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Asthma
Asthma
Asthma is a chronic disease that affects your ability to breathe. Your airways, the tubes that carry air in and out of your lungs, become tight, swollen and produce mucus. The airways are also sensitive, and may react strongly to things that you are allergic to or find irritating. Symptoms of asthma are wheezing, coughing, chest tightness and trouble breathing. Asthma can cause symptoms ranging from minor wheezing to life-threatening asthma attacks. - MA Department of Public Health
School Nurses help students with Asthma stay in control and in school. If your child has Asthma please contact your child’s school nurse for assistance. Keeping students with chronic health conditions in school is a health partnership between the parents/guardians, the medical home and school health services.
Concussion
Concussion
What is a Concussion?
A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.
Signs and Symptoms of a Concussion
Children and teens who show or report one or more of the signs and symptoms listed below, or simply say they just “don't feel right” after a bump, blow, or jolt to the head or body, may have a concussion or more serious brain injury.
Concussion Signs Observed
Can't recall events prior to or after a hit or fall
Appears dazed or stunned
Forgets an instruction, is confused about an assignment or position, or is unsure of the game, score, or opponent
Moves clumsily
Answers questions slowly
Loses consciousness (even briefly)
Shows mood, behavior, or personality changes
Influenza
Concussion Symptoms Reported
Headache or "pressure" in head
Nausea or vomiting
Balance problems or dizziness, or double or blurry vision
Bothered by light or noise
Feeling sluggish, hazy, foggy, or groggy
Confusion, or concentration or memory problems
Just not "feeling right" or "feeling down"
Influenza
Influenza
Several schools have seen an increase in students with influenza like illnesses (fever with cough or sore throat). It’s important to let your child’s school nurse know if you are keeping your child home with an influenza like illness(ILI) and/or if your child has been tested and is positive for the flu. Your child does not need to see the physician if they are sick with an influenza like illness, unless they have an underlying medical condition which would add to their risk or they are having difficulty breathing.
Below is a summary of information from MA DPH
The most common symptoms of flu are fever with cough, or sore throat. Symptoms can also include body aches, headache, chills, runny nose and feeling very tired. Some people, especially young children, also have diarrhea and vomiting. Symptoms last from a few days to up to a week or more.
How is flu treated?
People sick with flu should make sure to drink plenty of fluids, get plenty of rest, eat healthy foods, wash their hands often and stay home to avoid spreading the flu to other people. Over the counter pain relievers may help people with the flu feel more comfortable. Children and teens with the flu should never take aspirin, because a rare but serious disease called Reye syndrome can occur. Do not give cough or cold medicines to children younger than 4 years of age.
There are drugs available that your doctor may prescribe to treat flu. The drugs work best if started soon after symptoms begin. Your doctor can determine if you need treatment.
Stay home from work and school if you get sick with a flu-like illness (fever with cough or sore throat) and avoid contact with others so the virus does not spread. Stay at home until you have been free from fever for at least 24 hours after your last dose of fever-reducing medication (like Tylenol, Advil or Motrin). For most people this will mean staying at home for about 4 days.
How does flu spread?
The flu virus is in the wet spray (droplets of saliva and mucus) that comes out of the nose and mouth of someone who coughs or sneezes. If you are close enough to a person with the flu (3 - 6 feet) when they cough or sneeze, you can breathe in the virus and get sick. Flu symptoms start 1 - 4 days (usually 2 days) after a person breathes in the virus.
Flu is spread easily from person to person. The virus can also live for a short time on things you touch like doorknobs, phones and toys. After you touch these objects, you can catch the virus when you touch your mouth, nose, or eyes. Adults with flu can spread it from about one day before symptoms appear to about one week after. Children can spread the flu even longer after they get sick.
How can I prevent getting the flu?
Get flu vaccine every year as soon as it is available.
Wash your hands often with soap and water, or use an alcohol-based hand gel.
Cough or sneeze into a tissue or into the inside of your elbow if you don’t have a tissue. Throw tissues away and wash your hands. Always wash your hands before touching your eyes, nose or mouth.
