Student Well-Being

Flu Outbreaks Force Schools to Adjust Plans

By Linda Jacobson & Darcia Harris Bowman — January 07, 2004 7 min read
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A flu outbreak at Madison Junior High School in Ohio prompted school officials to close the building for two days. At Webber Junior High School in Fort Collins, Colo., where absenteeism recently hit 20 percent for two bad weeks, educators were forced to slow the pace of schoolwork so sick students did not fall behind.

In Washoe County, Nev., district officials were concerned that confusion over a tougher attendance policy was leading some parents to send their children to school even if they had flu-like symptoms.

Mother Kim Collins talks to her son, Nick, 9, as he opens his eyes briefly in a pediatric intensive care unit in Arkansas.

Kim Collins talks to her son, Nick, 9, on Dec. 8 as he opens his eyes briefly in the pediatric intensive-care unit at Arkansas Children’s Hospital in Little Rock. Among other complications, Nick developed a drug-resistant bacterial infection, a worrisome trend that doctors are starting to see in other flu cases. Nick was still in the hospital last week, but was recovering
—Danny Johnston/AP

The flu is serious business for schools this year. That is especially so in the Western half of the United States, which has been hit the earliest and, so far, the hardest by influenza this season. But health and school officials in the rest of the country are bracing for the contagious viral disease to begin having a similar impact as students return to classes after the holiday break.

Risk to Children

“It hasn’t reached what we call epidemic threshold status yet, in terms of deaths from influenza-like illness,” Dr. Julie Gerberding, the director of the federal Centers for Disease Control and Prevention, said at a Dec. 11 press conference. “But we won’t be surprised if that happens, given the pattern emerging right now.”

By late December, 45 states were reporting widespread outbreaks of influenza. At least 42 children ages 9 weeks to 17 years in the United States had died by mid-December from health complications caused by the flu, according to the Atlanta-based CDC. And U.S. supplies of flu vaccine were dwindling.

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Read the accompanying text, “Flu-Prevention Tactics for Schools.”

Influenza typically kills more than 36,000 Americans each year. Small children, the sick, and the elderly are always considered most at risk for developing serious complications after contracting the illness, which is caused by any of a number of viruses.

In past years, the CDC has not tracked child deaths due to the flu. But because of heightened fears, the agency is attempting to do so this year with the help of state health departments.

This year’s flu season struck early and hard, and public-health officials announced a surprise strain of flu virus—called the Fujian strain—found in infected people that is more virulent than other strains.

That strain wasn’t included in this year’s flu vaccine, and the deaths of children and adolescents had health officials working last month to determine if the virus was particularly dangerous to youngsters.

To head off any panic, state and federal health officials took pains to educate the public about the differences between common colds and the flu.

Colds, Dr. Gerberding said, usually begin gradually and are characterized by nasal congestion, sore throat, and sneezing—symptoms that are less common with influenza. Colds rarely involve fever.

The flu is more likely to have sudden onset, almost always involves fever, and is mainly characterized by aches, sore muscles, sore bones, and fatigue.

Attendance Issues

Meanwhile, some school districts in Western states most affected by the flu were scrambling to find out how high absenteeism rates would affect future state funding, which in many places is calculated on the basis of average daily attendance.

In California, some district administrators were calling the state education department to see if schools would be eligible for waivers, which would allow them to still receive credit for the days they had high numbers of students absent. A waiver can be granted if attendance drops to 90 percent or less, and if health officials determine that there is an epidemic.

The Contra Costa County office of education, which provides services to school districts in the county, was working with the local health department to determine if the cases were numerous enough in some areas of the county to meet those criteria.

With attendance, “every day actually counts,” said Gary Leatherman, a spokesman for the 31,000-student Fremont Unified School District, which is in Alameda County, Calif., near San Francisco.

Mr. Leatherman pointed out that while children are normally encouraged to attend school, situations such as the current one often leave educators urging them to do the opposite.

“You don’t want to be hyper-responsible,” he said. “There’s no reward for coming to school sick.”

In Nevada, parents in the 61,000-student Washoe County district, which includes Reno, had their own absenteeism concerns, because of a new district policy that no longer considers an absence due to illness as excused.

“Rather than automatically excluding medical absences on the front end,” explained Steve Mulvenon, a spokesman for the district, “we now do it on the back end of the process.”

That means that if a student is out more than the allowable number of school days, which is 18, and some of those absences were for medical reasons, parents will be allowed to file an appeal to not have those absences count against their child.

Those appeals will be “routinely approved,” Mr. Mulvenon said, as long as the dates of absence match those in the school’s database.

Mr. Mulvenon, however, said he suspected that confusion over the revised policy was leading some parents to “take kids who were sick and push them out the door.”

Closing Schools

In some extreme cases in certain parts of the country, administrators closed schools in an effort to give students time to recover and to keep illness from spreading.

In the Madison, Ohio, school district, located in the north-central part of the state, the absence of roughly a third of the 900 students at Madison Junior High led officials to close the school for two days, Dec. 11 and 12.

“We watched for three days because sometimes you get a spike,” said Roger D. Harraman, the superintendent of the 3,380-student district. “But in this case, the numbers kept rising.”

After students stayed away from school from a Thursday through a Sunday, absenteeism dropped back to normal levels.

But closing the junior high for two days took up two of the five days that schools in Ohio can use for snowstorms and other disruptions that take time from the school calendar.

Even when schools stay open during a flu outbreak, there are other issues they must tackle.

For instance, with so many students out sick, some material in class will be missed, said Matt Beatty, an assistant principal at Webber Junior High School in Fort Collins, where absenteeism in the 850-student Colorado school hit 20 percent for “two bad weeks.”

Mr. Beatty said that the school had two large events—a concert for 1,200 people and a dance for 800 in early November. “Two gyms full of hot people pretty much condemned us,” he said.

To make matters worse, he said, many students came back to school before they were fully recovered.

For most students, he said, grades for the year won’t be affected. Most of the extra work, he added, falls on teachers, who were busy giving makeup tests and providing remedial work for students who needed to catch up after missing school days.

“People were forced to just slow down and make sure we didn’t leave too many kids behind,” Mr. Beatty said.

Washing Hands

While trying to stay on top of students’ academic needs, school staff members have also been working to clear their buildings of germs.

In the Jefferson County, Colo., school district—where absenteeism hit 38 percent at a few of the 145 schools—dispensers of liquid hand sanitizer have been installed in many classrooms, said Rick Kaufman, a spokesman for the 86,600-student district. Officials also worked to make sure parents knew where they could take their children to get flu shots.

School officials said they’ve also sent repeated reminders to both parents and teachers to remind children to wash their hands throughout the day and keep their distance from sick classmates.

In Colorado’s 23,400-student Poudre district, which is north of Denver and includes Fort Collins, custodians used a 24-hour disinfectant on doorknobs, computer keyboards, and tables, and then would clean them all again the next day.

Still, it may be the students themselves who could do the most to prevent the spread of flu, some school officials suggested.

Superintendent Harraman of Ohio’s Madison district said the fact his junior high students got sick might have been because older students aren’t reminded to wash their hands as often as younger ones are.

Plus, he said, “when you’re looking at junior high, it’s not unlike them to open a bottle of Gatorade and pass it down the table” for others to share.

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