Health Guidelines

We will promptly attempt to notify you or a person you have authorized us to notify if we have knowledge that your child has been injured at school. One of the forms we ask you to complete at the beginning of each school year is a form authorizing designated school employees to consent to medical treatment in case your child is injured or becomes ill at school or school–related activities and requires emergency treatment. We, of course, will call you in such a situation and will also call for emergency assistance. It is important, however, that you understand that the school district is not responsible for any cost of medical treatment or services provided after an injury at school or a school related activity.

Because your child may have a medical condition that requires extra attention/care from school personnel, it is important the parent/guardian visit with the school nurse on the student’s campus. The school nurse will then inform others of care as needed. Up-to-date addresses and telephone numbers are imperative to the school as emergency care can arise at any time during school hours.

The following items may be applied to your child if needed:  Petroleum Jelly (for chapped lips) or saline drops/eye wash (for irritated eyes).  Please inform your campus nurse if you do not want these items applied to your child.

The wheelchairs/crutches in the campus clinics are for emergency use only and designed for transport, not daily use.  If your student requires temporary use of crutches or a wheelchair, they must be provided by the parent with a physician’s note, these mobility devices will not be provided by the clinic. 

By following the above guidelines, we hope to provide a healthy environment for everyone in the school community.

Meningitis Information for Students & Parents from the Texas Department of State Health Services

Screening

Students shall be screened by the school nurse or other school official with consideration for privacy and confidentiality. When a student is suspected of having head lice or the teacher notices excessive head scratching, the school nurse or other school official shall inspect the child. At our elementary campuses, if live lice are found, the school nurse or other school official shall check the student's siblings and all known household contacts on the same campus. A parent can call and request that their student be checked; however, a parent cannot request that another student be checked. 

Mass screenings are disruptive and initiate unnecessary use of lice medication that can cause resistance. SAISD will not conduct mass screenings.

Exclusion

Live Lice: Students with live lice will be sent home for treatment. Once treatment is completed, the student may return to school.

Nits: In alignment with recommendations from the American Academy of Pediatrics and Centers for Disease Control, students identified with nits will not be sent home early or removed from class/school. Students with nits may go home at the end of the school day to be treated. Parents may elect to pick up their student from school early to begin treatment. Nits may stay in hair after treatment, but successful treatment will kill crawling lice.

Treatment & Prevention

After each treatment, the CDC recommends that parents check their child’s hair and remove nits and lice every 2 – 3 days for the next 2 – 3 weeks. You do not need to remove nits when treating with spinosad topical suspension.

We recommend that parents use FDA-approved medicated treatment for lice, follow CDC treatment recommendations or DSHS treatment recommendations (see fact sheets below), and/or seek out treatment options from their child’s medical provider.

SAISD partners with Shannon Medical Center for our School Telemedicine Program. This program is available to all SAISD students (fees may apply) and is a quick as well as a convenient way to seek medical advice for your student should they have lice. More information about the School Telemedicine Program can be found, HERE.

The school nurse may ask campus custodial to ensure they vacuum or sweep carpets, furniture and curtains to pick up any live lice or nits that may have fallen or crawled there. The school nurse should also provide education to teaching staff about prevention measures such as teaching students not to share their personal items (e.g. brushes, jackets, hats, headphones) and separating personal items (e.g. backpacks, jackets, hats, headphones), as feasible.

Parent Notification

Letters shall be sent to the parents of students with active infestations within 48 hours as required by SB 1566. Also, as required by SB 1566, notification will be sent to the parents of Elementary students in the same class as the child with lice no later than five (5) days after the date on which the school official or nurse, as applicable, determines or becomes aware of the fact. Notices will include recommendations of the CDC for treatment and prevention of lice.

DSHS Lice Fact Sheets

What are Lice/¿Qué son los piojos? (English/Español)
What Should I Do If My Child Has Lice/¿Qué debo hacer si creo que mi hijo tiene piojos en la cabeza? (English/Español)
How Do I Keep Lice From Coming Back/¿Cómo evito que vuelvan los piojos? (English/Español)
Misconceptions and Truths about Lice Treatment/Mitos, ideas erróneas y verdades sobre el tratamiento de los piojos de la cabeza (English/Español)
Lice Resources/Recursos sobre los piojos de la cabeza (English/Español)

Bed bugs are becoming a common problem that significantly impacts our general quality of life, but they are not known to transmit disease.  The home of any person can be infested by bed bugs, regardless of ethnic background, type of home, or socio-economic status.  As this problem escalates, although rare, bed bugs may become an issue in our schools because they may “hitch-hike” on a student’s clothing, books, or backpack from an infested home.  It is important that if this happens, the school takes proactive actions to prevent infestation and stop them from spreading within the school setting.  The following are GUIDELINES that have been gathered and organized from public health agencies and academic institutions throughout the United States. 

What are bed bugs?