Use household cleaners to clean things that are touched often, like door knobs, toys, and phones.
Avoid close physical contact with people who are sick. Try to stay at least 3-6 feet from someone who is sick with the flu.
Lice
Lice
How to Avoid A "Hair Raising Experience"
Head lice often occurs in school aged children. While inconvenient, head lice do not cause medical harm and can be effectively treated.
Some things to know about head lice:
Head lice are not a sign of uncleanliness! They love clean hair.
Lice do not hop, jump, or fly. They crawl quickly, and the only way they can get from one person to another is through direct head to head contact.
Lice are not passed on pets. They need human blood to survive.
Schools are not the most common place where head lice are spread. Sleepovers are thought to be the most common way lice are passed from home to home.
School-wide head checks are not recommended by the American Academy of Pediatrics. The most effective screening occurs when parents frequently check their own children at home! (If help is needed to identify what you are seeing, please contact your school nurse).
The lifecycle of head lice:
Once a pregnant female or a male and female louse take residence in a head of hair, the reproduction process begins. A female lays about 6-10 eggs per day. The eggs can hatch anywhere from 3-10 days later. Once the egg hatches, the louse enters the nymph stage and cannot reproduce. It takes another 7-21 days for the nymph to grow into a mature adult that can reproduce.
Children usually have had head lice for about six weeks prior to initial diagnosis. It takes that amount of time for the child to develop sensitivity to the saliva of the louse that results in characteristic itchiness.
What do head lice look like?
Live lice are tiny black/brown insects that are similar in size to a sesame seed. Nits, which are eggs of the lice, are whitish, grey and stick to the hair shaft. They are not easily removed, like dandruff.
Signs of head lice:
Frequent head scratching, particularly at the top of the head and nape of the neck, and skin irritation or red bite marks around the ears and the nape of the neck.
What parents can do:
Check your child’s head weekly all year long. Call the school nurse if you suspect your child has lice. Call your physician to see what product he/she recommends for treatment.
Follow treatment directions exactly according to manufacturer’s instructions. For all over the counter treatment products, retreatment must be carried out again in 7-10 days. Use a lice comb to detect and remove lice and nits daily until all nits are removed. To kill lice on bedding, clothes, etc., wash and dry them as you would ordinarily. NEVER add any pesticide. Vacuum materials that cannot be washed. If you are concerned about head lice on carpets or furniture, vacuum them thoroughly or wipe smooth surfaces with a damp cloth. Place items that cannot be washed or dried, such as stuffed animals, in a tightly sealed plastic trash bag for 10 days. To kill lice on brushes, combs, or hair accessories, wash them with hot, soapy water.
Click here for information on returning to school after treatment.
MRSA
MRSA
(Methicillin-resistant Staphylococcus aureus)
Questions and Answers
MRSA is sometimes said as a single word, “mersa,” or by saying all four letters, “M-R-S-A”
What is MRSA?
MRSA is a kind of bacteria that is resistant to some kinds of antibiotics. To understand MRSA it is helpful to learn about Staphylococcus aureus bacteria, often called “staph,” because MRSA is a kind of staph.
What are staph?
Staph are bacteria commonly carried on the skin or in the nose of healthy people. About 25-30% of the U.S. population carry staph on their bodies at any time.
Do staph always make people sick?
No. Many people carry staph in their nose or on their skin for a period of time and do not know they are carrying them. They do not have skin infections. They do not have any other signs or symptoms of illness. This is called “colonization.”
Sometimes, though, staph can cause an infection, especially pimples, boils and other problems with the skin. These infections often contain pus, and may feel itchy and warm. Occasionally, staph cause more serious infections.
How are staph spread?
Staph are spread by direct skin-to-skin contact, such as shaking hands, wrestling, or other direct contact with the skin of another person. Staph are also spread by contact with items that have been touched by people with staph, like towels shared after bathing and drying off, or shared athletic equipment in the gym or on the field.
Staph infections start when staph get into a cut, scrape or other break in the skin. People who have skin infections—painful, swollen pimples, boils, and rashes, for example—should be very careful to avoid spreading their infection to others.
Is MRSA different from other staph?
