Flu, Chicken Pox Most Common in Schools

Twenty school-related disease outbreaks occurred in West Virginia last year, but none of them occurred in the Northern Panhandle, said Shannon McBee, state influenza coordinator.

McBee, one of the featured speakers during Friday’s Northern Panhandle Regional Public Health Conference at Oglebay Park’s Wilson Lodge, reviewed the most common outbreaks that occur in the Mountain State, and how school officials and health departments should handle them.

“We define an outbreak as an occurrence of a disease greater than would otherwise be expected at a particular time and place,” she said.

The most common school outbreaks include influenza, gastrointestinal illness, skin infections in sports teams and chicken pox. Influenza is typically identified as one having a fever greater than 100 degrees along with a cough and sore throat. A school outbreak is defined as three or more flu-like cases in a classroom or on a team within a three-day period.

“December to February is usually our peak for schools,” McBee said. “Ill persons, if they’ve had the flu, should stay home until 24 hours after their fever has ceased without the use of antipyretics – so no Motrin or Tylenol.”

McBee described school nurses as the “boots on the ground” when it comes to identifying and helping to stem an outbreak in a school. Keeping parents informed about an outbreak also is important.

A gastrointestinal outbreak, often referred to as the stomach flu, is defined as vomiting and two or more episodes of diarrhea in a 24-hour period. An outbreak is considered three to five cases within a three-day period.

“Ill individuals with (gastrointestinal) symptoms should be excluded from school until 48 to 72 hours after their symptoms resolve. When they return to school or work they should practice good hand hygiene – this is important because norovirus can spread in the stool for several weeks after symptoms have resolved.”

A skin infection outbreak is defined as two or more cases of the same infection in a contact sports team within an eight-day period. Skin infections can be viral, such as herpes gladiatorum or herpes simplex; bacterial, such as impetigo, staph, MRSA or folliculitis; or fungal, such as ringworm or tinea corporis.

“The management and return-to-play guidelines are different for each of these illnesses,” McBee said.

A chicken pox, or varicella, outbreak is considered to be five or more cases in a school or classroom.

“A single case of chicken pox can often lead to an outbreak in a school. … We want to make sure students are excluded until all the blisters have crusted over. This is typically five days after a rash onset,” McBee said.