Ask a School Nurse: How to Protect Kids from Infectious Diseases

A significant flu surge is impacting families across the U.S, with more than 300,000 hospitalizations of children and adults this season. How can schools help contain the spread of contagious illnesses like the flu? Robin Cogan, MEd, RN, a practicing school nurse and clinical coordinator with the Rutgers School of Nursing, shares strategies for school health professionals, parents, and caregivers.

Q: What illnesses tend to spread at school? 

A: In the bustling environment of schools, where students gather in close quarters, several illnesses tend to spread quickly. Here are some of the most common:

• Colds (Upper respiratory infections or URIs): Lead to mild symptoms like cough, congestion, runny nose, and sore throat. They spread through droplets from coughing, sneezing, or touching contaminated surfaces.
• Strep throat: Characterized by a sore throat, fever, headache, and stomachache. It spreads through close contact, especially in environments where children eat and play together.
• Flu (influenza): Known for its sudden onset of high fevers, body aches, chills, and respiratory symptoms, the flu can lead to missed days of school, work, and childcare. It spreads through respiratory droplets when an infected person coughs, sneezes, or talks, and can also spread by touching surfaces contaminated with the virus.
• Hand, foot, and mouth disease (HFMD): Common in young children, HFMD leads to mouth sores, rash on the hands and feet, and fever. It spreads through close contact and contaminated surfaces.
• Pink eye (Conjunctivitis): This eye infection can be bacterial, viral, or allergic. Symptoms include red, itchy eyes, eye discharge, and crusty eyelids. It spreads through direct contact with eye secretions or contaminated surfaces and objects like shared school supplies or computer keyboards.

Q: How can schools prevent the spread of these illnesses?

A: With the alarming rise in flu hospitalizations this season, schools are on high alert to prevent the spread of respiratory viruses. Here are some best practices:

• Practice frequent hand washing with soap and water for at least 20 seconds or use hand sanitizer with at least 60% alcohol. Schools can place hand sanitizing stations throughout the building and encourage students to wash their hands upon arrival at school, before eating, after using the restroom, and after coughing or sneezing.
• Teach students to cough or sneeze into their elbows or tissues, dispose of tissues properly, and avoid touching their faces. Posters and reminders in classrooms and hallways can reinforce these behaviors.
• Regularly clean and disinfect surfaces, especially those that are frequently touched, like doorknobs, light switches, desks, and shared equipment. Use EPA-approved disinfectants that are effective against viruses.
• Ensure rooms are well-ventilated to reduce the concentration of airborne viruses. Open windows when possible, use air purifiers, and maintain HVAC systems to improve air quality.\
• Implement policies for isolating sick students and staff. Follow local and state health department guidelines for quarantine periods when necessary.
• Promote vaccinations. Schools can host vaccination clinics or provide information on where to get vaccinated in the community. 

"Encourage families to get vaccinated against measles, flu, COVID-19, and other preventable diseases."

Q: How can parents and caregivers help?

A: Parents and caregivers play the most vital role in safeguarding their children and the school community from illnesses. Here are a few reminders:

• Teach, model, and reinforce proper handwashing techniques at home. Encourage children to wash their hands before eating, after using the restroom, and after coughing or sneezing.
• Ensure children are up to date with vaccinations, including annual flu and COVID shots. Vaccinations not only protect the child but also contribute to herd immunity, protecting vulnerable community members.
• Follow guidelines on when to keep children home from school if they are contagious. This prevents the spread of illness to others and allows the child to rest and recover.
• Encourage good sleep, nutrition, and physical activity to bolster immunity. A well-rested, well-nourished child is less likely to get sick.

"Inform schools about any contagious illnesses in the family to facilitate early intervention. Schools can then take appropriate measures to prevent outbreaks."

Q: What are some ways that schools can encourage vaccination?

School leaders should provide information on the importance of vaccinations through newsletters, meetings, and health fairs. Use clear, accessible language to explain the benefits and dispel myths. Enforce vaccination policies while providing support for families to comply. If possible, offer resources like transportation assistance or financial aid.

"Engaging with community leaders, religious organizations, and parent groups can also promote vaccination awareness. Work with trusted community figures to advocate for vaccinations." 

Q: How can school nurses and other staff educate students about illness prevention?

A: Educators can integrate illness prevention into the health curriculum, including hand hygiene, cough etiquette, and the importance of vaccinations. Use visual reminders in bathrooms, classrooms, and hallways such as handwashing instructions or “cover your cough” signs. Interactive methods like demonstrations, videos, and activities like "Germ Tag" or handwashing games, can make learning fun and memorable.

Q: What resources can schools refer to for more information on disease prevention?

A: Here are evidence-based resources that school health professionals can access for guidance and information:

• National Association of School Nurses (NASN): Provides guidelines, resources, and tools tailored for school health services staff.
• American Academy of Pediatrics (AAP): Publishes strategies for managing infectious diseases in educational settings.
• Centers for Disease Control and Prevention (CDC): Offers detailed guidance on infection control in schools.
• Local health departments: Can provide tailored advice and resources based on community health needs. They often offer training, materials, and support for schools to implement effective disease prevention measures.

Thank you, Nurse Cogan! 

Support childhood vaccinations with evidence-based materials from Healthier Generation’s Vaccine Resource Hub.