School Swine Flu Policy

On this page (Table of Contents):

1. Joint Letter to Parents Regarding the Swine Flu from the Principal's and the President's Offices
2. General Comments Regarding Swine Flu
3. What Pregnant Women Should Know About H1N1 Virus
4. Taking Care of a Sick Person in Your Home
5. Medications to Help Lessen Symptoms of the Flu
   

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י'ג תשרי תש'ע September 29, 2009

Dear Parents ,

We want to wish everyone a G'mar Chasima Tovah and a "Gut Gebentcht Yur!"

With the start of school we wanted to address two issues; one the nursing situation and secondly swine flu.

As some of you may know, the nurse's salary is paid for by the State of NJ as there is an entitlement for schools to have nursing coverage.   This year there was a cut in the budget for nursing coverage.   We have been in touch with various individuals connected with the State as well as the local officials to try and reverse this situation. We are guardedly optimistic that an increased allocation will be forthcoming.

There is a new nurse at YBH this year, Mrs. Gloria Clyman , a Passaic resident who has stepped up and has taken over the responsibilities from nurse Sarah.   The transition so far has been seamless.   Mrs. Clyman is very pleasant and capable.   We welcome Mrs. Clyman to YBH and we wish her much hatzlacha in all her endeavors.    Mrs. Clyman presently works at the Yeshiva every morning.   The afternoons are covered by a group of nurses and Physician Assistants ( PAs ), YBH parents who have volunteered their time to help out.   This group has been organized by Mrs. Rivka Lowy, who has taken a leadership role in coordinating these professionals and providing coverage for the afternoons. The Yeshiva is indeed fortunate to have Mrs. Lowy and we wish to express our hakaras hatov to her for all her efforts.    We are confident that all the needs of the students are being taking care of with the arrangement we have in place.   We will provide updates about the nursing situation as they become available.

Now on to Swine Flu.

The Swine Flu Virus has certainly made its mark over the past several months and it is anticipated that the epidemic will only get worse this fall and winter seasons.    We here at YBH, would like to inform the parents of what steps we have taken to provide as safe a learning environment as possible for the precious YBH talmidim and talmidos .   Attached to this letter is an information packet that we created from information downloaded from the Centers for Disease Control (CDC) web site and the Department of Health and Human Services.

We have formulated the following policy recommendations gathered from the CDC as well as from consultations with Pediatricians and Infectious Disease Specialists in our area.   In doing so, we have tried to balance two opposing concerns; the impact and hardship on families having children being sent home from the Yeshiva, as well as the Yeshiva trying to limit the potential spread of the virus from child to child.

• Any child with a temperature of 99.5° or greater, accompanied by symptoms such as a  cough, sore throat, a runny or stuffy nose, headache or body aches, chills or fatigue will be sent home from school.
• Any child will a temperature of 100° or greater, with or without the above symptoms, will also be sent home.
• In order to be able to return to YBH, a child must be fever-free for a full 24 hours without the use of fever reducing medications.

We are all working together to ensure a healthy environment.   Your cooperation with the above guidelines is greatly appreciated and required.   Parents should perhaps be considering various contingencies, should the need arise, chas v shalom .

We are pleased to inform you that we have installed dozens of hand sanitizing dispensers in and around the YBH building.   These are strategically situated at all entrances/ exits to the building as well as in the classrooms.    We would like to thank Michael Friedman, our facilities manager, for installing these units.   Additionally, we wish to thank Eliezer Greenberger, for being able to acquire refills for the hand sanitizing gels, free of charge. Yasher Koach to both of you.

The information packet is lengthy and contains a great deal of information.   Again we tried to balance providing too much information to parents against the concern that the illness caused by the Swine Flu virus may have a serious impact on our daily lives; and therefore, the extra information may be helpful.    You may want to hold on to this handout and use it as a resource guide should the need arise, chas v shalom.

Disclaimer: The following information is intended for general purposes only. Everyone should be advised to consult with their physicians for specific information with regard to their own situation.

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General Comments Regarding Swine Flu

The swine flu is a highly contagious illness. Here are some things that you can do to protect yourself and your family.

