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Published in Print: November 26, 2003, as Health Update

Health Update

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As Winter Approaches, Experts Advise Schools On Dealing With SARS

Like various strains of the flu that sicken millions each year, the deadly infectious disease known as sars may strike again. This time, national and international health agencies hope to be ready.

Experts at the federal Centers for Disease Control and Prevention in Atlanta have prepared a guide to help local and state public health agencies and other community organizations, such as schools, prepare for the possible re- emergence of severe acute respiratory syndrome.

Still in draft form, the report, "Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome," instructs health-care providers on emergency-response measures, surveillance of SARS cases, quarantine and hospitalization procedures, and management of the disease-transmission risks posed by international travel.

"In the absence of a vaccine, effective drugs, or natural immunity to [SARS], the only currently available public health strategies to limit the impact of SARS are rapid identification of infected persons and activation of the control measures that have proven effective in preventing transmission in other locales," the CDC says in the report.

SARS caught the world by surprise last year, and terrorized entire populations with its rapid spread. By the time the World Health Organization declared SARS a global health threat in March, the disease had already infected thousands since the first diagnosis was made in fall 2002 in China.

The virus was fully contained by this past July. In all, 8,000 people worldwide had been infected and nearly 800 had died of health complications caused by the virus.

Along with hospitals and workplaces, the CDC has prepared special guidance for schools, acknowledging that settings where hundreds of children gather daily and share restrooms, desks, and lunch tables could be ripe territory for a virus that spreads through close contact.

Although there were no reported SARS outbreaks in schools last year, parents, educators, and government officials in many of the most affected countries were worried by reports that the virus was capable of infecting entire apartment buildings within a few days.

In the absence of school-specific guidance from leading health agencies, administrators were left to decide for themselves what precautions to take during the height of the outbreaks last spring. Their reactions varied widely.

In Canada, for instance, a boarding school quarantined 18 students returning from visits to Hong Kong and Taiwan. The governments of Hong Kong and Singapore completely closed their school systems. And in the United States, a private school in Connecticut ordered 40 students and staff members returning from a China trip to stay home for nearly two weeks. ("Schools Take Measures to Safeguard Against New Respiratory Illness," April 9, 2003.) Most U.S. schools, however, did little to alter their routines.

The CDC advises that students who may have been exposed to SARS and develop fever and respiratory problems should not go to school.

Most important, the agency warns, school officials or parents should warn health-care providers of suspected SARS cases so they can ensure the disease doesn't spread to others when an infected student visits a clinic, hospital, or doctor's office.

Playground Hazard

A new federal study concludes that children who are repeatedly exposed to playgrounds and decks made of arsenic-treated wood are at increased risk of developing cancer.

In preliminary findings released Nov. 13 by the Environmental Protection Agency, data show that 90 percent of children who come into regular contact with wood treated with arsenic, a known carcinogen, face a greater than one-in- 1 million risk of cancer, the historic level of concern for the agency.

In response to the news, the watchdog group Environmental Working Group pointed out that the agency's findings contradicted a statement made in February 2002 by then-EPA Administrator Christine Todd Whitman, in which she said that arsenic-treated structures posed no danger to children.

In its own review of the data, the Washington-based group noted that the problem is greatest in the Southern states, where 10 percent of all children face a cancer risk that is 100 times higher than for the general population.

Teen Tobacco Use

Tobacco use by teenagers fell considerably between 2000 and 2002, but new strategies may be needed to keep younger children from acquiring the habit, a CDC report concludes.

Cigarette smoking, the most common form of tobacco use among high school students, declined significantly, from 28 percent in 2000 to 22.9 percent last year, according to the report, and overall tobacco use—which includes cigars, pipes, and smokeless tobacco—in that population fell from 34.5 percent to 28.4 percent over the same two-year period.

Among middle school students, however, there was no significant decline in overall tobacco use or for use of any individual tobacco product. That lack of progress, the CDC warns, is a cause for concern. The report suggests that health officials might need to improve proven anti-smoking strategies and devise new methods aimed at younger children.

The study was based on surveys of 26,119 middle school students and 13,538 high school students.

—Darcia Harris Bowman

Vol. 23, Issue 13, Page 9

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