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Ref: Local PA nurse working with officials for pandemic preparedness

Post Gazette

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District nurse working with state to plan for pandemic, other crises

Thursday, April 12, 2007

By Angela Hayes, Pittsburgh Post-Gazette
Darcy Yeloushan handles any ailment from scraped knees to high fevers as a nurse for East Allegheny School District, but she knows in the future she might have to deal with more serious illnesses. While the school practices evacuation plans for possible fires and chemical spills, authorities have never addressed flu pandemic preparedness.

That is why Ms. Yeloushan is working with school, community and state officials to develop an emergency response plan should a flu pandemic develop.

The action plan is part of a statewide call for schools to work with their communities and create an effective response in the event of a flu crisis, namely avian flu. East Allegheny, Quaker Valley and other local school districts are heeding the call. "I don't think we are really at risk right now. We're just following all their rules," Ms. Yeloushan said about working in conjunction with the Pennsylvania Department of Health.

Ms. Yeloushan is trying to cover all bases of preparedness, from delegating tasks within the staff to contacting grief counselors who would help the students cope in the event of a crisis. She even wrote a sample letter to be sent out to the parents of 950 students so she would have them "all in line and ready to go," she said.

"I'm very proactive in getting things done early. I don't like to scramble," she said.

"Students aren't just going to get sick, it's going to be everybody," she said.

Schools would play a key role in flu pandemic response, because the buildings might be used by the state to house patients and as sites to administer mass medication if hospitals were full.

School buildings also would provide a large space if the state called for a quarantine to prevent avian flu from spreading. Even school buses might be used in the event of emergency.

Tom Mangan, Emergency Preparedness and Response manager for Allegheny County, urges schools to take an "all hazards approach" when designing their preparedness plan, so it can be used if other types of crises hit.

"Everything is within the realm of possibility," he said, alluding to natural disasters, terrorist attacks, bomb threats and other situations that would disrupt the school community. "You have to think about everything and anything that could happen."

Mr. Mangan said it's important for the school and community to work together in a coordinated fashion when faced with emergency situations. He said in the event of a flu pandemic, school nurses would be helpful in recognizing symptoms among children, tracking cases and reporting them to the health department.

If a pandemic occurred, symptoms might be seen in children sooner than adults; another reason to implement a plan for school districts, Mr. Mangan said.

But Ms. Yeloushan said sometimes it is hard to recognize a "true flu," let alone the avian flu. School nurses are further hampered by regulations that limit them to tracking symptoms and prohibit them from making diagnoses.

Ms. Yeloushan learned about the signs for avian flu when she attended a tabletop discussion Mr. Mangan led to educate school representatives about flu pandemic preparedness.

The discussion addressed the four issues in dealing with a flu pandemic -- recognition, containment, treatment and recovery. But with no vaccine to prevent avian flu and no medication to fully combat it, the third issue remains unsolvable.

"I think this is a building concern," Mr. Mangan said.

Mr. Mangan showed video clips of simulated live newscasts reporting outbreaks of avian flu to emphasize the reality of a potential pandemic. For Ms. Yeloushan, this drove home the urgency.

So far, the avian flu, called H5N1, is in phase three on a World Health Organization scale of six. That means there is no or very limited human to human transmission. So far, the only human cases have been reported in Asia and Africa.

But health officials warn that the virus could spread to the United States. They also warn that if the virus mutated by mixing with a common, or garden variety, flu, the resulting new virus could be transferred by human to human contact. This would elevate the flu pandemic stage above phase three and call for emergency response.

Tom Foster, director of support services for Quaker Valley School District, also attended Mr. Mangan's discussion on pandemic flu. As a result, the district is in the process of preparing a "pandemic flu 101" pamphlet outlining the potential severity of an avian flu outbreak.

Mr. Foster said he will meet with community officials monthly until they develop an emergency preparedness policy. Mr. Foster said the school district is still in the beginning stages of drafting its plan.

"When and if this hits, we'll have plans in place for what we do," he said. "These kinds of things -- you don't like to talk about them, but you have to be aware of them," Mr. Foster said.

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