Few studies have examined pandemic response in schools so when St. Louis University (SLU) researchers evaluated school disaster response capability, with a focus on bioterrorism and disease outbreaks, they were surprised at the lack of pandemic preparedness by education institutions.
The study, led by Terri Rebmann, Ph.D., associate professor at St. Louis University’s Institute for Biosecurity, found that schools are less prepared for a biological event or pandemic than they are a natural disaster. The study also found that among schools that did have a disaster plan, almost half didn’t include coordination with state or local agencies.
“We were putting this [study] together at the end of the H1N1 pandemic so we expected that to have raised awareness within the schools of the importance of planning for these events,” Rebmann said in a phone interview on Monday. After 2009’s H1N1 pandemic killed 18,000 people worldwide some schools created pandemic plans. Most didn’t.
The study surveyed 2000 nurses at elementary, middle, and high schools in 26 states. Less than half of schools reported having a plan to address biological events or updating their existing plan in response to the H1N1 pandemic. Only 4 percent of schools reported using an infectious disease scenario in a school disaster exercise.
“We assumed they would have updated it in response to the H1N1 pandemic and that was not the case for a large number of schools,” she said. “I sort of perceive that as a lost opportunity and I think that was a little surprising.”
Less than half of schools, 44 percent, said they participated in any kind of community disease surveillance programs.
Disease surveillance activities coordinated by local and state public health officials can help detect widespread illness faster. School-based surveillance can be a valuable asset to these early-detection programs by tracking numbers of absences or students reporting flu-like or gastrointestinal (GI) symptoms -- the type of symptoms which en masse are indicative of a probable outbreak.
“For a lot of infectious diseases, kids are often disproportionally affected, especially children that have underlying illnesses like diabetes or asthma. They tend to be the first to get sick with a new emerging infectious disease or even influenza,” Rebmann said. A sudden spike in severe influenza-like illness in children with asthma can be an indication of something spreading through the community.
Only 48 percent of schools surveyed report cases of flu-like illness. Only 20 percent report GI illnesses.
The study says schools should update response plans annually and address gaps in infectious disease emergency planning.
"Health care professionals can best inform school administrators about unique aspects of pandemic planning that need to be included in school disaster plans," Rebmann said in a press release distributed on Monday.
"Results from this study indicate that better prepared schools were ones that involved their nurses in the disaster planning committee. The school nurse is the best person in a school district to know about infection control and be able to make recommendations about the best interventions to implement during a biological event."