CONNECTICUT TECHNICAL HIGH SCHOOL SYSTEM PANDEMIC INFLUENZA & HIGHLY COMMUNICABLE DISEASE PLAN
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1 CONNECTICUT TECHNICAL HIGH SCHOOL SYSTEM PANDEMIC INFLUENZA & HIGHLY COMMUNICABLE DISEASE PLAN August 2009 Revised February 2015
2 Contents Introduction... Error! Bookmark not defined. Plan... 3 Immunization... 3 Education... 4 Identification of at Risk Students... 5 Containment of Ill Staff and Students... 5 Removal of Students... 6 Cleaning and Disinfecting Surfaces... 6 Monitoring Illness in Schools... 6 Cooperation with Local and State Health Departments... 7 Heightened Surveillance... 7 Closing Schools... 8 Committee... 8 Evaluation... 8 Use of Buildings...8 Responsibilities:... 8 References and Resources Page 2 of 10
3 CONNECTICUT TECHNICAL HIGH SCHOOL SYSTEM PANDEMIC INFLUENZA & HIGHLY COMMUNICABLE DISEASE PLAN Introduction The safety, health and welfare of students and staff are a priority of the Connecticut Technical High School System (CTHSS). The CTHSS will work closely with state and local departments of health, State Department of Education (SDE) officials, the Department of Administrative Services (DAS), emergency preparedness officials, school administrators and school nurses to provide a coordinated response in the event of a pandemic influenza (flu) or other infectious disease threat or outbreak. The CTHSS will follow the SDE Influenza Pandemic Continuity of Operations Plan including personnel provisions. Plan Immunization Certain immunizations are required for school attendance under State of Connecticut Law and inadequately immunized students may be excluded from school 1. The law, however, does allow medical and religious exemptions from immunization. Connecticut does not permit philosophical exemptions to immunization. The CTHSS requires documentation of medical exemption to immunization on the Connecticut Department of Public Health Medical Exemption Certification 2 form. This form must be accompanied by documentation from a physician 3. Religious exemptions must be documented on the Connecticut Department of Public Health Religious Exemption Certification form. The completed exemption form will be maintained by the school nurse in the student s Cummulative Health Record (CHR). According to the Connecticut Department of Public Health, a child with a medical or religious exemptions is permitted to attend a school except in the case of an outbreak of vaccinepreventable disease. In the event of an outbreak of vaccine preventable disease, all susceptible 1 School-Related Immunizations Immunization Of School Children Against Measles, Mumps, Rubella, Poliomyelitis, Diptheria, Tetanus, Pertussis, Hemophilus Influenzae Type B (Hib), Hepatitis B, And Varicella 2 Medical and Religious Exemption forms are located at: 3 Connecticut Department of Public Health (2015) Immunization Exemptions Certification forms. Page 3 of 10
4 children will be excluded from the school setting based on public health officials determination that school is a significant site for disease exposure, transmission and spread into the community. Children without proof of immunity, including children with religious and medical exemptions shall be excluded from these settings for this reason and will not be able to return until (1) the danger of the outbreak has passed as determined by public health officials, (2) the child becomes ill with the disease and completely recovers, or (3) the child is immunized 4. The Connecticut Technical High School System will provide excluded students with an Alternative Education Program, when indicated, in compliance with State and Federal regulations. School nurses are responsible for tracking the immunization status of students and identifying students who are inadequately immunized and do not have a valid religious or medical exemption in place. An immunization record must be on file with the school nurse prior to enrollment in the CTHSS. Immunization records will be maintained in the student s CHR, and electronic medical record. If it is determined that a CTHSS student is not in compliance with mandated immunizations, the nurse will notify the parent/guardian in writing that the student is not in compliance with state law and that documentation of adequate immunization, immunity or exemption is required for continued school attendance. The school nurse will document all attempts made to notify the parent/guardian of inadequate immunization status. If after a minimum of two written notifications, the parent/guardian fails to provide evidence of adequate immunization, immunity, or exemption, the principal will be notified and exclusion from school will be considered. The CTHSS encourages its employees and parents of students and students to speak to their health care provider regarding the need for an annual influenza immunization and immunization against other infectious diseases. School nurses may work with the School-Based Health Center, local health authorities and/or community providers to facilitate the immunization of students. The nurse may also facilitate an annual flu vaccination clinic to be held at the school for students and/or employees, when there is no cost to the CTHSS. Education The CTHSS s policy on Immunization is communicated to parents and students in the school s annual Student/Parent Handbook and the school s website pdf and Page 4 of 10
5 A school administrator or designee in consultation with the school nurse is responsible for the communication of the following general information to staff, students and parents throughout the school year: a. Prevention measures that can be taken to stop the spread of the flu and other communicable diseases in the school setting. b. Recognition of the signs and symptoms of the influenza or other communicable disease. c. When it s appropriate to stay home from school due to illness and guidelines for return. Recommendations are: A student or staff person with temperature of or greater should be fever free (without the use of fever reducing medication) for 24 hours before returning to school. For an illness that requires antibiotic treatment, the student or staff person should take the prescribed antibiotic for at least 24 hours before returning to school. A student or staff person suffering with severe vomiting and/or diarrhea should be symptom free for 24 hours before returning to school. In certain situations, medical clearance from the student s health care provider and/or the district medical advisor may be required prior to reentry. This information is also communicated to students and staff in the School s annual Staff and Student/Parent Handbooks and on the school s website. Identification of at Risk Students At the beginning of each school year, and as needed throughout the school year, the school nurse will identify students who are at higher risk for complications from the flu or other communicable disease: which includes pregnant women and people with certain chronic and acute medical conditions (such as pulmonary disease, diabetes, neuromuscular disorders, immunosupression or heart disease). Containment of Ill Staff and Students Students and staff who appear to have an influenza-like illness or other highly communical illness upon arrival to school or who become ill during the day will be promptly moved to an area in the health office where they are separated from other students and staff. Page 5 of 10