Firstly try to prevent the spread of germs:

• Cover your nose and mouth with a tissue when you cough or sneeze, or if no tissues are readily available, then cough or sneeze into your sleeve. Throw the tissue in the trash after you use it.
• Wash your hands often with soap and warm water, especially after you cough or sneeze. Sanitizing hand gels may also be used.
• Avoid touching your eyes, nose or mouth. Germs spread this way.
• Try to avoid close contact with sick people. This is especially true if you are pregnant and you live or have close contact with someone who has H1N1 flu.
• Stock up on household, health, and emergency supplies, such as water and Tylenol®
• Washing your hands often will help protect you from germs.

When washing with soap and water, use warm water and wash for 15 to 20 seconds. If you are using alcohol-based hand gels, rub the gel on your hands until dry.

How Flu Spreads
The main way that influenza viruses spreads is from person to person in respiratory droplets of coughs and sneezes. This can happen when droplets from a cough or sneeze of an infected person are propelled through the air and deposited on the mouth or nose of people nearby. Influenza viruses may also be spread when a person touches respiratory droplets on another person or an object and then touches their own mouth or nose (or someone else's mouth or nose) before washing their hands.

What are the symptoms of Swine Flu H1N1?
Symptoms are like seasonal flu and include the following:

• Fever
• Cough
• Sore throat
• Body aches
• Headaches
• Chills and fatigue
• Sometimes, diarrhea and vomiting

What should I do if I get sick?
If there is H1N1 flu in your community pay extra attention to your body and how you are feeling.

If you are sick, you may be ill for a week or longer. You should stay home and keep away from others as much as possible, including avoiding travel and not going to work or school, for at least 24 hours after your fever is gone except to get medical care or for other necessities. If you leave the house to seek medical care, wear a facemask, if tolerable, and cover your coughs and sneezes with a tissue. In general, you should avoid contact with other people as much as possible to keep from spreading your illness, especially people at increased risk of severe illness from influenza. With seasonal flu, people may be contagious from one day before they develop symptoms to up to 7 days after they get sick. Children, especially younger children, might potentially be contagious for longer periods. People infected with the novel H1N1 are likely to have similar patterns of infectiousness as with seasonal flu.

How is H1N1 flu treated?

• Drink plenty of fluids to replace those you lose when you are sick.
• Your doctor will decide if you need antiviral drugs such as Tamiflu® or Relenza® . Antiviral drugs are prescription pills, liquids or inhalers that fight against the flu by keeping the germs from growing in your body. These medicines can make you feel better faster and make your symptoms milder.
• If you have a fever, you may want to take Tynelol or Motrin. Avoid Aspirin and Aspirin containing medications.

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What Pregnant Women Should Know About H1N1 Virus

What if I get this new virus and I am pregnant?
With the regular flu, pregnant women are more likely than other individuals to get sick and have more serious problems. These problems may include early labor or pneumonia. As of now, we do not know if this virus will do the same, but it should be taken very seriously. It is also not known as of now if the virus affects the baby.

Is it ok to breastfeed my baby if I am sick?
Breastfeeding often protects babies. Breast milk passes on antibodies from the mother to a baby and antibodies help fight off infection. Babies who are breastfed, tend not get as sick and are sick less often from the flu, than do babies who are not breastfed.

• Do not stop breastfeeding if you are ill. This will help protect your baby from infection.
• Be careful not to cough or sneeze in the baby's face, wash your hands often with soap and water.
• Your doctor might ask you to wear a mask to keep from spreading this new virus to your baby.
• If you are too sick to breastfeed, pump and have someone give the expressed milk to your baby.

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Taking Care of a Sick Person in Your Home

H1N1 flu virus infection can cause a wide range of symptoms, including fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with this illness. Like seasonal flu, novel H1N1 flu in humans can vary in severity from mild to severe. Certain groups are at higher risk of complications such as people age 65 years and older, children younger than 5 years old, pregnant women, people of any age with chronic medical conditions (such as asthma, diabetes, or heart disease), and people who are immunosuppressed.

