(UPDATE) New A (H1N1) response guidelines for schools out
abs-cbnNEWS.com | 06/25/2009 5:22 PM
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MANILA - The Department of Health (DOH) on Thursday released a revised set of guidelines for schools to follow as a response to the spread of influenza A (H1N1).
The DOH released Interim Guidelines No. 18 dated June 24, or the Revised Response Level Guide for Schools, "with the information that as of June 19, 2009 several confirmed cases of influenza A (H1N1) had been found in a few schools in Metro Manila and in a few provinces."
Under the revised guidelines, the criteria for Response Level 3 is: a school has a confirmed case of influenza A (H1N1) and there is yet no confirmed community-level transmission of the virus.
The response steps under this Response Level 3 would be that school officials can temporarily suspend classes and lift it after ten days.
Under this response level, the principal or school head declares class suspensions, either for the whole school or only for those buildings, areas, or sections affected by the illness.
If two or more schools in one city or municipality have confirmed A (H1N1) cases, the division superintendent declares suspension of classes in affected schools, or depending on the location of the schools affected, in the entire city or municipality.
For colleges and universities, the school head declares class suspensions, either selectively or for the whole school.
No suspension under Response Level 4
Meanwhile, the additional criteria to implement Response Level 4 is: there is confirmed comunity-level transmission in the area around the school.
The revised guidelines mandate that there would be no class suspensions, except when there are "unusually severe illness or clinical manifestations" or if there are large numbers of simultaneously ill students and/or school staff."
The school head can also decide to temporarily close down a school based on the severity or manifestations of influenza A (H1N1) illness among students or the local population, the number of people simultaneously ill, and on the recommendation of the DOH or regional Center for Health Development.
Also under Response Level 4, "reverse isolation" will also occur, meaning students and school employees residing in areas without community-level transmission should be advised not to report" to the affected school until the number of influenza-like illnesses in the school or area around the school has subsided. If they are still to go to school, they will be required to wear face masks.
Rationale for revised rules
The DOH said that class suspensions are to be done as part of containment measures to limit exposure to index case or case clusters.
Suspensions are also to be done to allow school officials to plan and institute an intensified campaign in the school and community for health and hygiene awareness, and for school sanitation and decontamination measures.
Suspensions should also allow schools to coordinate with local health officials and the DOH regional Centers for Health Development, who would then document and report "clinical manifestations and progress" and investigate the source and extent of transmission of the illness.
The DOH also said that class suspensions are lifted after ten calendar days after the diagnosis of the first confirmed case "as a rule."
The health department has ruled out extending suspensions once additional cases are reported in the same group of students or staff, since the "likelihood that transmission has occurred prior to the occurrence of symptoms and laboratory testing is high."
In this case, the focus should be on individual patient care, and only the patients should be sent home for quarantine and/or be sent to a health facility.
Extent of suspension in schools
The health department also said that calling off classes under Response Level 3 should be based on the physical configuration of school buildings and the section or class assignments of the patients.
School officials can call off classes only in selected buildings, units, or sections where the cases have been reported, to avoid disruption of classes especially when other units or sections of the school have no confirmed A (H1N1) cases.
The schools should also have a contingency plan of action to "minimize both the spread of infection and the disruption of classes," which include special arrangements for students on home quarantine or reverse isolation so that they could catch up on lessons. Kris Danielle Suarez, abs-cbnNEWS.com
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