Dear ODNS Parent or Guardian: 

During the coming year, more people than usual in our communities are likely to be getting sick with influenza. In addition to the “seasonal” influenza every fall, Minnesotans are already getting ill from the novel H1N1 influenza (“swine flu”) that first appeared last spring. Novel H1N1 influenza never completely went away over the summer, so the flu season has started early this year.  Right now, H1N1 still seems to be acting like seasonal influenza in terms of how sick it makes people and how it is spread. Most people who have had novel H1N1 flu have gotten better without complications. However, like any flu virus, novel H1N1 can be a serious disease. Some people have been hospitalized with novel H1N1, and several deaths have occurred from it in Minnesota.

People at high risk for complications from influenza (including seasonal and novel H1N1 influenza) are children under 5 years of (especially those under age 2 ), people with underlying medical conditions (such as heart, lung or kidney disease, asthma, diabetes, neurological or neuromuscular disorders, or a suppressed immune system), pregnant women, and people over age 65.     

 [Although your child may be school-aged, please note that all children in the program should follow the below steps to protect the young children in our childcare or early childhood education program.] 

Influenza spreads when a person with the flu coughs or sneezes. You can help us prevent the spread of influenza by taking the following important steps:     

1. Vaccinate your child.  The Minnesota Department of Health recommends vaccinating all children older than 6 months against seasonal influenza. Because children younger than 6 months can not be vaccinated against influenza, it is important that anyone caring for children in this age group receive the vaccine.

A separate vaccination will be needed for novel H1N1 influenza. The vaccine is likely to be available in late September or October. Initial target groups for H1N1 vaccination are pregnant women, people who live with or care for children younger than 6 months of age, people age 6 months to 24 years, people 25 through 64 years of age with chronic health disorders or weakened immune systems, and health care providers. It is likely that two doses of H1N1 vaccine will be needed, given several weeks apart.

2. Keep your child home if they have symptoms of the flu. That means a fever of 100 degrees Fahrenheit or greater, with cough and/or a sore throat.  You should check your child for these symptoms each morning before sending them to childcare or the early childhood education program (you may wish to use the attached screening form to help you). Children who have these symptoms will be sent home. Other symptoms that may occur with influenza include runny nose, headache, body aches, and, sometimes with novel H1N1 influenza, vomiting and diarrhea.    

3. Sick children should stay home for 7 days after their symptoms started or 24 hours after their acute symptoms are gone, which ever is longer. Children should not come back to childcare or the early childhood program until they are well enough to participate in activities. Children should stay home and avoid contact with others except to get medical care. Do not use aspirin or aspirin-containing products when your child has influenza symptoms.  

Some additional important points: 

 o        The exclusion period for children in childcare and early childhood is longer than the period used for school-aged children.  Because most children in childcare and early childhood programs are high risk (less than 5 years old), young children are known to shed influenza longer than adults, young children have difficulty washing their hands and covering their coughs, and influenza can spread efficiently through childcare and early childhood programs. MDH believed a longer exclusion period was prudent.

o          Children need to stay home for 7 days after their symptoms started or 24 hours after their symptoms are gone (which ever is longer) even if they are on antiviral drugs such as Tamiflu (oseltamivir) or have had a flu test that is negative. Flu tests are not always accurate.

o          When you contact us to say that your child will be out sick, please let us know they have influenza-like illness (flu symptoms). This will help us know the amount of flu activity in the childcare/early childhood program and protect the other children.   

o          Children can spread influenza before symptoms begin and may still be able to spread the illness when returning to the childcare or early childhood program. To avoid spreading the virus, it is very important that they wash their hands frequently, and cover coughs and sneezes with a sleeve or tissue.

o          Plan ahead of time for the care of your child for at least 7 days in case your child develops flu symptoms.          

4. Promptly pick up your child if he/she develops symptoms of influenza. We will check your child for illness when they arrive and will also monitor children for illness during the day.  Ill children will be sent home. If your child develops symptoms of influenza, they will be separated from other children. You will be contacted and we ask that you promptly pick up your child.

5. Teach your child to clean their hands often, with soap and water or an alcohol-based hand rub. They will need to use soap and water if their hands are soiled. We will remind them to clean their hands regularly during the day. This is very important for every one. 

6. Teach your child to cover coughs and sneezes. Although this is difficult for young children, they should use a tissue when one is available, but they can also cough or sneeze into an elbow or arm. Hands should not be used to cover a cough or sneeze.

7. Teach your child to avoid sharing personal items. That includes items like drinks, food, sippy cups, or eating utensils.

    8.  If your child is at high risk for complications from influenza, you should plan to take some additional precautions.      This includes all children younger than 5 years old and children with chronic health problems like asthma, diabetes, heart or lung disease, metabolic conditions, and neurologic and neuromuscular disorders. If you are not sure whether your child is at higher risk, please check with a doctor.

 If your child is at high risk: 

o          Talk to your doctor now to develop a plan that meets your child’s individual health needs.

o          Contact your doctor immediately if your child develops influenza symptoms. If your child needs antiviral drugs, they should be started within two days of symptoms for the best response.

o          Contact your doctor to see whether antiviral drugs are needed if your child has had close contact with others who have influenza symptoms.

o          If someone else in your household is at high risk for complications from influenza, their doctor should be consulted to discuss a plan for what to do if they have close contact with someone with influenza symptoms or develop influenza symptoms. 

9. Learn how to care for a person with flu symptoms at home and when to seek medical attention. Check the CDC and MDH websites: 

o          http://www.cdc.gov/h1n1flu/guidance_homecare.htm 

o    http://www.health.state.mn.us/divs/idepc/diseases/flu/h1n1/basics/care 

If novel H1N1 influenza begins causing more severe disease, some of the recommendations in this letter may change. We will keep you informed if any additional steps become necessary.   

For more information, visit the Minnesota Department of Health website at www.mdhflu.com or the federal flu website at www.flu.gov.  If you have questions about our childcare/early childhood education program policy please feel free to contact me. 

Sincerely,
Barb Howe
ODNS Director

-Barb, Grace, Sue, Bonnie & Maggie

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Click Here for a Symptom Screening Tool for Parents and Providers

Click Here for Parent Fact Sheet for children in a Child Care Program