Yes. MRSA is different from other staph because it cannot be treated with some antibiotics. When antibiotics are needed to treat a MRSA infection, the right antibiotic must be used. If the right antibiotic is not used, the treatment may not work.
MRSA is just like other staph in almost every other way:
MRSA can be carried on the skin or in the nose of healthy people, and usually not cause an infection or make them sick.
It can cause minor skin infections that go away without any special medical treatment.
It is spread the same way as other staph.
The symptoms are the same as other staph infections.
What are the symptoms of an infection caused by staph?
Pimples, rashes, pus-filled boils, especially when warm, painful, red or swollen, can mean that you have a staph or MRSA skin infection.
Occasionally, staph can also cause more serious problems such as surgical wound infections, bloodstream infections and pneumonia. The symptoms could include high fever, swelling, heat and pain around a wound, headache, fatigue and others.
What should I do if I think I have a staph skin infection?
Keep the area clean and dry. See your doctor, especially if the infection is large, painful, warm to the touch, or does not heal by itself.
How will my doctor know if I have a MRSA infection?
The only way to tell the difference between MRSA and other staph infections is with lab tests. Lab tests will also help your doctor decide which antibiotic should be used for treatment, if antibiotic treatment is necessary.
Your doctor will usually take a sample on a swab (like a Q-tip) from the infected area. The
sample will be sent to a laboratory to see if the infection is caused by staph. Blood and other
body fluids can also be tested for staph.
How are MRSA infections treated?
Most MRSA skin infections are treated by good wound and skin care: keeping the area clean and dry, washing your hands after caring for the area, carefully disposing of any bandages, and allowing your body to heal.
Sometimes treatment requires the use of antibiotics. Lab tests help your doctor decide which antibiotic should be used for treatment, if antibiotic treatment is necessary. If antibiotics are prescribed, it is important to use the medication as directed unless your doctor tells you to stop. If the infection has not improved within a few days after seeing your doctor, contact your doctor again.
How can I prevent a staph infection?
Regular handwashing is the best way to prevent getting and spreading staph, including MRSA. Keep your hands clean by washing them frequently with soap and warm water or use an alcohol-based hand sanitizer, especially after direct contact with another person’s skin.
Keep cuts and scrapes clean and covered with a bandage until they have healed.
Avoid contact with other people’s wounds or bandages.
Avoid sharing personal items such as towels, washcloths, toothbrushes and razors. Sharing these items may transfer staph from one person to another.
Keep your skin healthy, and avoid getting dry, cracked skin, especially during the winter. Healthy skin helps to keep the staph on the surface of your skin from causing an infection underneath your skin.
Contact your doctor if you have a skin infection that does not improve.
EEE
EEE
What is Eastern Equine Encephalitis?
Eastern equine encephalitis (EEE) is a rare but serious disease caused by a virus.
How is the EEE virus spread?
The virus that causes EEE is spread through the bite of an infected mosquito. In Massachusetts, the virus is most often identified in mosquitoes found in and around freshwater, hardwood swamps.
EEE virus particularly infects birds, often with no evidence of illness in the bird. Mosquitoes become infected when they bite infected birds. Although humans and several other types of mammals, particularly horses and llamas, can become infected, they do not spread disease.
How common is EEE in Massachusetts?
EEE is a very rare disease. Since the virus was first identified in Massachusetts in 1938, fewer than 100 cases have occurred. Over 60% of those cases have been from Plymouth and Norfolk counties.
Outbreaks of EEE usually occur in Massachusetts every 10-20 years. These outbreaks will typically last two to three years. The most recent outbreak of EEE in Massachusetts began in 2004 and included 13 cases with six fatalities through 2006.
What are the symptoms of EEE?
The first symptoms of EEE are fever (often 103º to106ºF), stiff neck, headache, and lack of energy. These symptoms show up three to ten days after a bite from an infected mosquito. Inflammation and swelling of the brain, called encephalitis, is the most dangerous and frequent serious complication. The disease gets worse quickly and some patients may go into coma within a week.
What is the treatment for EEE?
