UFT fact sheet on Ebola for schools with students who may have recently traveled to West Africa
With the first reports of confirmed Ebola cases in Dallas, the specter has risen of a possible epidemic.
But we should not panic. Chances are there will never be an Ebola epidemic in the United States. Despite the ongoing bumbling of how Ebola cases and healthcare worker protections have been handled in Dallas, the risk of contracting Ebola remains extremely low for U.S. citizens. The chances of transmission in a school setting are even lower.
Understanding some basic facts about Ebola is the first step to protecting students and staff in the event Ebola comes to New York City.
Ebola viral disease
Ebola viral disease (EVD) was first reported in 1976 in Africa. Since then, there have been small outbreaks, usually in rural areas. The current Ebola outbreak is the largest in history. EVD is considered a hemorrhagic (bleeding) fever disease because victims experience high fevers and often external bleeding.
The early symptoms of Ebola often make it difficult to diagnose. Once someone is infected, the virus may incubate for two to 21 days with no symptoms. Early symptoms include high fever - usually over 101 degrees Fahrenheit, chills, muscle aches and fatigue. As the disease progresses, victims often develop a rash over their torso, abdominal tenderness and diarrhea. Some experience kidney and liver failure, profuse bleeding from the mouth and gastrointestinal tract and severe neurological symptoms. Patients usually endure a two-week course of painful symptoms. If they survive, they generally have no long-term health effects associated with the infection and have lifetime immunity to the disease.
There is currently no specific anti-viral therapy for Ebola. However, several new therapies and a vaccine are now being tested. If these clinical tests are successful, the Centers for Diseases Control and Prevention (CDC) and the World Health Organization plan to have all of these available by early 2015 for West African patients and any others in need.
Routes of transmission and risk of infection
A person is at risk of infection if he or she comes into direct contact with the blood or bodily fluids of a person who is both infected and showing symptoms. Most Ebola victims were exposed because they cared for loved ones at home or were healthcare workers whose protective equipment and gear were inadequate. According to the CDC, the virus is not transmitted through the air or water.
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How schools with West African populations should prepare
The UFT believes that schools with large populations of West African students should put in place additional precautions that are based on CDC guidance for travelers who have been to West Africa within the last 21 days. Every child with a fever of 100.4 degrees Fahrenheit or higher should be evaluated to determine whether, within the past 21 days, the child traveled to or from a high-impact area in West Africa or had contact with someone with a confirmed or suspected case of Ebola. If a student meets these criteria, arrangements should be made with the city health department to transport that person to the appropriate healthcare facility.
Most important is that the precautions below are exercised without stigmatizing students.
The UFT recommends, among other things, that:Â
All students at designated schools should have their temperatures taken every day as they enter the school for the duration of the Ebola crisis. The city should provide necessary equipment for taking temperatures rapidly, and school nurses should train staff how to take temperatures quickly and efficiently. If necessary, additional staff should be deployed to these schools to assist in these daily checks.
Any student with a temperature above 100.4 degrees Fahrenheit should be isolated immediately for further assessment by the school nurse.
The nurses’ assessment should follow the city health department’s triage guidelines.
Classroom staff − paraprofessionals and teachers − should be given additional training and guidance on how to recognize signs and symptoms so that children with fever or other symptoms are immediately referred to the nurse.
Chances are that most students with high temperatures in these schools will be found to have a communicable disease other than Ebola. This is one of the added benefits to the approach of identifying students with elevated temperatures early and isolating them from the school community. If these procedures are followed, we may reduce the risk for all students of contracting influenza, enterovirus 68 or another highly communicable disease.
What other precautions should be in place in schools?
Practicing standard universal precautions against the spread of infection is the most effective method to protect students and staff. Since the Occupational Safety and Health Administration (OSHA) promulgated its bloodborne pathogens standard, most school districts have adopted these universal precautions. Now is the time to reinforce their use in schools. In summary, these precautions include:
1. Frequent hand-washing and use of alcohol-based hand sanitizers when hand-washing is not feasible.
2. Equipping all staff – including school bus drivers, school nurses, teachers, paraprofessionals, custodians and office personnel − with gloves and other protective clothing that can be used to prevent exposure to blood and bodily fluids.
3. Maintaining puncture-proof needle-disposal boxes in the nurse’s office.
4. Having a strict protocol that includes the judicious use of disinfectants and sanitizers for cleanups of blood and bodily fluids.
All staff at schools with students from West Africa should be trained on this terrible disease so that they may be sensitive to the emotional and social toll of Ebola on students and parents. Reducing fear and anxiety will be a high priority if the goal is to keep everyone safe while minimizing any unnecessary school disruptions.
For further information, see the New York City Department of Health and Mental Hygiene’s resource page on Ebola