Parents seek better communication about swine flu from schools

Erik Potter

With the swine flu making a fall comeback in Massachusetts and a vaccine still largely unavailable, Regina Gabriel was getting nervous.

A mother of three, she has one son with severe asthma and another, 7-year-old Stephen, with a recently diagnosed bronchial condition.

She heard that a classmate of Stephen’s had been diagnosed with swine flu, an illness experts say strikes more severely among children and those with certain medical conditions.

With the stakes high, Gabriel said she wanted to be informed right away if there had been a confirmed case of swine flu in her son’s school.

Trouble is, unless it is a severe case, doctors no longer identify which sub-type of flu is present in a patient — whether it is swine flu or another of the Type A varieties of flu.

And even if the identifying test is done, a swine flu case is not technically confirmed until it has been tested by the state laboratory, which hadn’t happened yet at the West Bridgewater school.

“The guidelines are that we treat the H1N1 just like the seasonal flu, and we don’t report individual cases of seasonal flu,” Patricia Oakley, the West Bridgewater school superintendent, said.

The West Bridgewater situation illustrates the conflict growing between parents hungry for swine flu information from their children’s school and district officials following internal guidelines for handling suspected cases among their students.

“I think parents are right to be concerned,” said Dr. Larry Madoff, director of the Division of Epidemiology and Immunization at the state Department of Public Health. “Kids have died (from the swine flu), even kids without underlying medical conditions.”

The swine flu — officially called 2009 H1N1 influenza — is a certified pandemic, striking tens of thousands of people across the country.

However, the odds of being hospitalized by the illness are less than one in a thousand, and the odds of dying are even smaller than that, according to Madoff.

“This flu does not appear to be any more severe than the seasonal flu we see every year, but it’s completely understandable and rational for a parent to be worried that their kid can be sick,” he said.

In the West Bridgewater case, Gabriel’s son Stephen is a student at the Rose MacDonald Elementary School. Gabriel learned that her friend’s son, who is a classmate of Stephen, was diagnosed with the swine flu by a pediatrician last Monday.

His mother reported it to the school and on Monday night, superintendent Oakley sent an e-mail to parents informing them that it is flu season and they should keep their children home if they are experiencing any flu symptoms. The e-mail did not specifically say there was a case of swine flu at the school.

“Until our health department gets a confirmed case from a state lab, I don’t have anything in writing that these cases are confirmed,” Oakley said.

That doesn’t satisfy parents searching for more definitive information so they help protect their children.

“I think if the swine flu is as dangerous as they say it is, I needed information, and I didn’t get it,” said Gabriel, who decided to keep Stephen home from school as a precaution.

“I just think they should have called us as parents and told us that there were children tested positive with the swine (flu) ... and let me make the decision” of whether to keep my son home or not, she said.

The superintendent stressed that the school is following all of the government guidelines and that she sent the memo to parents as a precaution to remind parents of the importance of flu prevention techniques.

Unlike the seasonal flu, H1N1 disproportionately affects young people.

The latest numbers from the federal Centers for Disease Control and Prevention put the total number of pediatric deaths from swine flu at 129 nationwide, as of Friday.

Seventy-three of those have occurred since Aug. 30 (though none of those have been in New England), and 15 during the week of Oct. 25-31, the most recent period for which data is available.

Getting the flu vaccine can be a matter of ‘luck’

Madoff, of the state Department of Public Health, said the state has distributed about 600,000 doses of swine flu vaccine.

There are several different varieties of the vaccine, some designed for adults, some for children, others for pregnant women. The state tries to target the type of dose to the appropriate population — children’s doses to pediatric centers, doses for pregnant women to gynecology centers, etc.

Without knowing every local situation, Madoff said, who gets the vaccine and when can be random chance.

“It could be luck of the draw,” he said. “We’re trying also to spread it around geographically so no one region of the state or one small group of communities get it and others don’t.”

Easton, for example, has 200 doses of the vaccine to distribute. It’s not enough to do a full public flu clinic with, so it is targeting them to an at-risk population, children in preschool through second grade.

The town board of health made private appointments by phone to administer the vaccine rather than turn away a crowd of people at a publicized distribution site.

“As we get more of the vaccine, we’ll be able to expand that and move that up through the grades,” said Easton School Superintendent Michael Green.

Some schools hold clinics, others await vaccine

East Bridgewater schools don’t have any vaccine yet, but are making plans to hold in-school flu clinics for students at the high school and middle school when vaccine becomes available.

West Bridgewater’s public health department is waiting to see how much it will receive of the 1,500 doses the town requested. Health Agent Robert Casper said the department is in talks with the school district to hold a community flu clinic at one of the schools when the vaccine arrives, probably next month.

Gordon Luciano, a School Committee member for the Bridgewater-Raynham district, wants to hold weekend flu clinics on-site for all the school-age children in the two towns.

Brockton officials disagreed over the best way to dispense the vaccine.

The Enterprise reported Friday that Brockton School Superintendent Matthew Malone had not taken the advice of the city’s public health director about the process for vaccinating students against H1N1 influenza, ordering the vaccinations to be done outside of school hours.

Louis Tartaglia, executive director of the city Board of Health, strongly recommended the vaccines be given during school hours, saying this would result in the highest level of participation.

Malone decided that the vaccinations will be performed outside of school hours, starting Friday for preschool students.

The Enterprise

By the numbers

Deaths among children:

- 129:  Total number of pediatric deaths from swine flu nationwide as of Friday, according to the federal Centers for Disease Control and Prevention.

- 73:  Deaths that have occurred since Aug. 30 (though none of those have been in New England), and 15 during the week of Oct. 25-31, the most recent  figures available.