Diane Holl

Nurse

Phone: (603) 428-3476 x257

Email: diane.holl@sau24.org

October 15, 2010

When children come into contact with germs, simply touching their eyes, nose, or mouth can unknowingly infect them. And once they're infected, it's usually just a matter of time before the whole family comes down with the same illness. Good hand washing is the first line of defense against the spread of many illnesses, from the common cold to more serious illnesses such as meningitis, bronchitis, influenza, hepatitis A, and most types of infectious diarrhea. Global Hand washing Day is October 15, 2010. It seems like we should all wash our hands multiple times per day. That is in fact the case. Using a nailbrush once a day can help reduce germs under nails. This reduces the chance for planting organisms around the skin after scratching. Nails can be the forgotten area of the hand wash strategy.

For a hand washing video for children visit:

http://www.globalhandwashingday.org/GHD_Video.asp

October 15, 2010

We have had two cases of chickenpox in our school. Chicken pox is a contagious disease caused by the varicella-zoster virus. It is spread by close contact (i.e., sharing breathing space or direct touch) with infected secretions from the nose, throat or rash. The rash starts with crops of small red bumps on the stomach or back and spreads to the face and limbs. It rapidly becomes blistered, oozy and crusts over. People may have only a few bumps or be totally covered. Anyone who is exposed to chickenpox and has not had it before has a very good chance of developing this disease. It is most common in school-aged children and in children is generally not serious. Anyone with chicken pox should stay at home for one week after the rash appears or until all of the vesicles become dry. When a pregnant woman or a person with a weak immune system who has not had the chicken pox is exposed, he/she should contact a physician. Up to 90% of people who receive the chicken pox vaccine will not get chickenpox. People who do get chickenpox after having the vaccine usually have a milder form of the disease. If you have any questions about this illness, please contact the school nurse or your family physician.

September 17, 2010

With the start of a new school year, health advocates are advising parents to be aware of the potentially harmful effects of high-energy drinks, which have become increasingly popular with kids, teens and young adults. Most energy drinks deliver a stiff dose of sugar and caffeine. The Poison Control Center reminds us that caffeine is a stimulant and a diuretic. Too much caffeine can cause: jitteriness and nervousness, upset stomach, headaches, difficulty concentrating and difficulty sleeping. It may also cause further dehydration when used for fluid replacement. The effects of caffeine on children may be more pronounced and if ingested in excessive quantities, the caffeine-rich energy drinks can have significant toxic effects. Many of these drinks also contain additional ingredients whose safety or effectiveness has never been tested in children — including herbal supplements, guarana (a source of caffeine), and taurine (an amino acid thought to enhance performance). Be critical when reading labels, and talk to your child's doctor if you have any questions. Teach your child not to be so quick to believe the hype when it comes to power drinks. For athletes and non-athletes alike, nothing beats a well-balanced diet. Most kids who eat well, stay hydrated, and get enough physical activity and rest will have plenty of energy — naturally.

June 8, 2010

During the past week, I have noticed many children are taking part in the newest craze, “Silly Bandz”. Some doctors say one of the hottest new fads for kids may actually come with a hidden danger. Silly Bandz are colorful rubber bands molded into different shapes -- like animals and cars -- that kids wear on their arms. Some kids wear dozens of Silly Bandz at a time, and doctors said they have been seeing cases where children are wearing too many, and cutting off the flow of blood to their hands. I have had several children remove these bands at school, especially when they are wearing many, because they have been causing indentations on their skin. Doctors have said that wearing a few of the bands is fine, but added kids should remember to take all of them off when they go to bed.

