. Under some circumstances, it may be appropriate to consider suspending classes and/or discretionary activities where students have close contact.

Stopping germs and staying healthy

There are everyday behaviors to stay healthy and prevent spread of influenza:

• If you are sick, stay home from work or school.
• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water, especially after you cough or sneeze. If you don't have access to soap and water, use an alcohol-based hand sanitizer.
• To further prevent the spread of germs, avoid touching your eyes, nose or mouth.
• Avoid close contact with sick people.

Public Health has re-launched its Stop Germs, Stay Healthy! campaign, and is using mass media and printed materials to educate residents and local organizations on healthy behaviors.

H1N1 virus, also known as "swine flu" and "swine Influenza A," is a virus that can spread from people who are infected to others through coughs and sneezes. When people cough or sneeze, they spread germs through the air or onto surfaces that other people may touch. H1N1 virus is not transmitted from pigs to humans or from eating pork products.

Recommendations for seeking medical care

H1N1 is widely circulating in the community, but since most infections are relatively mild, fewer tests are being conducted to determine if an ill person is infected with the H1N1 virus. Laboratories are focusing limited testing resources on people with more severe symptoms. Public Health is recommending that you do not seek medical unless you have more severe flu symptoms including fever, cough, sore throat, body aches or are otherwise feeling more seriously ill. Call your health care provider to discuss your symptoms and if you need to be evaluated. Your health care provider will determine if a test is appropriate, based on guidelines from Public Health.

Public Health will continue to work with health care providers to test flu patients who develop severe illness or are associated with clusters of other sick people.

For more information and frequent updates: www.kingcounty.gov/health/H1N1. Recorded Flu Hotline: 877-903-5464.

Providing effective and innovative health and disease prevention services for over 1.8 million residents and visitors of King County, Public Health - Seattle & King County works for safer and healthier communities for everyone, every day.