The following guidance on Enterovirus D68 from the Maine Center for Disease Control and Prevention was distributed by the Maine DOE to all Maine school nurses on Friday, Oct. 3.
Each year, millions of people become ill due to respiratory illnesses. Some of the more common respiratory illnesses in schools may include influenza, pertussis and the common cold. The common cold can be caused by many viruses including enteroviruses, one strain of which (EV-D68) is responsible for several outbreaks in the United States in 2014, including one recent case here in Maine. Schools should be aware of these illnesses, how to prevent them and what is reportable.
- Influenza is a viral illness characterized by a fever with a cough and/or sore throat. Everyone is at risk for influenza, but certain individuals are at higher risk of serious complications.
- Pertussis is a bacterial illness characterized by coughing fits and paroxysm which may lead to vomiting or gagging.
- Common colds can be caused by many different disease agents, but are usually characterized by cough, runny nose, sneezing and sore throat.
- Enterovirus D68 is one of many viral causes of the common cold. This strain appears to be more severe than some of the other cold agents, and can cause wheezing and difficulty breathing in addition to the common cold symptoms.
What schools can do:
- Promote vaccination among students and staff. Influenza and Pertussis are both vaccine preventable diseases, and high vaccination rates can reduce transmission within schools.
- Stay home if you are sick. This applies to both students and staff.
- Influenza – individuals should stay home until 24 hours after fever resolves without the use of fever reducing medications.
- Pertussis – individuals should stay home until they have competed 5 days of antibiotics.
- Colds – there is no standardized recommendation for returning during/after a cold. Individuals with colds are typically infectious for 4-7 days after symptoms begin.
- Promote good respiratory hygiene. Encourage students and staff to cough into their sleeve, or tissues rather than hands. Dispose of used tissues in wastebaskets. Frequently wash hands with soap and water. Alcohol based hand gel is NOT effective against enteroviruses.
- Increase environmental cleaning. Frequently clean high touch surfaces, like door knobs, desks, and light switches.
What to report:
- All outbreaks are reportable in Maine. In a school, an outbreak is defined as ≥15 percent absenteeism when the majority of individuals out are due to illness. Outbreaks should be reported through MEDMS.
- For more information on outbreak reporting through MEDMS see http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/influenza/maineflu/educators.shtml.
- Pertussis should be reported to Maine CDC at 1-800-821-5821
For more information:
- Influenza website: maineflu.gov
- Pertussis website: http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/vaccine/pertussis.shtml
- Enterovirus website: http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/airborne/enterovirus.shtml
- Orderable materials: http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/order-form-wn.shtml
- Disease consultation and reporting line: 1-800-821-5821
- Non-confidential questions and information can be sent to firstname.lastname@example.org