H1N1 Vaccine Update-Oregon Department of Human ServicesContact:
    Christine Decker Stone, 971-673-1282, office; 503-602-8027, cell; christine.l.stone@state.or.us
    H1N1 vaccine shipments on the way to Oregon; more coming soon

    As the first H1N1vaccine doses are being shipped around the country, Oregon public health officials expect there will be enough vaccine in Oregon so that widespread vaccination can begin around the middle of October at local flu clinics, with a particular focus on key priority groups.

    "Over the course of the flu season we are expecting to have a large enough supply to vaccinate everyone with the H1N1 vaccine," says Mel Kohn, M.D., public health director for Oregon. "With these first shipments, children, pregnant women, health care workers and others on the priority list should be first in line.” The priority list is:
    · Children and young adults 6 months to 24 years old;
    · Pregnant women;
    · People caring for or living with infants under 6 months of age;
    · People aged 25 to 64 with medical conditions that put them at a higher risk for influenza-related complications;
    · Health care workers;
    · Frontline law enforcement and public safety workers.
    It is expected that the first shipment to Oregon will be distributed directly to Oregon counties on a per capita basis. The first vaccine doses will arrive mostly in nasal spray form, although over the course of the season both the nasal spray and injectable vaccine should be available, Kohn said.
    Most people should be able to get vaccinated by their health care provider, although other options will be available across the state as well. State and local public health officials will spread the word about the availability of H1N1 flu shot clinics once vaccine begins arriving in substantial quantities. Information on vaccine availability will be posted on the state public health Web site at www.flu.oregon.gov and will also be available from the state hotline at 1-800-978-3040.
    "All local public health departments be working to ensure vaccines are quickly and broadly distributed across the state and people will have a wide variety of options, whether through their health care provider or a community flu clinic," says Dr. Gary Oxman, health officer for Multnomah, Clackamas and Washington counties.
    The nasal spray vaccine is as effective as a shot for healthy people between ages 2 and 49. However, health officials recommend that some groups wait for the injectable vaccine, including: pregnant women, children younger than 2, and people with asthma and other chronic respiratory diseases. Injectable vaccine is expected to begin arriving in substantial quantities later in October.
    Regular seasonal flu shots, which do not protect against H1N1, are also recommended, and are currently available. Information on where to get one is available on the Public Health Flu Web site at www.flu.oregon.gov or from the state hotline at 1-800-978-3040.
    "We ask that everyone keep informed about H1N1 in Oregon and how they can best protect themselves and their families," says Kohn. "Together we can slow the spread of this flu as much as possible and reduce the impact on our state."
    Since September 1, 2009, there have been 16 hospitalizations in Oregon from the flu: six were confirmed H1N1 and the rest influenza A. One death was reported in September.
    Public health experts continue to advise the public to take basic precautions to help slow the spread of all influenza:
    • Wash your hands;
    • Cover your cough;
    • Stay home if you are sick.
    For more information on where to get the vaccine when it becomes available, please visit the Oregon Department of Human Services Web site www.flu.oregon.gov or call the Oregon Public Health Flu hotline: 1-800-978-3040.
      H1N1 ResourcesDue to the concerns regarding the H1N1 flu, we have posted several informational links:



      or call
        Free Flu Clinic November 7Free Flu Clinic at Clackamas County Fairgrounds Friday November 7,2008