There is no treatment for EEE. In Massachusetts, about half of the people identified with EEE died from the infection. People who survive this disease will often be permanently disabled. Few people recover completely.
What can you do to protect yourself from EEE?
Since the virus that causes EEE is spread by mosquitoes, here are some things you can do to reduce your chances of being bitten:
Schedule outdoor events to avoid the hours between dusk and dawn, when mosquitoes are most active.
When you are outdoors, wear long pants, a long-sleeved shirt and socks. This may be difficult to do when the weather is hot, but it will help keep mosquitoes away from your skin.
Use a repellent with DEET (N, N-diethyl-m-toluamide), permethrin, picaridin (KBR 3023), or oil of lemon eucalyptus [p-methane 3, 8-diol (PMD)] according to the instructions given on the product label. DEET products should not be used on infants under two months of age and should be used in concentrations of 30% or less on older children. Oil of lemon eucalyptus should not be used on children under three years of age. Permethrin products are intended for use on items such as clothing, shoes, bed nets and camping gear and should not be applied to skin.
Keep mosquitoes out of your house by repairing any holes in your screens and making sure they are tightly attached to all your doors and windows.
Remove areas of standing water around your home. Here are some suggestions:
Look around outside your house for containers and other things that might collect water and turn them over, regularly empty them, or dispose of them.
Drill holes in the bottom of recycling containers that are left outdoors so that water can drain out.
Clean clogged roof gutters; remove leaves and debris that may prevent drainage of rainwater.
Turn over plastic wading pools and wheelbarrows when not in use.
Change the water in birdbaths every few days; aerate ornamental ponds or stock them with fish.
Keep swimming pools clean and properly chlorinated; remove standing water from pool covers.
Use landscaping to eliminate standing water that collects on your property.
Did you know?
Mosquitoes can begin to multiply in any puddle or standing water that lasts for more than four days! Mosquito breeding sites can be anywhere. Take action to reduce the number of mosquitoes around your home and neighborhood. Organize a neighborhood clean up day to pick up containers from vacant lots and parks and to encourage people to keep their yards free of standing water. Mosquitoes don't care about fences, so it's important to remove areas of standing water throughout the neighborhood.
Need more information?
EEE and personal protection: MDPH, Division of Epidemiology and Immunization at 617-983-6800 or online at www.mass.gov/dph. You may also contact your local board of health (listed in the telephone directory under “government”).
Mosquito control in your city or town: Mosquito control in Massachusetts is conducted through nine mosquito control districts. The State Reclamation and Mosquito Control Board (SRMCB) oversees all nine districts. Contact information for each district can be found online at www.mass.gov/agr/mosquito/districts.htm. You may also contact the SRMCB within the Massachusetts Department of Agricultural Resources at 617-626-1777 or your local board of health.
Health effects of pesticides: MDPH, Center for Environmental Health at 617-624-5757
Source: Eastern Equine Encephalitis Public Health Fact Sheet, April 2007
West Nile Virus (WNV)
West Nile Virus (WNV)
What is West Nile Virus?
West Nile virus (WNV) is a mosquito-carried virus that can cause illness ranging from a mild fever to more serious disease like encephalitis or meningitis. It was first identified in the United States in 1999.
How is WNV spread?
WNV is most commonly spread to people through the bite of an infected mosquito.
WNV may also be spread through blood transfusion or organ transplant. In addition, there are rare reports of WNV being passed from pregnant or breastfeeding women, who are infected with WNV, to their babies. Since these reports are rare, the health effects on an unborn or breastfeeding baby are unclear and still being studied.
People do not become infected by having direct contact with other infected people, birds or animals.
Why does my health department want me to report dead birds?
When WNV infects birds, it can cause high mortality (death) in certain species, including crows, blue jays and robins. Collecting information about the location of these types of dead birds can help identify areas where WNV may be active in Massachusetts. If you would like to report a dead bird in your area, call the MDPH Public Health Information Line at 866-MASS-WNV (866-627-7968). MDPH generally collects this information from May through September.
What are the symptoms of WNV?
The majority of people who are infected with WNV (approximately 80%) will have no symptoms.