April 13, 2010

We are seeing some cases of pediculosis (head lice), mostly in the 1^st and 6^th grade. Head lice are tiny insects that live only on people’s scalps and hair. The adults hatch from small eggs called nits, which are attached to the individual hairs near the scalp. Nits are tiny oval shaped specks attached to the hair and cannot be moved easily up and down the hair (as could specks of dandruff). The major symptom is itching caused by the bite of the louse. They are spread by crawling from person-to-person directly, or onto personal items, such as combs, brushes, head coverings, clothing, bedding and towels. Never treat “just in case” in the absence of signs of head lice. Lice products are pesticides, which are toxic if overused. I’ve been getting some questions about the possibility of head lice spreading through the shared use of helmets in sports. The extent to which head lice are transmitted to others via helmets is unknown. Ideally, making sure children have and use their own equipment can eliminate risk of transmission. If this is not possible, you can clean the items between children by wiping them with a damp paper towel. An additional measure would be to encourage each child to wear a baseball cap to help shield the hair from contact with the helmet. Helmets should never be sprayed. Most importantly- and best for the entire community- all parents should screen their children regularly. Please call the nurse if you have any questions.

March 24, 2010

We are beginning to see more strep throat among our students. Strep sore throat tends to be accompanied by fever, tender swollen neck glands, headache and stomach ache. However, it can also occur with cough, runny nose, or other cold symptoms. It is very important to treat this disease in order to prevent its spread to others and the possible development of complications. Anyone infected with this illness is excluded from school until 24 hours after beginning antibiotic therapy and until there is no fever present. If your child develops sore throat symptoms, please have an evaluation by your health care provider.

Mud season has arrived and some students are having trouble keeping their clothing from becoming wet and muddy! If this is your child, it might be helpful to send extra clothes to school. Some days we don’t have the right sizes to help out everyone who comes to the nurse for a change of clothes. Thanks!

January 26, 2010

Children get as many as eight colds per year or more, and we have our share of cold symptoms at school this week. Colds are the most common infectious disease in the United States and the No. 1 reason children visit the doctor and stay home from school. Most colds are caused by rhinoviruses that are in invisible droplets in the air we breathe or on things we touch. More than 100 different rhinoviruses can infiltrate the protective lining of the nose and throat, triggering an immune system reaction that can cause a throat sore and headache, and make it hard to breathe through the nose. Medicine can't cure the common cold, but it can be used to relieve such symptoms as muscle aches, headache, and fever. However, aspirin should never be given to children younger than 12, and all children and teens under age 19 shouldn't take aspirin during viral illnesses, because such use may increase the risk of developing Reyes Syndrome, a rare but serious condition that can be fatal. Saltwater drops in the nostrils can relieve nasal congestion (you can buy saline nose drops at any pharmacy). A cool-mist humidifier increases air moisture and petroleum jelly on the skin under the nose soothes raw noses. But what about chicken soup? There's no real proof that eating it can cure a cold, but sick people have been swearing by it for more than 800 years. Why? Chicken soup contains a mucus-thinning amino acid called cysteine, and some research shows that chicken soup helps control congestion-causing white cells, called neutrophils. And remember…the first line of defense against germs is hand washing.

January 19, 2010

We continue with a few cases of head lice this month, most recently two students in the first grade. Head lice are spread only by crawling from person-to-person directly, or onto personal items, such as combs, brushes, head coverings, clothing, bedding and towels. The most effective screening for head lice occurs when parents check their own children at home. If you have any questions about this nuisance, please contact me.

News about a natural disaster, such as the devastating earthquake in Haiti, could make children worry that something similar is going to hit home, or fear a part of daily life — such as rain and thunderstorms — that they'd never worried about before. According to psychologists, to calm children's fears about the news, parents should be prepared to deliver "calm, unequivocal, but limited information." This means delivering the truth, but only as much truth as a child needs to know. The key is to be as truthful yet as inexplicit as you can be. There's no need to go into more details than your child is interested in. Also, talk about what you can do to help. In the case of a news event like a natural disaster, children may gain a sense of control and feel more secure if you find ways to help those who have been affected.

