September 1, 2009 – As influenza returns to New York City this fall, the Health Department will work intensively with schools, parents and communities to prevent illness among children and teachers, but health officials do not plan to close schools that experience influenza activity. Instead, following the recommendations of HHS Secretary Kathleen Sebelius, Education Secretary Arne Duncan, and the Centers for Disease Control and Prevention, the Health Department and the Department of Education will pursue measures designed to slow transmission while classes and activities continue. Key objectives of the plan include getting children vaccinated, keeping them home when sick, encouraging them to cover coughs and sneezes with sleeves or tissues, and ensuring that they wash hands thoroughly and frequently.
Schools could encounter two strains of influenza this season, as seasonal influenza returns along with the H1N1 virus that affected the city last spring. Schools don’t normally close on account of influenza, but the Health Department recommended some temporary closures last spring because H1N1 was new and its potential impact was unknown. Now that H1N1 is better understood, experts agree that conventional infection-control measures are more appropriate than school closure.
“The steps needed to control influenza in our schools are simple,” Health Commissioner Thomas Farley and Schools Chancellor Joel I. Klein wrote in a joint letter outlining the policy for parents. “By getting your children vaccinated, keeping them home when they’re sick, and teaching them the importance of washing hands and covering coughs, you can help keep our schools open and safe this year.”
The City’s strategy for the coming season includes three basic components:
1. Vaccination. As vaccine for H1N1 influenza becomes available this fall, the City will distribute it to health care providers and will also offer free vaccination to school-aged students. The City will offer vaccination to students in all NYC elementary schools, public and non-public, and to older children at central sites in each borough. Each school or center will hold two vaccination sessions, approximately four weeks apart. Timing and logistics will depend on the supply of H1N1 vaccine and the availability of staff to administer it. No child will be vaccinated without the consent of a parent or guardian.
2. Monitoring. From the start of the school year, school nurses will use a city-wide database to report the number of students seen for influenza-like illness during the school day. Influenza-like illness, or “ILI,” is defined as fever with cough or sore throat. In a daily public report – posted online at www.nyc.gov/flu – the City will list all schools reporting five or more cases of influenza-like illness on the previous day. The daily school report will also show the previous day’s absentee rate for every public school, though it is important to understand that absenteeism is not by itself a measure of influenza activity.
3. Infection Control. Each of the city’s 1,500 public schools will start the year with an influenza-prevention campaign that includes signs, posters and classroom instruction on covering coughs and washing hands. Restrooms will be continuously stocked with soap and paper towels, and parents will get written reminders to keep their children home when they’re sick. If a school nurse sees 5 or more cases of influenza-like illness in one day, the school will send a second letter to parents stressing the need to keep sick children home.
If a school experiences excessive influenza activity – defined as 4 percent of the student body (at least 15 children) being seen by a school nurse for influenza-like illness on a single day – a doctor or supervising nurse will visit the school to assess the situation. Besides shoring up the school’s infection-control efforts, the health supervisor will determine whether the school has students whose health conditions place them at high risk of influenza complications. If a school has a high concentration of medically vulnerable children, the Health Department may recommend additional safety measures and may consider school closure as a last resort.
How parents can prepare their children for the fall influenza season
- Vaccination is the best way to prevent influenza. All children aged 6 months to 18 years should get vaccinated against seasonal influenza. Some children under age 9 may need 2 doses, 4 weeks apart, for full protection. Ask your doctor what is right for your child.
- When it becomes available, children should get the H1N1 vaccine. The seasonal influenza vaccine will not protect against the H1N1 virus. Children aged 6 months to 18 years need a separate vaccination for H1N1. That vaccine will be available this fall. People will need 2 doses, given at least 3 weeks apart.
- The Health Department urges parents to arrange for child care in advance on the chance their children get sick and need to be home for several consecutive days.
- Read important posters, flyers, brochures, bulletins and fact sheets about influenza and how to manage it. For information, call 311 or visit www.nyc.gov/flu, New York City’s one-stop flu-information center.