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.  Varicella (or chickenpox) does not cause a respiratory illness but it does infect individuals by entering through the respiratory tract and conjunctiva.  Schools should be aware of these illnesses, how to prevent them, and what to report.

Diseases:

• 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 paroxysms 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.
• Varicella is a viral illness that causes a blister-like rash, itching, tiredness, and fever. It is spread in the air when an infected person coughs or sneezes. It can also be spread by touching or breathing in the virus particles that come from the blisters.

What schools can do:

• Promote vaccination among students and staff. Influenza, pertussis, and varicella are all vaccine preventable diseases, and high vaccination rates can reduce transmission within schools. Ensure vaccine records are complete and up to date.
• 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.
  • Varicella – individuals should stay home until all their blisters scab over.
• 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.
• Increase environmental cleaning. Frequently clean high touch surfaces, like door knobs, desks, and light switches.

What to report:

• Outbreaks – All outbreaks are reportable in Maine. In a school, an outbreak is defined as ≥15% absenteeism when the majority of individuals out are due to illness. Outbreaks should be reported through NEO.
• For NEO dashboard absenteeism reporting form guidance
• Pertussis and Varicella should be reported to Maine CDC at 1-800-821-5821, an outbreak will be considered for these two diseases when there are three or more cases within a facility.

For more information:

• Maine CDC’s website

• Orderable materials

• Disease consultation and reporting line: 1-800-821-5821

• Non-confidential questions and information can be sent to disease.reporting@maine.gov

On Wednesday, October 3, beginning at 2:18 p.m. Eastern Time, there will be a nationwide test of the Integrated Public Alert and Warning System (IPAWS). The Federal Emergency Management Agency (FEMA), in coordination with the Federal Communications Commission (FCC), will conduct a nationwide test of IPAWS and its Emergency Alert System (EAS) and Wireless Emergency Alerts (WEA) to (1) assess the operational readiness of the infrastructure for distribution of a national message, and (2) determine whether improvements are needed.

The WEA portion of the test commences at 2:18 p.m. ET and the EAS portion follows at 2:20 p.m. ET. This test message will be sent to cell phones that are connected to wireless providers participating in WEA, which is why it is important to make local education agencies (LEAs) aware in advance.

Since learning time will likely be disrupted, school safety partners, including the U.S. Department of Education’s Office of Safe and Healthy Students and its REMS TA Center, and the Youth Preparedness group within FEMA’s Individual and Community Preparedness Division, highly encourage local agencies to use the time to provide a teachable moment about emergency preparedness. For example, LEAs can do the following:

• Craft a customized message notifying of the upcoming IPAWS test, while also providing information that is specific to your district. For example, you may want to provide details about your local emergency notification systems or describe how your LEA plans to communicate with school populations during real emergencies.
• Ensure that messaging sent about IPAWS is accessible to those with access and functional needs. FEMA has prepared an accessible version of the announcement about this month’s test that can be shared with the whole school community. All community members are encouraged to watch this brief video.
• We recommend that schools and school districts plan a review of drill protocols with students to coincide with the IPAWS notification. For example, schools are required to conduct annual evacuation drills, and the interruption from the IPAWS notification on October 3 could serve as a marker to review drill procedures with students or to conduct this drill. If planning a drill or exercise at this time is not possible, emergency planning teams at schools and school districts can be encouraged to use this event as an impetus to setting their calendar of drills and exercises for the school year.
• Schools and school districts need to create a Communications and Warning Annex as a part of any comprehensive and high-quality school emergency operations plans (EOPs) and as recommended in the Guide for Developing High-Quality School Emergency Operations Plans (PDF).
• Utilize the fact sheets that FEMA created in to describe IPAWS and its EAS and WEA systems to LEA Web pages and share them via social media and other dissemination channels:
  • English Version of the Fact Sheet
  • Spanish Version of the Fact Sheet

Maine and our nation’s federal partners are committed to strengthening the National Preparedness System, and this test provides just one example of that commitment.

For further information:

Contact the REMS TA Center, your national school safety technical assistance center, at info@remstacenter.org or 1-855-781-REMS [7367] if you have questions about this test or need general support with emergency preparedness planning.

Contact Pat Hinckley, Transportation and Facilities Administrator, at pat.hinckley@maine.gov or 207-624-6886 if you have questions about Maine school security.

The Maine Center for Disease Control – School Oral Health Program (SOHP) has been a part of many school’s programs since the 1980’s. The program started with a weekly fluoride mouth rinse and dental sealants to second graders and classroom education.

The Program has evolved to over the last several years from the mouth rinse to fluoride varnish application twice a year along with dental screenings for the children.  In the last year The Maine CDC has met with the Department of Education’s School Nurse Consultant, Emily Poland and an advisory group to restructure the SOHP with the goal to make implementation of the activities of the program easier for schools and school nurses. We understand that school nurses have many demands for their time and school resources are very tight. We surveyed the school nurses this past Spring for feedback on a restructure of the SOHP.  We had a 99% response rate back and 91%, responded stating they were in favor of a new structure to the SOHP.

