June 2011
To all schools, early child care centres and Kohanga reo
Re: Gastroenteritis, Influenza-like illnesses, Measles, Sore throats - Group A Streptococcal infection, Meningococcal disease
THIS IS A REMINDER TO ALL SCHOOLS AND THEIR STUDENTS PARENTS AND CARERS
Winter is the season for many cold and flu-like illnesses, stomach bugs (gastroenteritis), in particular Norovirus. In New Zealand this year we have also seen several outbreaks of measles in Auckland and Hawkes Bay.
All these illness are spread in similar ways and the prevention messages are the same
- Wash your hands
- Cover your mouth when you cough (cough and sneeze etiquette)
- Carry out regular cleaning of all surfaces.
Stomach bugs (Gastro-intestinal illnesses)
Winter sees a peak of stomach bugs; especially those caused by viruses. Children should be kept from school if they have vomiting and/or diarrhoea and should not return until they are well and have had at least 24 hours of no diarrhoea and/or vomiting. These bugs are spread via hands to mouths. They can remain on surfaces such as door handles and thus regular cleaning is encouraged. Please encourage hand washing before preparing food, eating meals and after visiting the toilet.
If the school has two or more cases associated with a specific room or year group, they are encouraged to discuss this with Population Health, who has guidelines available for institutions regarding outbreaks of gastro-intestinal illnesses, and their management.
Influenza-like illness
Winter is the time for coughs, colds and influenza like illnesses. Most of these are caused by viruses or bacteria which are spread via droplets by someone coughing and sneezing into their hand not washing it and passing it to someone else's hand or a surface which then becomes contaminated. Those individuals who now have the virus on their hands can easily rub their eyes or put their hand in their mouths, without thinking, and thus transfer the virus to themselves. Therefore regular cleaning in schools is encouraged at this time. It is also recommended that children practice good cough and sneeze etiquette and hand hygiene.
Sore throats
Sore throats can be caused by a number of bacteria or viruses. When a sore throat is caused by Group A Streptococcal bacteria, if untreated, it can cause Rheumatic Fever – a serious disease that attacks the heart. All sore throats need to be seen by a doctor or nurse, and particularly if the child is in a high risk group for rheumatic fever, swabbed, and if positive for Group A Strep, treated with a ten day course of antibiotics. If this is done, Rheumatic Fever can be prevented.
Group A Strep is spread by droplets from someone coughing and sneezing. Good hand hygiene and covering ones mouth when coughing and sneezing is important to prevent the spread of Group A Strep. Sore throats matter – get them checked!
Measles
Over the last year there have been several outbreaks of measles in New Zealand, with cases continuing to be identified in Auckland and Hawkes Bay. There are also many countries worldwide currently experiencing outbreaks of measles. Unfortunately, many of the primary sources of such outbreaks are unvaccinated people travelling from abroad. Many subsequent cases here in New Zealand have occurred in unvaccinated children and young adults.
Symptoms include fever, runny nose, cough, loss of appetite, and conjunctivitis. White spots may also occur in the mouth. After 3 to 5 days a rash appears at the hairline, moves to the face and upper neck, then moves down the body and usually lasts 4-6 days. The rash is not itchy. The infectious period for measles is the four days prior to the rash appearing and then a further four days after the onset of the rash.
Measles is highly contagious and each case is likely to infect a further 12-18 non immune persons. Should your child show these symptoms it is crucial that seek medical advice and contact your doctor by phone first so as not to risk further spread by sitting in a waiting area.
The only preventative measure against measles is to ensure that your child/children are up to date with their MMR vaccinations available from your family GP practice.
Meningococcal disease
Even with the number of cases of MeNZB decreasing, there will be cases of meningococcal disease in the Waikato. It is assumed that without the large number of MeNZB cases, Waikato will still see approximately six to 10 cases of meningococcal disease a year.
We would like to take this opportunity to remind you of the signs and symptoms of the disease. Meningitis and septicaemia (blood poisoning) are not always easy to recognise, and symptoms can appear in any order. Some may not appear at all. In the early stages, the signs and symptoms can be similar to many other more common illnesses, for example flu.
Trust your instincts. If you suspect meningitis or septicaemia, get medical help immediately.
Early symptoms can include fever, headache, photophobia (not able to look at light), nausea (feeling sick), vomiting (being sick), a rash and muscle pain, with cold hands and feet.
A rash that does not fade under pressure can be a sign of meningococcal septicaemia. This rash may begin as a few small spots anywhere on the body and can spread quickly to look like fresh bruises. The spots or rash are caused by blood leaking into the tissues under the skin. They are more difficult to see on darker skin, so look on paler areas of the skin and inside the lower eyelid. The spots or rash may fade at first, so keep checking.
However, if someone is ill or is obviously getting worse, do not wait for spots or a rash to appear. They may appear late or may not appear at all.
If your child is unwell and you are in doubt please seek medical advice.
If you require any further information regarding the above please either contact your Public Health Nurse or Population Health.
Thank you for your time.
Kind regards,
Dr Anita Bell
Medical Officer of Health
Population Health, Waikato DHB
Ph: 07 838 2569