January 4, 2010

Words cannot express my feelings about our Henniker community. I have been completely overwhelmed by the generosity of everyone, both personally and for the many who helped our children this holiday season. There are so many people to thank. Among them, individual community members, our students (who collected money to help others during “hat day”), the student council, many departments at New England College, our own generous staff members, PTA members, Saint Theresa’s and the Henniker Congregational Church, and many others. We truly do have a community of good hearted, caring people. Many children were helped; at last count 116 children. I am so fortunate to know you all, and to be a part of, and recipient of your generosity. Thank you so much! I hope that the New Year will bring good health and happiness to all of you.

December 21, 2009

We have had a reported case of chickenpox in our kindergarten. Chicken pox is a contagious disease caused by the varicella-zoster virus. It is spread by close contact (i.e., sharing breathing space or direct touch) with infected secretions from the nose, throat or rash. The rash starts with crops of small red bumps on the stomach or back and spreads to the face and limbs. It rapidly becomes blistered, oozy and crusts over. People may have only a few bumps or be totally covered. Anyone who is exposed to chickenpox and has not had it before has a very good chance of developing this disease. It is most common in school-aged children and in children is generally not serious. Anyone with chicken pox should stay at home for one week after the rash appears or until all of the vesicles become dry. When a pregnant woman or a person with a weak immune system who has not had the chicken pox is exposed, he/she should contact a physician. Up to 90% of people who receive the chicken pox vaccine will not get chickenpox. People who do get chickenpox after having the vaccine usually have a milder form of the disease. If you have any questions about this illness, please contact the school nurse or your family physician.

News 12/11/09

We continue to have children diagnosed with strep throat. Strep sore throat tends to be accompanied by fever, tender swollen neck glands, headache and stomach ache. However, it can also occur with cough, runny nose, or other cold symptoms. It is very important to treat this disease in order to prevent its spread to others and the possible development of complications. Strep can be passed on to others through nose and mouth secretions. The symptoms generally appear within one to three days after being infected and the diagnosis is best made by a throat culture. Strep infections are treated with an antibiotic for 10 days. Anyone infected with this illness is excluded from school until 24 hours after beginning antibiotic therapy and until there is no fever present. If your child develops sore throat symptoms, please have an evaluation by your health care provider. The best way to prevent the spread of this disease is to reinforce the importance of hand washing with your child and to remind him/her not to share food or eating utensils. Please contact the nurse’s office with any questions. 

NEWS 12/03/2009

Although we have had a decrease in absences and fewer children being sent home due to flu systems, there continues to be widespread H1N1 flu activity in New Hampshire. We will continue to monitor our school population and reinforce preventative practices. Please contact your doctor if your child has an underlying medical condition and has not had the H1N1 vaccine, as there is now more vaccine available in our state. We will soon be entering the seasonal flu season and there are clinics being scheduled throughout New Hampshire. Your doctor’s office should also have this vaccine available. On another note, we have recently seen several cases of strep throat and this illness must be treated with an antibiotic. If you have any questions, please contact the school nurse.

Good sleep is important for the health and happiness of every person, no matter how old or young. Without getting enough sleep it is hard to stay healthy, pay attention and enjoy the day. Children ages 5-12 need 10 to 11 hours of sleep every night. A good night’s sleep will help your child:

Remember what they learned all day.

Have more energy for sports and play.

Better able to fight germs and illness.

Pay attention.

Feel better about themselves.

11/16/2009

In the past couple of weeks, the WHO and the CDC have been strongly emphasizing the notion that one way to save lives and lighten the burden on our health care system is to prevent severe illness from influenza like illness.  Early treatment is important to prevent severe illness for certain groups. There are several distinct groups of people who need to contact a health care provider or seek treatment at the very onset of flu symptoms.  Those include: pregnant women, children 0-2 year olds, adults 65 years of age and older, anyone with underlying medical conditions including but not limited to asthma, neurological and neurodevelopmental conditions, chronic lung disease, heart disease, and more (see comprehensive list here: http://www.cdc.gov/h1n1flu/highrisk.htm).  In addition, anyone who presents with severe illness, that can look different in children and adults, must seek immediate medical attention.