Bed bugs are small insects that feed on people while they sleep.  Bed bugs do not live on a person.  Bed bugs usually hide during the day and come out to feed during the night.  Adult bed bugs have flat, rusty-red-colored oval bodies, are about the size of an apple seed, big enough to be easily seen, but often hide in cracks in furniture, floors, or walls.

A bed bug bite may develop into an itchy welt that is similar to a mosquito bite.  Bed bug bites do not transmit disease, but their bites are a nuisance and can cause significant itchiness, secondary infections, anxiety, and sleeplessness.  Infestations are also very difficult and expensive to control.  They can also be transmitted from one location to another in backpacks, clothing, luggage, books, and other items. Bed bugs are rarely transported into a house by pets.

Actual bed bug infestations in schools are uncommon and it is necessary that the bug be identified as a bed bug which should be done by a pest management professional. These bed bugs could be carried home by another student which can be a major concern to the school – bed bugs are very difficult and expensive to eradicate.

School closure related to bed bugs is not recommended.

What if you find a bed bug on a student (Student is the source)?

If you find a bed bug on a student, this may be an indication that the student has bed bugs in his/her home.  DON’T PANIC. Remember, people do not become infested with bed bugs, bed bugs feed on people. Bed bugs can crawl on or off a person or their belongings at any time.

Identification

Any bed bugs found on a student or their belongings should be removed and collected for identification. Initial identification should be arranged through the Maintenance Department any repeated findings of bed bugs do not need to be identified by maintenance, so long as the same bug type is found. Try to keep specimens as intact as possible in a jar or baggie. Please do not attach them to tape. Do not allow untrained staff to identify bugs or apply pesticides on school property.

*Parents will be notified only after the bug has been confirmed to be a bed bug by maintenance. 

Treatment of Affected Area

• If the bug is confirmed to be a bed bug, the maintenance department will determine treatment of the affected area (i.e. classroom, office). Preventative treatment residual lasts approximately 2 months. The Maintenance Department will not spray the same area, preventatively, more frequently than every 2 months for bed bugs found on a student’s person or belongings. 
• Notify school custodial staff to vacuum the affected area during the end of the day cleaning routine. Place that vacuum bag into a plastic bag/garbage bag and tightly seal for disposal (for bag less vacuums, empty the contents of vacuum into a plastic bag/garbage bag and tightly seal for disposal.  Clean the vacuum. This practice should remain in place until it is felt that campus exposure has been limited. 
• If the student has siblings, the campus administrator or the campus nurse of the school reporting should notify the coordinator of health services. The coordinator of health services will contact the campus nurse of the sibling, as well as, maintenance.

How do we limit exposure while the student is at school?

It is not recommended to exclude students from school for an infestation in the home. It is important to treat the student with discretion, dignity, and respect when addressing  this issue.

• After the bed bug is confirmed by the maintenance department, the campus nurse or school service worker/at-risk coordinator will notify the student’s parent/guardian by telephone to let them know a bug was found on the student’s belongings. SAISD protocol to limit exposure will be reviewed. A recommendation will also be made for a home inspection by a licensed professional. 
• Parents may be embarrassed and hesitant to admit having bed bugs and students may also be embarrassed and not want others to know.  Students may come to school tired, anxious, or afraid because of this problem. Discretion in handling this situation is strongly recommended. Schools should work sensitively with parents of any student living in an infested home to develop strategies for preventing the further spread of bed bugs.
• After speaking with the student’s parent/guardian, remove the student discreetly from the classroom and examine their clothes and belongings. Store their personal items in a garbage bag or sealed plastic bin until the student leaves the school. If the student’s clothing has been affected, it is recommended that a new set of clothing is provided to the student. Clothing should be placed in a  sealable bag (e.g. Ziplock). If a dryer is available, the student’s clothing can be run through the dryer for 20-30 minutes on high heat. Before going home the student should change back into their clothing. These measures  may need to be done daily until the home infestation is resolved.

Providing Education

• Provide education to the parent/guardian of students who have suspected infestations of the home information on the treatment of the bites, control of the infestation, and the need to use professional exterminator service in the home.
• Provide instruction on actions parents can take to reduce the spread of bed bugs to the school environment. This includes:  
  • Laundering items worn outside the home first with dry heat for 20-30 minutes followed by washing in hot water and drying again in high heat. 
  • Storing freshly washed clothing and other items taken daily to school in a sealed plastic bin or sealable bag (e.g. Ziplock) until the student needs to take them outside the home. These items should be inspected daily. 
  • Routine cleaning of all hard surfaces with normal cleaning solutions.

Transportation (Student source, only)

After the bug has been confirmed as a bed bug by maintenance, the campus administrator or school nurse should notify transportation that a student who rides the bus was found to have bed bugs on their person. Transportation has internal processes for treatment of the affected bus. 

After initial bed bug identification and for any repeated findings, if a student is unable to get a new set of clothing or their clothing is unable to be run through a dryer, transportation should be made aware so they can make appropriate arrangements for transportation. Any clothing or belongings that need to be transported should be in a sealed plastic bin or sealable bag (e.g. Ziplock), if unable to do this, the parent should be asked to pick up student belongings. 