A newly designed SOHP has been designed to  fit the needs of Maine schools as well as the Maine Center for Disease Control. District public health hygienists will work with schools to provide dental screenings, fluoride varnish, dental sealants (when applicable), dental education and care coordination. The district hygienist will be working with school nurses and staff throughout this upcoming school year to provide these services at our participating schools.

Dental decay in children is still the most common childhood disease. Over 51 million hours of school time is lost annually due to dental disease. Maine is working towards reducing the rate of dental decay among Maine’s school children.

For more information contact Nicole Breton, Director of Rural Health and Primary Care at Nicole.Breton@maine.gov or 287-5524.

Maine Department of Education in collaboration with Maine Center for Disease Control and Prevention (Maine CDC) is sharing this important guidance with schools regarding mosquito-borne illnesses. Maine CDC developed the information and guidance in this letter.

Three mosquito-borne illnesses are considered a local risk in Maine: Eastern Equine Encephalitis (EEE), Jamestown Canyon virus (JCV), and West Nile virus (WNV).  These are potentially serious viral infections transmitted to people from the bite of an infected mosquito.  These diseases are especially severe in children (as well as adults over 50).  It is important to practice preventative strategies since there is no vaccine or effective treatment for humans.

Maine saw the first human case of WNV in 2012, the first human case of EEE in 2014, and the first human case of JCV in 2017. Maine did not have any positive EEE or WNV mosquito pools, human cases, or animal cases in 2017. Maine had two human cases of JCV in 2017. Mosquito testing in Maine does not include JCV and laboratory testing for JCV in humans is done out of state.

Maine identified a WNV case in a Maine resident and a WNV positive mosquito pool in Kittery to date in 2018. The human case of WNV became ill on a road trip and likely acquired the infection out of state. Massachusetts, New Hampshire, and Vermont identified mosquito pools positive for WNV to date in 2018. Massachusetts also identified several humans with WNV and New Hampshire identified several birds with WNV to date in 2018.

The risk for contracting mosquito-borne diseases is highest from dusk to dawn and when temperatures are above 50 degrees (and especially above 60 degrees), since these are the conditions when mosquitoes are most actively biting.

Schools play an important role in preventing mosquito-borne illnesses.  Maine CDC and its consulting experts recommend:

• Cover up outdoors. Children and others on outdoor field trips and participating in other outdoor activities for a significant amount of time when the temperature is above 50 degrees should be encouraged to cover up with long sleeve shirts, pants, and socks; and/or,
• Use repellent.Use an EPA approved repellent containing DEET, picaridin, IR3535, or oil of lemon eucalyptus on exposed skin and/or clothing.  The repellent/insecticide permethrin can be used on clothing and can be effective through several washes.  Always follow the package directions. Details on recommended repellents.
  • School employees and volunteers must have authorization from parents or guardians before applying repellents to minor children (CMR 01-026, Chapter 10, Section 2.I.4.iii).
  • Schools that schedule practices or games at dusk or evening with temperatures above 50 degrees should encourage the use of repellent for all participants including coaches and observers.

Implement Integrated Pest Management strategies.Since we anticipate the risk from mosquito-borne illnesses to continue, schools should consult with their IPM Coordinator to review their IPM policy. Information on Maine’s School IPM Program.

Please monitor Maine CDC’s arboviral website for the most up to date information on positives detected in the state. If mosquito-borne disease activity increases in your area, the following strategies should be implemented:

1. Use EPA approved repellents. These should be available to both students and staff who are outdoors, particularly during dusk and dawn hours. If you have an outdoor event, repellent should be available to spectators as well to limit the risk of mosquito-borne diseases.
2. Consult with your school IPM coordinator and implement a plan to reduce the number of mosquitoes and mosquito breeding sites on school grounds.
3. Limit and/or reschedule evening outdoor activities. Unless the dusk temperature is forecast to be less than 50 degrees, limit or reschedule outdoor evening activities such as school athletic events so people are able to go indoors by one hour before sunset.

All these recommendations are especially true in those areas with previously-identified mosquito-borne illnesses. However, the lack of identified virus in an area of the state does not mean there is no risk.

Maine CDC has one-page fact sheets for EEE, WNV, and repellents which we encourage you to send home with students, share by email, and/or post on your school website(s), as you deem appropriate. Access the facts sheet here.

Resources to learn more about mosquito-borne illness and mosquito control:

• Maine’s weekly arboviral surveillance reports
• Maine CDC’s Vectorborne Website
• Maine CDC Disease Reporting: 1-800-821-5821 for consultation or disease.reporting@maine.gov
• Maine CDC’s frequently asked questions website for mosquitoes and mosquito-borne diseases
• Maine Board of Pesticide Control: 207-287-2731
• Maine Department of Environmental Protection (Maine DEP):1-800-452-1942 or  (info on pesticides and wetlands)
• University of Maine Cooperative Extension: 1-800-287-0274
• Federal CDC EEE Website
• Federal CDC WNV website

Maine Department of Education and Maine CDC continue to work very closely together and are greatly appreciative of your assistance in keeping Maine’s children and school communities healthy.