        Free Flu Clinic Spanish

        Free Flu Clinic English
        Center for Disease Control Winter Weather PreparednessCenter for Disease Control Winter Preparedness
          Winter Safety Tips
          Whether winter brings severe storms, light dustings, or just cold temperatures, the American Academy of Pediatrics (AAP) has some valuable tips on how to keep your children safe and warm.
          What to Wear:
          - The rule of thumb for older babies and young children is to dress them in one more layer of clothing than an adult would wear in the same conditions.
          - Hypothermia develops when a child's temperature falls below normal due to exposure to cold. It often happens when a youngster is playing outdoors in extremely cold weather without wearing proper clothing.
          - As hypothermia sets in, the child may shiver and become lethargic and clumsy. His/her speech may become slurred and his/her body temperature will decline.
          - If you suspect your child is hypothermic, call 911 at once. Until help arrives, take the child indoors, remove any wet clothing, and wrap him/her in blankets or warm clothes.
          - Frostbite happens when the skin and outer tissues become frozen. This condition tends to happen on extremities like the fingers, toes, ears, and nose. They may become pale, gray, and blistered. At the same time, the child may complain that his/her skin burns or has become numb.
          - If frostbite occurs, bring the child indoors and place the frostbitten parts of his/her body in warm (not hot) water. 104 degrees Fahrenheit is recommended. Warm washcloths may be applied to frostbitten nose, ears, and lips. Do not rub the frozen areas.
          - After a few minutes, dry and cover him/her with clothing or blankets. Give him/her something warm to drink.
          - If the numbness continues for more than a few minutes, call your doctor.
          Winter Health
          - If your child suffers from winter nosebleeds, try using a cold air humidifier in the child's room at night. Saline nose drops may help keep tissues moist.
          - Cold weather does not cause colds or flu. But the viruses that cause colds and flu tend to be more common in the winter, when children are in school and are in closer contact with each other. Frequent hand washing and teaching your child to sneeze or cough into the bend of his/her elbow may help reduce the spread of colds and the flu.
          - Children between the ages of six and 59 months should get the influenza vaccine to reduce their risk of catching the flu.

          For more tips, please visit http://www.aap.org/advocacy/releases/decwintertips.htm.
          The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health, safety, and well-being of infants, children, adolescents, and young adults.
          Flu Information for School Age ChildrenHighlights123
          November E-Journal
          Volume 8, Number 8
          HomeAbout UsHealth in SchoolsEducators & FamiliesImmigrant and Refugee ChildrenPublications & ResourcesNews Room
          Home > Health in Schools > Health Services > School Health Services > School Health Issues > Flu

          Flu Season and Schools
          Click Here for Flu Facts
          Fast Flu Facts
          Things to Keep In Mind for School Age Children
          Things for schools to keep in mind
          More information
          Related Links

          Fast Flu Facts

          Adapted from the Centers for Disease Control and Prevention
          Click here for information from the CDC

          * Flu symptoms include fever, headache, chills, body aches, tiredness, dry cough, sore throat, and nasal congestion.

          * Flu is spread when a person who has the flu coughs, sneezes, or speaks and sends the flu virus into the air. The virus enters the nose, throat or lungs of a person and multiplies. Flu spreads less frequently when a person touches a surface that has flu viruses on it.

          * If you get the flu: rest, drink plenty of liquids, and avoid alcohol and tobacco.

          * Antibiotics like penicillin will not cure the flu. The best way to prevent the flu is to get a flu shot. However, in October 2004, the American flu vaccine supply was cut in half. CDC and the U.S.-based influenza vaccine manufacturer have prioritized the populations eligible for the limited supply. Initially, priority populations include: hospital staff, long-term care providers, nursing homes, and private providers who care for young children. Additional priority populations eligible to receive vaccination with inactivated influenza vaccine include all children aged 6-23 months, adults 65 years of age and older, persons aged 2 to 64 years with underlying chronic medical conditions, residents of nursing homes and long-term care facilities, all women who will be pregnant during the influenza season, children 6 months to 18 years of age who are on chronic aspirin therapy, health care workers with direct patient care, out-of home caregivers and household contacts of children under 6 months of age.

          * Over-the-counter medications may relieve symptoms of flu. The National Institute for Allergies & Infectious Diseases recommends acetaminophen (Tylenol) for children; aspirin or acetaminophen for adults. Decongestants, cough suppressants, and use of a humidifier can provide symptomatic relief.

          * Three antiviral medicines are available by prescription that will help prevent flu infection: Tamiflu, Flumadine and Symmetrel.

          Things to keep in mind for school-age children

          * Do NOT give aspirin to a child or teenager who has the flu. To learn why, click here http://www.niaid.nih.gov/factsheets/flu.htm

          * Most antihistamines cause sleepiness. If a child still has a stuffy nose when she returns to school, parents may want to ask their child's doctor to prescribe a non-sedating antihistamine.

          * Encourage children to cover coughs and sneezes, wash hands frequently, and keep hands away from eyes, nose and mouth.

          * A sick child is advised to stay at home during the first days of illness when symptoms are most severe and the infection is most contagious. Children can return to school when symptoms are improving and no fever has been detected for 24 hours.

