Return after flu

[KeeperOfTheIceRN]

What are your guidelines for students returning after having the flu? My campus is currently in freakout mode because a student who was diagnosed on Tuesday is here today. However, per their MD note they returned on Tuesday, they could come back to school either yesterday or today or once they are fever free for 24 hours w/out meds. According to parents student had no fever yesterday and is not running a fever today, therefore, they are here. Teachers are panicking due to the cough this student has.

Is there anything else I can do? Technically this student is cleared to come back per MD note (and assuming parents are telling the truth about no fever yesterday), but we're a really small school. It won't take much to make our attendance drop to the point of closure for illness. If you consider the several I've sent home the last 2 days for ILI, I have to say I'm a little on edge too.

Thanks for any help!

[MrNurse(x2), ADN]

31 minutes ago, AdobeRN said:

I wish the parents would keep the kids out an extra day or so - some of them are just not ready to return, exhausted by noon and in my office with me calling parents to pick them up.

I am thankful we have a fever policy - fever free x24 hours without meds. That will keep some of them home even if doctor states they can return after first dose of Tamilflu and they are really still feverish.

The problem with antivirals is the body stops the fever but remains contagious, that is why I am looking into a policy to protect other students.

[UrbanHealthRN, BSN, RN]

While we're on the subject of flu...

It's showing up now with my kiddos. I was told by our health department back in the fall that If I see enough cases pop in a classroom or building, call the department to determine if it's an outbreak and then exclude any non-vaccinated kids until the outbreak has passed. A paragraph about excluding non-vaccinated kids for vaccine-preventable diseases is also written into our state law for schools.

I called the health department today because I have multiple kids in the same one-classroom center who've all come down with the flu. I asked about the non-vaccinated kid in that class, and am now being told yes, this classroom has an outbreak, but flu is not on the list of excludable vaccine-preventable diseases.

Does anyone's state or health department give guidance on this? I can't believe I just got a totally different response today.

[halohg, RN]

On 2/5/2019 at 3:23 PM, UrbanHealthRN said:

I called the health department today because I have multiple kids in the same one-classroom center who've all come down with the flu. I asked about the non-vaccinated kid in that class, and am now being told yes, this classroom has an outbreak, but flu is not on the list of excludable vaccine-preventable diseases. 

That is my thought, since it is not a mandated vaccine you cannot exclude.

another thought I wonder if the return date recommendation varies due to influenza A verse influenza B diagnosis?

[UrbanHealthRN, BSN, RN]

10 hours ago, halohg said:

That is my thought, since it is not a mandated vaccine you cannot exclude.

another thought I wonder if the return date recommendation varies due to influenza A verse influenza B diagnosis?

The flu vaccine actually is a mandated vaccine- kids have until December 31st each year to get it done- and the only non-vaccinated kids who can stay are the ones who have medical or religious exemptions filled out. And because there's a vaccine for the flu, I'd assume it's a vaccine-preventable disease. But we all know what assuming does, and after doing a little digging yesterday, it looks like my second phone call to the health department was the correct one, and not everyone excludes kids during this particular disease outbreak.

[AdobeRN]

26 minutes ago, UrbanHealthRN said:

The flu vaccine actually is a mandated vaccine- kids have until December 31st each year to get it done- and the only non-vaccinated kids who can stay are the ones who have medical or religious exemptions filled out. And because there's a vaccine for the flu, I'd assume it's a vaccine-preventable disease. But we all know what assuming does, and after doing a little digging yesterday, it looks like my second phone call to the health department was the correct one, and not everyone excludes kids during this particular disease outbreak.

Just curious - mandated by your state or the school district?

[UrbanHealthRN, BSN, RN]

40 minutes ago, AdobeRN said:

Just curious - mandated by your state or the school district?

State mandated. But my state is pretty lax about vaccine "religious exemptions"- personal objections also fall under that definition, and nobody questions it.

[halohg, RN]

10 hours ago, UrbanHealthRN said:

The flu vaccine actually is a mandated vaccine

Not in all states

[UrbanHealthRN, BSN, RN]

14 minutes ago, halohg said:

Not in all states

Sorry- I meant in my state. I felt like my first post in this thread wasn't clear, and then I tried to clarify, but maybe I'm not doing a good job of that.

[Amethya]

I'm keeping an eye out myself, I had one already tested positive for flu, and he has an older brother who is in 6th grade, but no symptoms. I'm waiting to see what the mother's doctor's says if he can go to school or not. I'm not risking anything.