A smaller number of people who become infected (~ 20%) will have symptoms such as fever, headache, body aches, nausea, vomiting, and sometimes swollen lymph glands. They may also develop a skin rash on the chest, stomach and back.
Less than 1% of people infected with WNV will develop severe illness, including encephalitis or meningitis. The symptoms of severe illness can include high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness and paralysis. Persons older than 50 years of age have a higher risk of developing severe illness.
How common is WNV in Massachusetts?
Because most people who are exposed to WNV have no symptoms, it is difficult to know exactly how many people have been infected. People who develop severe illness with WNV are most often reported. Between 2000 and 2006, 54 people were reported with WNV infection in Massachusetts. Six of these people died. Cases have been identified from around the state.
Is there any treatment for WNV?
There is no specific treatment for WNV infections. People with mild WNV infections usually recover on their own.
People with severe WNV infections almost always require hospitalization. Their symptoms may last several weeks and neurological effects may be permanent. Approximately 10% of people who develop severe illness will die from the infection.
What can you do to protect yourself from WNV?
Since WNV is most commonly spread by mosquitoes, here are some things you can do to reduce your chances of being bitten:
Schedule outdoor events to avoid the hours between dusk and dawn, when mosquitoes are most active.
When you are outdoors, wear long pants, a long-sleeved shirt and socks. This may be difficult to do when the weather is hot, but it will help keep mosquitoes away from your skin.
Use a repellent with DEET (N, N-diethyl-m-toluamide), permethrin, picaridin (KBR 3023), or oil of lemon eucalyptus [p-methane 3, 8-diol (PMD)] according to the instructions on the product label. DEET products should not be used on infants under two months of age and should be used in concentrations of 30% or less on older children. Oil of lemon eucalyptus should not be used on children under three years of age. Permethrin products are intended for use on items such as clothing, shoes, bed nets and camping gear and should not be applied to skin. More information on choosing and using repellents safely is included in the MDPH Fact Sheet on Mosquito Repellents which can be viewed online at www.mass.gov/dph/cdc/factsheets/factsheets.htm. If you can’t go online, contact the MDPH at (617) 983-6800 for a hard copy.
Keep mosquitoes out of your house by repairing any holes in your screens and making sure they are tightly attached to all your doors and windows.
Remove areas of standing water around your home. Here are some suggestions:
Look around outside your house for containers and other things that might collect water and turn them over, regularly empty them, or dispose of them.
Drill holes in the bottom of recycling containers that are left outdoors so that water can drain out.
Clean clogged roof gutters; remove leaves and debris that may prevent drainage of rainwater.
Turn over plastic wading pools and wheelbarrows when not in use.
Change the water in birdbaths every few days; aerate ornamental ponds or stock them with fish.
Keep swimming pools clean and properly chlorinated; remove standing water from pool covers.
Use landscaping to eliminate standing water that collects on your property.
Did you know?
Mosquitoes can begin to multiply in any puddle or standing water that lasts for more than four days! Mosquito breeding sites can be anywhere. Take action to reduce the number of mosquitoes around your home and neighborhood. Organize a neighborhood clean up day to pick up containers from vacant lots and parks and to encourage people to keep their yards free of standing water. Mosquitoes don't care about fences, so it's important to remove areas of standing water throughout the neighborhood.
Need more information?
WNV and personal protection: MDPH, Division of Epidemiology and Immunization at 617-983-6800 or online at https://www.mass.gov/service-details/west-nile-virus-wnv. You may also contact your local board of health (listed in the telephone directory under “government”).
Mosquito control in your city or town: Mosquito control in Massachusetts is conducted through nine mosquito control districts. The State Reclamation and Mosquito Control Board (SRMCB) oversees all nine districts. Contact information for each district can be found online at www.mass.gov/agr/mosquito/districts.htm. You may also contact the SRMCB within the Massachusetts Department of Agricultural Resources at 617-626-1777 or your local board of health.
Health effects of pesticides: MDPH, Center for Environmental Health at 617-624-5757
Source: West Nile Virus Public Health Fact Sheet, May 2007
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