          Things for schools to keep in mind

          The Iowa and Vermont Departments of Health have posted the following guidance for schools. Adapted by CHHCS for a national audience.

          * Any employee, student, teacher, or staff suspected of having the flu should not attend school.

          * Wash hands several times a day using soap and warm water for 15-20 seconds (this is generally around the time it takes to sing the ABC's). Dry hands with paper towels or automatic hand dryers if possible. In school, allow regular breaks for the students and teachers to wash hands. Young children should be instructed and assisted to ensure proper hand washing. Restrooms should be checked regularly to ensure that soap and paper towels are always available.

          * The flu can be spread from coughs or sneezes. Make sure tissues are available in all classrooms. Students and staff should cover their mouths when coughing and use a tissue when sneezing or blowing their noses. Tissues should be thrown away immediately following proper hand washing (alcohol hand gels may be used in the classrooms to minimize disruption).

          * Schools may be required by their local health departments to report flu absences when they reach a locally determined number. Reporting outbreaks assists in disease surveillance and understanding the impact on the community.

          * Staff and students (especially those with medical conditions and anyone else who wants to lower their risk of getting the flu) should get the flu shot. Remember, it is never too late in the flu season to be vaccinated. Check with your local health department on availability of vaccine: www.cdc.gov/other.htm#states

          * Closure of individual schools in the event of an outbreak has not proven to be an effective way of stopping the flu but that decision should be made by the appropriate school officials based on other considerations.

          * Schools should be extra-vigilant that ill students be excluded from sports activities, choir or any activities that may involve close contact, since transmission of the flu may be easier in these situations. All students and staff should avoid sharing glasses, water bottles, drinks, spoons/forks, etc.

          * School buses, because of the enclosed space, may allow for easy spread of the flu. Tissues should be available on the buses, and students should be encouraged to cover nose and mouth while coughing or sneezing. Disinfect commonly handled interior surfaces (i.e. door handles, hand rails, etc.) between loads of students, if possible.

          * In the school, clean commonly used surfaces such as door handles, handrails, eating surfaces, desks, etc., frequently with disinfectant. (Bleach solutions or commercial disinfectants are appropriate.)

          More information:

          Influenza: The Disease. From the Centers for Disease Control and Prevention.

          NIH: Flu Web site.
          How to tell the difference between a cold and flu. [Spanish version] http://www.niaid.nih.gov/publications/cold/sick.pdf

          Health Matters: Flu. From the National Institute of Allergy and Infectious Diseases.

          Related Links:

          CHHCS News Alerts - 2006

          September 8, 2006 - Update on This Year’s Flu Vaccine

          August 3, 2006 - 2006-2007 Flu Vaccine Production Starts

          May 5, 2006 - HHS Funds Push for Cell-Based Influenza Vaccine

          March 30, 2006 - Relenza Approved for Flu Prevention

          March 2, 2006 - HHS Steps Up Purchase of Flu Medication

          February 23, 2006 - Advisory Committee Calls for Flu Shots for Children to Age Five

          February 10, 2006 - CDC Says More Healthcare Workers Need to Get Flu Shots

          January 23, 2006 - FDA Warns of 'Influenza-Preventing' Products

          January 17, 2006 - Two Antivirals Lose Effectiveness Against Flu
          Christmas Trees
          DALLAS, Nov. 13 -- Once again allergists have focused on the Christmas tree as the source of extra Yuletide allergic symptoms, and they have implicated shedding mold spores as the suspect grinch.

          Action Points

          Explain to interested patients that allergists have long known that allergy symptoms often recur during the Christmas season and they've suspected the traditional tree is the cause.
          Note that this study shows that mold spores increase steadily over the two weeks a tree is usually up, suggesting that the cause of allergy symptoms is mold.
          This study was published as an abstract and presented orally at a conference. These data and conclusions should be considered to be preliminary as they have not yet been reviewed and published in a peer-reviewed publication.
          The number of mold spores in the air of a typical home climbed sharply during the two weeks a tree was up, found John Santilli, M.D., of St. Vincent's Medical Center in Bridgeport, Conn.

          That means that those sensitive to mold spores -- between 5% and 15% of the population -- are likely to have allergy symptoms over Christmas, Dr. Santilli said at the American College of Allergy, Asthma, and Immunology meeting here.

