School Nurses Teach Healthy Habits
By LINDA COMINS
WHEELING — Area school districts take a two-pronged approach to promote wellness: teaching healthy habits and preventing the spread of disease.
At this time of year, influenza and pneumonia capture most of the illness-related headlines, but school personnel also remain vigilant to stem childhood illnesses. School nurses maintain close contact with county health departments and state officials to monitor potential outbreaks.
Melissa Soltesz, a nurse assigned to Warwood School, Steenrod Elementary School and Bethlehlem Elementary School, said, “Our biggest concern is monitoring any child that may exhibit any sign of illness: a temperature, they don’t look good, they might have a cough, they say they don’t feel well.”
She said Ohio County Schools works with the Wheeling-Ohio County Health Department to guide its policies and handle any outbreaks of contagious diseases. For example, she said if children have temperatures above 100 degrees, “we really do want them to go home and stay home and be fever-free for 24 hours without any fever-reducing medication.”
Common-sense health practices aid prevention. She said, “We try to encourage hand washing. We have hand sanitizers throughout the school and tissues throughout the school.”
Naturally, education plays a role in schools’ preventive approach to illness. In lessons with preschool and kindergarten classes, nurses and teachers cover topics such as “how to cover your mouth when you cough; how to cough into your elbow; get a tissue if you need one; if you sneeze or cough, use hand sanitizer,” Soltesz said.
“Even with fourth or fifth grades, we do a hygiene lesson every year,” she added.
When cases of flu or some type of severe illness occur, school nurses consult with the county health department’s staff and health officer Dr. William Mercer.
“They help us with guidelines on how to track severe illness,” Soltesz said.
In addition, she said the school district receives notification from the West Virginia Department of Education “when it may be necessary to close schools due to some type of illenss. It’s looked on a school-by-school, county-by-county basis.”
Sometimes, if an illness also spreads to teachers, schools may close “if they don’t have enough staff to instruct the students,” she said. Soltesz, who has been in the school system for 13 years, added, “Fortunately, we have not had to do that at any of my schools.”
She said, “The state Department of Education is really good about (telling) what the flu is doing this season, what areas are affected … If there is an outbreak or some sort of illness, the health department will give all of the nurses in the county a head’s up so we know what to look for.”
Either Mercer or Howard Gamble, health department administrator, could recommend additional sanitizing to prevent the spread of germs in a serious outbreak.
Soltesz said, “I’ve been very fortunate. We have not had to do any of that. We just do routine cleaning. Normally, teachers will clean desks at the end of every day or ask the students to clean with a (bleach) wipe. Fortunately, routine cleaning is all we’ve had to do in my schools.”
Camille DelGuzzo, school nurse for Martins Ferry City Schools’ three facilities, said letters are sent home to alert parents when a couple of cases of a contagious illness, such as strep throat or pink eye (conjunctivitis), occur in the same classroom.
“If there’s something like impetigo, even one in the classroom, I’ll send a letter home to that classroom,” she added. Impetigo is a highly contagious bacterial skin condition that affects young children.
When a pattern of illness is reported, custodians also are notified to perform extra cleaning of desks in classrooms. “We have strong disinfectants that custodians clean with,” DelGuzzo said.
For prevention, students are encouraged to bring tissues to school, while bleach wipes and hand sanitizers are stored in every classroom and in the lunchroom. “Our rooms even have sinks right there in the room for kids to wash their hands,” DelGuzzo said.
With more than 500 children enrolled in Martins Ferry City Schools, the nurse said, “Cleaning is the important thing. We stress to kids to wash their hands, to practice good hand washing.”
In addition, she said, “We hold a flu clinic each fall for staff members to get their flu shots.”
To keep the St. Clairsville-Richland School District’s classrooms germ-free, Superintendent Walt Skaggs said, “We try to be as proactive as possible. We sanitize the rooms. We have a fogger which kills any of those germs which otherwise wouldn’t be there … If we have a big bump in illness, we use it (the fogger) every day.”
A school nurse is assigned to serve both buildings in St. Clairsville. For preventive measures, Skaggs said the nurse and teachers “promote hand washing and cleanliness, and try to reinforce that on a continuous basis.”
At staff meetings, district officials stress the importance of being vigilant to stem the spread of illness. Skaggs said, “We make sure that our staff are watching the kids and making sure they’re doing what they need to do.”
Meanwhile, Linda Mehl, director of nursing for the Belmont County Health Department, said Lynn Schrum, the department’s infectious disease nurse, works with infection control practitioners in local hospitals and lists cases of reportable diseases in a disease reporting system that goes to the Ohio Department of Health.
Schrum also communicates with school nurses in Belmont County and receives monthly reports from them on a wide variety of health problems, including lice infestation, strep throat, chickenpox and other childhood illnesses. Mehl said, “If they start seeing two kids in a classroom or in a family having the same type of illness, they forward that (information) to her (Schrum).”
Schrum also shares information with the regional epidemiologist, a nurse who is based in Noble County and works with several counties. “You try to link the cases before you try to determine if it’s an outbreak,” Mehl said.
“The regional epidemiologist keeps a lot of data for us,” she said. “Anytime we have anything unusual, we talk with her. She’s probably dealt with it in another county.”
When a serious communicable disease such as meningitis occurs, the health department starts an investigation and follows protocol set for by the Ohio Department of Health for each disease. The state department has a communicable disease manual that lists “what’s reportable and what’s not reportable, so it’s consistent with everyone,” she added.
Dr. George L. Cholak, Belmont County health commissioner, has the authority to close schools during severe outbreaks, Mehl said, adding, “In my more than 20 years of public health, I’ve never seen it happen. Some of the schools may have closed for their own choice if half of the kids are out with the flu. That’s kind of up to them.”
After meningitis was reported several weeks ago in Indian Valley Local Schools in Gnadenhutten, Ohio, facilities were closed for a day and cleaned extensively. Mehl said, “Everybody had been exposed at that point. The closing was for parents’ peace of mind. Most of the kids had already been exposed.”
Ohio’s unvaccinated children face certain restrictions if contagious diseases are reported in schools.
“We have in Ohio people who decide not to get their kids vaccinated. You have some kids in schools that are not vaccinated against certain diseases,” Mehl said.
During the incubation period for one of those diseases, “a child who is not vaccinated will have to be excluded from school. It’s three weeks for measles,” she said. “It’s up to school policy whether that exclusion would be an excused or unexcused absence. They (school officials) decide how to handle as to how they’re going to get their work done.”
Health and school officials keep watch on other contagious conditions, such as ringworm, which is a fungus, and Methicillin-resistant Staphylococcus aureus, which is a bacterium that causes infections. Student athletes, in particular, may encounter ringworm or MRSA if they engage in contact sports such as wrestling. Mehl said, “We work with the schools to try to keep that from spreading.”
Measures to halt the spread of these conditions may involve covering affected areas or treating infected athletes for a certain period of time before they can continue with the sport. “It depends on the disease,” the nursing director said.