NEWS 11/03/2009

We continue to see an increase in children with Flu symptoms. It appears that the flu (most cases are H1N1) will continue to affect more people during the next weeks. Our state, as well as the country, is experiencing widespread influenza –like illness (ILI).  Please keep your child home if they appear ill, and do not let them return to school until they have been fever free for 24 hours without the use of fever reducing medications. If you are reporting your child as absent, it is very helpful if you leave information about their symptoms, such as fever, cough, sore throat, runny nose, headache, body aches, sometimes vomiting and diarrhea). The average length of this illness is usually between 3 to 5 days. As many of you are aware, vaccines for H1N1, as well as the regular flu vaccine are in short supply. It is recommended that children receive both the seasonal and H1N1 flu vaccines, especially if your child has an underlying chronic health condition, such as asthma. Vaccine availability changes on a daily basis. Contact your health care provider to check on the availability of vaccine. Please continue to reinforce hand washing, cough etiquette and not sharing food or drink. Feel free to contact me with any questions or concerns.

We are also experiencing some case of pediculosis (head lice). Recently, the 6^th grade has been most affected. Call me if you have any questions about head lice.

Lastly, the holiday season is approaching and there may be some families who are having an extreme difficulty getting any gifts for their children this year. Again, contact me in the nurse’s office; I may be able to help.

Flu News 10/27/2009

We have had an increase in students with flu symptoms this week. In all probability it is H1N1. Some children have had a sore throat, cough or headache for a day or so, before getting a fever. There have been instances of students also having vomiting and diarrhea. Symptoms of the 2009 H1N1 flu virus include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some may also have vomiting and diarrhea. According to the CDC, people may be infected with the flu, including 2009 H1N1, and have respiratory symptoms without a fever. Please keep your children home if they appear to be getting ill. They must also remain home for 24 hours after being fever free without the use of fever reducing medications. If your child becomes ill, contact your healthcare provider, especially if they have any chronic underlying conditions. New Hampshire’s Department of Health and Human Services has also set up an H1N1 flu public inquiry phone line. Residents with questions about the virus or vaccine can call 211. The line is open from 8 a.m. to 5 p.m. Monday through Friday. Please contact the school nurse if your child is absent and has flu symptoms, or if you have further questions or concerns.

News From the Nurse 10/21/2009

Listed below is an updated document from the CDC about the H1N1 virus that may prove informative, especially in light of all the recent media attention. http://www.cdc.gov/h1n1flu/qa.htm

Our school is part of the NH H1N1 school surveillance program, and the criteria for reporting flu symptoms is very specific and includes fever and cough or sore throat. Interestingly, information from the CDC also states that people may be infected with the flu, including 2009 H1N1, and have respiratory symptoms without a fever. Other symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people may have vomiting and diarrhea. Please continue to follow preventative advice, including: washing hands often with soap and water. If soap and water are not available, use a hand sanitizer. Avoid touching your eyes, nose or mouth and try to avoid close contact with sick people. This season, there is a seasonal flu vaccine to protect against seasonal flu viruses and a 2009 H1N1 vaccine to protect against the 2009 H1N1 influenza virus (sometimes called “swine flu”). A flu vaccine is the first and most important step in protecting against flu infection.

News From the Nurse 10/07/2009

We continue to see some cases of pediculosis (head lice), mostly on our elementary students. Head lice are tiny insects that live only on people’s scalps and hair. The adults hatch from small eggs called nits, which are attached to the individual hairs near the scalp. Nits are tiny oval shaped specks attached to the hair and cannot be moved easily up and down the hair (as could specks of dandruff). The major symptom is itching caused by the bite of the louse. Contrary to popular belief, head lice are not a sign of unclean people or homes. Lice do not jump or fly. They are spread only by crawling from person-to-person directly, or onto personal items, such as combs, brushes, head coverings, clothing, bedding and towels. The most effective screening for head lice occurs when parents check their own children at home. Never treat “just in case” in the absence of signs of head lice. Lice products are pesticides, which are toxic if overused. Head lice are not a source of infection or disease; they are simply a nuisance. Please call the nurse if you have any questions.