6 When simple face masks are available, the student with symptoms consistent with the CDC s case definition of influenza or other airborne disease will wear a face mask while waiting for dismissal, only with the student s consent and only if easily tolerated by the student. Removal of Students A student with a communicable condition may be removed from school and directed to see his/her family health care provider. This is at the discretion of the school nurse and/or principal or designee in consultation with the state and local health departments and district medical advisor as needed. Cleaning and Disinfecting Surfaces Schools should clean and disinfect the school buildings in accordance with regular routine and schedule. The health and safety consultant will notify schools of any changes that occur related to a specific strain of influenza or other communicable disease. Monitoring Illness in Schools The school nurse will follow the Connecticut Department of Public Health (CT DPH) Reportable Disease guidelines 5 and report cases of communicable disease that are strongly suspected by the nurse or diagnosed by a Health Care Provider to the local health department (LHD) and CTHSS School Nurse Supervisor. The principal or designee will be the main contact with the local health department regarding pandemic flu planning and during a pandemic flu or other infectious disease scare or outbreak. The school nurse, in consultation with the attendance officer and principal, will notify the LHD and the school nurse supervisor whenever there is a pattern of calls or illness among students or staff that raises public health questions. The school nurse supervisor will be notified of specific LHD recommendations in regards to the concern. When an individual school s absentee rate approaches 10%, possible reasons for the increase in absenteeism will be explored. It must first be determined whether there are any existing nonmedical reasons that are contributing to the increased absentee rate. This initial investigation will be conducted by the school nurse and attendance officer. 5 Connecticut State Department of Public Health (2015) Infectious Disease Reporting. Page 6 of 10
7 Cooperation with Local and State Health Departments The CTHSS has requested that local health departments (LDHs) include the CTHSS schools in their pandemic flu planning and Individual CTHSS schools will follow the pandemic flu plan or direction of their local health department in coordination with the superintendent or designee. Heightened Surveillance Upon advisement from the school nurse supervisor, the consultant for health and safety or the LHD schools may need to further heighten surveillance. This may include: a. Calling the parents/guardians of absent students to determine whether the students symptoms are consistent with influenza other infectious disease, as defined by the Center for Disease Control (CDC); b. logging the specifics of student absences due to illness in the nursing documentation program for tracking purposes; c. conducting morning screening of students for symptoms; d. reporting findings at designated intervals to central office, LHDs and the CT DPH as needed; e. The school nurse supervisor will notify the CT DPH of absentee rates greater than >10%, when the cause of absenteeism is suspected to be influenza or other communicable disease. The school nurse supervisor and health and safety consultant in consultation with the district medical advisor, CTHSS superintendent or designee, school principal or designee and state and local health departments will identify and communicate what action is necessary to protect students, staff and visitors/clients during a pandemic flu or other infectious disease scare or outbreak Page 7 of 10
8 Closing Schools A school closing will occur when the superintendent or designee and school s principal or designee decide the step is necessary for the safety of the students and staff. Committee The CTHSS will maintain a Pandemic Flu and Communicable Disease Committee that will meet as the need arises. Membership will include the health and safety consultant, a school administrator, the school nurse supervisor, the physical education and health consultant, the superintendant or designee and representatives from the human resources and data systems departments. The committee will report directly to the CTHSS superintendent or designee. Evaluation Evaluation of the effectiveness of this plan will be ongoing during times of activation by the school nurse supervisor, the consultant for health and safety and the superintendant or the designee. In addition, Pandemic Flu and Communicable Disease Committee will conduct a review of the plan and make revisions as necessary. Use of Buildings State and local officials will have the full cooperation of the CTHSS and may incorporate CTHSS buildings, as needed, in the execution of the state and local emergency plans. Responsibilities In the event of the activation of a local, state or CTHSS pandemic flu plan or other communicable disease plan: 1) The superintendent or designee, the school nurse supervisor and health and safety consultant will monitor and implement CDC, state and local health departments and SDE recommendations. 2) Building use will be coordinated by the CTHSS chief of engineering services in conjunction with the school principal or designee. Page 8 of 10
9 3) The superintendent or designee and the school principal or designee will determine the need for individual school closure in conjunction state and local health departments. 4) A report of school closure due to communicable disease will be made by the school nurse supervisor, using the voluntary reporting system, to the CDC 5) Communications to students, parents and staff regarding operational changes will be coordinated by CTHSS superintendent or designee in consultation with the commissioner of education and state board of education. 6) Health communications including letters to parents and recommendations for CTHSS students and staff will be coordinated by the school nurse supervisor and health and safety consultant in conjunction with the superintendent or designee and the district medical advisor. 7) The coordination of sanitation and cleaning of a schools will be coordinated by the health and safety consultant 8) Media communications will be coordinated by the public information officer for the SDE. Page 9 of 10
10 References and Resources: Centers for Disease Control. Preparing for the Flu: A Communication Toolkit for Schools (Grades K-12) Including 2009 H1N1. The CDC. Centers for Disease Control and Prevention: Diseases and Conditions. Centers for Disease Control and Prevention Connecticut State Department of Education Hartford and Middletown Influenza Pandemic Continuity of Operations Plan, Version 1.0 Department of Health and Human Services, USA. Page 10 of 10
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