          "Our patients consistently have a dramatic increase in asthma and sinus complaints occurring every winter," he said. "We recently noted this rise to be especially pronounced during the holiday season."

          It is the second year in a row that researchers here have pointed the finger at Christmas trees. Canadian researchers last year showed that people with allergies were more likely to have symptoms if they had a tree in the house, compared with allergic volunteers who didn't celebrate Christmas. (See: ACAAI: Allergens Lurk Under the Christmas Tree)

          Dr. Santilli and other allergists have focused the suspicion on the traditional tree, but it hasn't been clear what causes the symptoms. Pollen, dust mites, spores, and even the fresh pine scent have been suggested as causes.

          Now the answer is clear, Dr. Santilli said. It is mold spores. "We were suspicious of it, but [the study] has validated our observations," he said.

          He and colleagues placed an Allergenco MK-3 air sampler in a Bridgeport home and took 12 readings over the 14 days the tree was up.

          Initial readings showed a level of 800 spores per cubic meter of air -- not much higher than the normal level of 500 to 700. But within a few days the number began to rise beyond healthy levels.

          At the fourth observation, the level of about 1,500 spores per cubic meter and by the 12th observation (on day 14 when the tree was being taken down) the level had peaked at 5,000.

          For several days during the two-week period -- when spore levels were about 4,000 per cubic meter -- the captured spores exhibited hyphae, string-like extrusions that indicate the spores are actively growing and reproducing, Dr. Santilli said.

          The clinical implication of the study, Dr. Santilli said, is that doctors should caution patients that they might experience symptoms if they have a Christmas tree so they should be ready with their medications.

          Equally, he said, doctors might suggest that the tree be cut fresh, put up only on Christmas Eve, and then removed within a few days.

          The study reinforces what many doctors already know -- that Christmas trees make people sick -- and names the culprit, commented Todd Mahr, M.D., of Gunderson Lutheran Clinic in La Crosse, Wis., who was not involved in the study and is a member of the program committee for the meeting.

          "This study truly shows it is mold spores," he said.
          "As an allergist, I recommend against trees," Dr. Mahr said, and if patients insist on having one, he recommends they go back on their medications for the holiday season.
          The researchers reported no outside funding for the study and said they had no potential conflicts

          Leslie Currin RN
          Health Services Specialist
          Student Learning and Partnerships
          Oregon Department of Education
          Telephone 503-947-5812

          Influenza Update: Important InformationParents and Staff!We want you to be sure to read the following web site for information on
          Health servicesDianne Holme joined the disrict in February. She is experienced in allergy and asthma and is a real asset to the nursing team. Bonnie and Dianne mailed out over 700 letters for students identified with health concerns. Please complete the parent information and have the doctor complete the physician information if you have a doctor visit planned before school resumes. If the health issue is no longer a problem, please write N/A and return to your student's school or to the nurses at the district office. Please request a medical concerns letter if a new health condition develops.

          Medications for the 2006-2007 school year need to be picked up from your student's school by June 29. If your student requires medications, either prescription or over the counter, a new "Authorization for Medication" form for each medication must be filled out each year.

          Please update immunizations received. The 2008-2009 school year will have additional requirements of a 2nd. chicken pox vaccination and the Hepatitis A. Young girls are also encouraged to receive the Human Papillomavirus Vaccine.
          Any questions can be addressed to the Clackamas County Health Department at 503-655-8799 or Family Immunization Information.
            ImmunizationsThe annual immunization review will be submitted to Clackamas County by January 17.  To avoid the exclusion process, most students will need 5 DTaP, DT,Td, TdaP, 4 polio, Varicella of history of chickenpox disease, 2 Measles/Mumps/Rubella and 3 Hepatitis B.   For medical exemption a letter must be submitted signed by a licensed physician stating: Child's name, birth date, medical condition that contrindicates vaccine, list of vaccines contrindicated, approximate time until condition resolves, if applicable, the physician's name and contact information.
            For religious exemption, please request a brochure to read about potential risks and possible exclusion during a disease occurrence.  You may request specific immunizations for exemption.

            Please sign and date all information to be updated for your student.  Contact me at 503-266-0033 for questions.
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