We continue to gather data concerning students or staff with flu symptoms. We have not had many reports recently of fevers with coughs and or sore throats. Please continue to reinforce prevention habits in your family, such as hand washing, which will decrease the transmission of any communicable illness.

News From the Nurse 10/01/2009

The most recent available information about H1N1 in New Hampshire shows regional activity for the week ending September 19^th. In our school there have been a few students and staff with flu-like symptoms this week. We have implemented a school web-based tool that reports to the state our daily absenteeism among students and staff, as well as school nurse visits for influenza-like illness. We also continue to follow preventative steps to help decrease the spread of any illness. The most recent information about H1N1 vaccine states that it will arrive in mid October. The following populations will be vaccinated by their private physicians with the first shipments of vaccine:

a. Pregnant Women

b. Children 6 months to 5 years with medical conditions

c. Health care workers and first responders with direct patient contact

Followed as soon as possible by:

d. Children 5 through 18 years of age with medical conditions

e. Household contacts of children less than 6 months of age, especially siblings

f. Young adults 19 through 24 years of age with medical conditions

News From the Nurse 9/25/2009

According to the NH Division of Public Health Services, the H1N1 virus currently appears to be acting like seasonal influenza in terms of the severity of illness and transmission of infection. The state recognizes that cases are occurring in communities, and that it is not possible to identify every case of H1N1 influenza because the symptoms are similar to those of other acute respiratory infections (there is no routine testing done for H1N1). The Bureau of Communicable Disease states that H1N1 influenza is most likely present in every community and we should all assume that we could be exposed to H1N1 influenza. Prevention is the key, whether you are at the grocery store, visiting with friends, at school or the workplace. The recommended approach focuses on decreasing transmission of infections to others.

· Stay home from work or school if you are sick

· Cover your cough or sneezes with your sleeve

· Wash your hands frequently

For further information, you may contact the Bureau of Communicable Disease at 271-4496

CDC has revised their document entitled: What To Do If You Get Sick: 2009

H1N1 and Seasonal Flu: http://www.cdc.gov/h1n1flu/sick.htm

FRIENDS OF SCHOOL HEALTH

The NH Department of Education, Office of School Health has initiated a new mailing list that is intended for school community members, such as PTO/PTA, parents, teachers, students, and other community members. It will provide information and resources that generally relate to the strong link between academics and health.

Here is a link describing the new list, showing archived postings for this month, and offering automated sign up: 

http://maillist2.nh.gov/mailman/listinfo/nhsn-friends

September 18, 2009

We have had six people in our school with flu symptoms, but there may be others who have not reported this information to the school. If your child has flu symptoms, it would help greatly if you would let the school know. Health care providers are not testing for H1N1, but are relying on symptoms to make their diagnosis. H1N1 as well as seasonal influenza are respiratory illnesses, and the symptoms may include fever (100º F, 37.8º C, or greater), cough, sore throat, a runny or stuffy nose, body aches, headache, and feeling very tired. Some people may also vomit or have diarrhea. All parents should ensure that they have a thermometer at home, know where it is, and make sure it works. Anyone who has a chronic health condition or becomes sick with flu-like symptoms should contact their healthcare provider for advice. Sick children and staff should remain at home for at least 24 hours after they no longer have fever, or do not have signs of fever, without using fever-reducing drugs. It is not okay to send a child to school after giving a drug to mask a fever because they will likely spread the illness they have to many more. Any child who is determined to be sick while at school will be sent home immediately. Parents should think about making some back up plans to stay home with a child if they become ill. If you have flu symptoms, please stay in your home so as not to infect other members of the community. Other prevention efforts are important too. Parents should teach their children to wash their hands often with soap and water. It is also important to teach children not to share personal items like drinks, food, or utensils. Finally, teach children to cover up their coughs or sneezes using their elbow, instead of their hand, when a tissue is unavailable. Parents need to do all these things themselves too and set good examples for their children.