People with novel H1N1 flu who are cared for at home should:

• check with their health care provider about any special care they might need if they are pregnant or have a health condition such as diabetes, heart disease, asthma, or emphysema
  check with their health care provider about whether they should take antiviral medications
• keep away from others as much as possible. This is to keep from making others sick. Do not go to work or school while ill.
• stay home for at least 24 hours after fever is gone, except to seek medical care or for other necessities. (Fever should be gone without the use of a fever-reducing medicine.)
• get plenty of rest
• drink clear fluids (such as water, broth, sports drinks, electrolyte beverages for infants) to keep from being dehydrated
• cover coughs and sneezes. Clean hands with soap and water or an alcohol-based hand rub often and especially after using tissues and after coughing or sneezing into hands
• wear a facemask - if available and tolerable - when sharing common spaces with other household members to help prevent spreading the virus to others. This is especially important if other household members are at high risk for complications from influenza.

Steps to Lessen the Spread of Flu in the Home

When providing care to a household member who is sick with influenza, the most important ways to protect yourself and others who are not sick are to:

• keep the sick person away from other people as much as possible especially others who are at high risk for complications from influenza
• remind the sick person to cover their coughs, and clean their hands with soap and water or an alcohol-based hand rub often, especially after coughing and/or sneezing
  have everyone in the household clean their hands often, using soap and water or an alcohol-based hand rub. Children may need reminders or help keeping their hands clean
• ask your health care provider if household contacts of the sick person-particularly those contacts who may be pregnant or have chronic health conditions-should take antiviral medications such as (Tamiflu®) or (Relenza®) to prevent the flu
• If you are in a high risk group for complications from influenza, you should attempt to avoid close contact (within 6 feet) with household members who are sick with influenza. If close contact with a sick individual is unavoidable, consider wearing a facemask, if available and tolerable. Infants should not be cared for by sick family members.

Placement of the sick person

• Keep the sick person in a room separate from the common areas of the house. (For example, a spare bedroom with its own bathroom, if that's possible.) Keep the sickroom door closed.
• Unless necessary for medical care or other necessities, people who are sick with an influenza-like-illness should stay home and keep away from others as much as possible, including avoiding travel, for at least 24 hours after fever is gone. This is to keep from making others sick. Children, especially younger children, might potentially be contagious for longer periods.
• If persons with the flu need to leave the home, they should wear a facemask, if available and tolerable, and cover their nose and mouth when coughing or sneezing
• Have the sick person wear a facemask - if tolerable - if they need to be in a common area of the house near other persons.
  If possible, sick persons should use a separate bathroom. This bathroom should be cleaned daily with household disinfectant.

Protect other persons in the home

• The sick person should not have visitors other than caregivers. A phone call is safer than a visit.
• If possible, have only one adult in the home take care of the sick person. People at increased risk of severe illness from flu should not be the designated caretaker, if possible.
• If you are in a high risk group for complications from influenza, you should attempt to avoid close contact (within 6 feet) with household members who are sick with influenza. If close contact with a sick individual is unavoidable, consider wearing a facemask, if available and tolerable.
• Avoid having pregnant women care for the sick person. (Pregnant women are at increased risk of influenza-related complications and immunity can be suppressed during pregnancy).
  Avoid having sick family members care for infants and other groups at high risk for complications of influenza.
• All persons in the household should clean their hands with soap and water or an alcohol-based hand rub* frequently, including after every contact with the sick person or the person's room or bathroom.
  Use paper towels for drying hands after hand washing or dedicate cloth towels to each person in the household. For example, have different colored towels for each person.
• If possible, consideration should be given to maintaining good ventilation in shared household areas (e.g., keeping windows open in restrooms, kitchen, bathroom, etc.).
• Antiviral medications can be used to prevent the flu, so check with your health care provider to see if some persons in the home should use antiviral medications.