What if you find a bed bug in the classroom (School is the source)?

Identification

Identification should be arranged through the Maintenance Department. Try to keep specimens as intact as possible in a jar or baggie. Please do not attach them to tape. Do not allow untrained staff to identify bugs or apply pesticides on school property. Maintenance will determine treatment of affected areas. 

In the affected area

• Any backpacks, lunchboxes, and other items that go back and forth to school can also be inspected daily and sealed in plastic containers to prevent bed bugs from getting into them.
• Hard surfaces will  be cleaned with standard cleaning products.
• Notify the school custodian staff to vacuum the affected area during the end of the day cleaning routine. Place that vacuum bag into a plastic bag/garbage bag and tightly seal for disposal (for bag less vacuums, empty the contents of vacuum into a plastic bag/garbage bag and tightly seal for disposal. Clean the vacuum.
• The school principal should consider notifying the affected class or classes.  Please contact the Director of Schools and the coordinator of health services before sending out the letter.  

Information and resources gathered from

The Centers for Disease Control and Prevention (www.cdc.gov)
Environmental Protection agency (EPA) (http://www.epa.gov/bedbugs/)
Texas Department of State Health Services
Indiana State Department of Health
University of Kentucky (http://www.ca.uky.edu/entomology/entfacts/ef636.asp)
New York City Department of Health and Mental Health (www.nyc.gov/html/doh/html/vector/vector-faq1.shtml)
 

What You Need to Know About Staph/MRSA Skin Infections

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MRSA in Schools

Answers to commonly asked questions about MRSA skin infections in schools (from the U.S. Department of Education).

MRSA in Schools

Most people have heard of terms like “staph infection,” “antibiotic resistant bacteria,” and “MRSA” (pronounced mersa).  Staphylococcal bacteria often referred to as “staph” are commonly occurring bacteria found on the skin and in the noses of all people.  Most staphylococcal species never cause infection.  However, when infection does occur due to staph, Staphylococcus aureus—one of these species of staph—is usually the cause.  While all people have some staphylococcus species on their skin and in their noses, only one in every three or four people have S. aureus.  Even if they have S. aureus on their skin or in their noses, most people are not ill.  These people who have bacteria but are not ill are called “carriers”.  S. aureus carriers do not have staph infections.

When staph does cause infections, it may cause minor skin or soft tissue infections, such as boils or impetigo, which occur spontaneously without an obvious source of infection.  Persons with staph skin infections may complain of an “infected pimple,” “an insect bite,” “spiders bite,” or “a sore.”  Many staph infections cause minor redness and swelling without pain, and infected persons may not seek medical attention.  However, staph infections can cause more serious, sometimes deadly, infections such as abscesses, pneumonia, and soft tissue (wound) and bloodstream infections.  Staph can also cause food borne illness in persons who eat food contaminated with the bacteria.

“MRSA” stands for methicillin resistant S. aureus.  Initially, MRSA strains were resistant to the antibiotic methicillin, a form of penicillin.  Now they are resistant to many antibiotics and are sometimes called “multi-resistant” S. aureus.  MRSA is not the only antibiotic resistant bacteria.  Initially, infection with MRSA was associated with exposure to health care environments, such as hospitals.  However, other MRSA strains have evolved that affect previously healthy persons who have not had contact with health care facilities.  MRSA causes the same types of infections as S. aureus that is not resistant to methicillin; however, MRSA may be more difficult to treat and can be rapidly fatal.

We cannot eliminate staph because it is everywhere. However, because staph is everywhere and has the potential to cause infection, everyone—not just health care workers—must be involved in prevention.

Staph can be transmitted by infected persons and by carriers.  Factors that appear to be related to transmitting staph from one person to another or making a person more susceptible to infection include:

1. Poor hygiene, especially lack of hand washing
2. Close physical contact or crowded conditions
3. Sharing personal products
4. Contaminated laundry items
5. Shaving
6. Lancing (puncturing, picking, piercing) boils with fingernails or tweezers
7. Activities that result in burns, cuts, or abrasions or require sharing equipment
8. Intravenous drug use, unsanitary tattoos, and body piercing
9. Inadequate access to proper medical care

All information contained in this article as well as more detailed information is available at the Texas Department of State Health Services website at www.mrsaTexas.org.

Information about Vaping from the Texas Department of State Health Services

What is Zika?

Zika is a virus spread to people through mosquito bites and sexual contact with an infected person. The most common symptoms of Zika are: fever, rash, joint pain, and conjunctivitis (red eyes).

Prevent mosquito transmission by getting rid of standing water on your property, mowing the grass, and using window screens. If you are planning on spending time outdoors, wear long pants and sleeves when possible and use insect repellent. Please see below fact sheets and websites for more information and travel guidance.

Zika Resources

Zika Fact Sheet
How to Protect Against Mosquito Bites
How to Prevent Mosquitos / Cómo Prevenir Mosquitos
www.cdc.gov/zika
www.texaszika.org