If you are the caregiver

• Avoid being face-to-face with the sick person.
• When holding small children who are sick, place their chin on your shoulder so that they will not cough in your face.
  Clean your hands with soap and water or use an alcohol-based hand rub after you touch the sick person or handle used tissues, or laundry.
• Talk to your health care provider about taking antiviral medication to prevent the caregiver from getting the flu.
• If you are at high risk of influenza associated complications, you should not be the designated caretaker, if possible.
• If you are in a high risk group for complications from influenza, you should attempt to avoid close contact (within 6 feet) with household members who are sick with influenza. Designate a person who is not at high risk of flu associated complications as the primary caretaker of household members who are sick with influenza, if at all possible. If close contact with a sick individual is unavoidable, consider wearing a facemask or respirator, if available and tolerable.
• Monitor yourself and household members for flu symptoms.

Using Facemasks

• Avoid close contact (less than about 6 feet away) with the sick person as much as possible.
• If you must have close contact with the sick person (for example, hold a sick infant), spend the least amount of time possible in close contact and try to wear a facemask.

Household Cleaning, Laundry, and Waste Disposal

• Throw away tissues and other disposable items used by the sick person in the trash. Wash your hands after touching used tissues and similar waste.
• Keep surfaces (especially bedside tables, surfaces in the bathroom, and toys for children) clean by wiping them down with a household disinfectant according to directions on the product label.
• Linens, eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately, but importantly these items should not be shared without washing thoroughly first.
• Wash linens (such as bed sheets and towels) by using household laundry soap and tumble dry on a hot setting. Avoid "hugging" laundry prior to washing it to prevent contaminating yourself. Clean your hands with soap and water or alcohol-based hand rub right after handling dirty laundry.
• Eating utensils should be washed either in a dishwasher or by hand with water and soap.

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Medications to Help Lessen Symptoms of the Flu

Antiviral medications can sometimes help lessen influenza symptoms, but require a prescription. Most people do not need these antiviral drugs to fully recover from the flu. However, persons at higher risk for severe flu complications, or those with severe flu illness who require hospitalization, might benefit from antiviral medications. Antiviral medications are available for persons 1 year of age and older. Ask your health care provider whether you need antiviral medication.

Influenza infections can lead to or occur with bacterial infections. Therefore, some people will also need to take antibiotics. More severe or prolonged illness or illness that seems to get better, but then gets worse again may be an indication that a person has a bacterial infection. Check with your health care provider if you have concerns.

Warning! Do not give aspirin (acetylsalicylic acid) or aspirin-containing products (e.g., bismuth subsalicylate - Pepto Bismol) to children or teenagers who have the flu; this can cause a rare but serious illness called Reye's syndrome. Check ingredient labels on over-the-counter cold and flu medications to see if they contain aspirin.

• Children younger than 4 years of age should NOT be given over-the-counter cold medications without first speaking with a health care provider.
• Children 5 years of age and older can take medicines without aspirin, such as acetaminophen (Tylenol®) and ibuprofen (Advil®, Motrin®, Nuprin®), to relieve symptoms.
• The safest care for flu symptoms in children younger than 2 years of age is using a cool-mist humidifier and a suction bulb to help clear away mucus.
• Fevers and aches can be treated with acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®, Nuprin®) or nonsteroidal anti-inflammatory drugs (NSAIDS). Examples of these kinds of medications include:
  

  Generic Name	Brand Name
  Acetaminophen	Tylenol®
  Ibuprofen	Advil®, Motrin®, Nuprin®
  Naproxen	Aleve

• Over-the-counter cold and flu medications used according to the package instructions may help lessen some symptoms such as cough and congestion. Importantly, these medications will not lessen how infectious a person is.
• Check the ingredients on the package label to see if the medication already contains acetaminophen or ibuprofen before taking additional doses of these medications-don't double dose! Patients with kidney disease or stomach problems should check with their health care provider before taking any NSAIDS.

Check with your health care provider or pharmacist if you are taking other over-the-counter or prescription medications not related to the flu.

For More Information

The Centers for Disease Control and Prevention (CDC) Hotline (1-800-CDC-INFO) is available 24 hours a day, 7 days a week.
Centers for Disease Control and Prevention
1600 Clifton Rd
Atlanta, GA 30333
OR GO TO WWW.FLU.GOV
800-CDC-INFO
(800-232-4636)

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