Health Office News!!! 

Cheryl DiLisio  RN, BSN, NCSN        Ann Hudson RN, BSN    
cdilisio@johnsonschool.org                          ahudson@johnsonschool.org                     
phone: 781-581-1600 x4
fax: 781-593-3937 (dedicated fax in Nurse's Office)

*Effective communication between the Health Office and parents is extremely important in order to help your child in the event of an illness or injury. You may leave a message any time (24/7) with any information we need to be aware of regarding your child. We will return your call as soon as possible. We are better able to care for your child if we have the specific information available to us. Also, please make sure the home phone, work and cell numbers on file are the most recent and up to date. Call the main office if any changes are made during the school year.

*Reporting an absence to the Main Office: 
Please call #781-581-1600 to report your child absent. All calls must be before 8:30 am each day your child will not be in school. You may leave a message if your child is sick or injured and the secretary will forward this to the Health Office. Please note your child's symptoms on the recording if they are ill with a fever or other contagious illness.  This will allow us to track multiple illnesses in a classroom or in a group of students and inform parents if a classroom is has a particular concern.
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We have 9 students at our school that have Life Threatening Allergies to Tree nuts, Peanuts, wheat, milk, eggs, and many other food items.  Strict avoidance of the allergen is the ONLY was to prevent a life threatening allergic reaction. **Please remember that ALL our classrooms are NUT FREE regardless of whether there is a student in that classroom/grade with a nut allergy. This includes products which state "may contain traces of" nuts/peanuts/tree nuts or "manufactured in a facility which processes" nuts/peanuts/tree nuts.  
Click HERE to read further details of the
Johnson School Life Threatening Allergy guidelines.

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Access forms or documents sent home via email HERE!!

Parent information/resources and Medical forms now available to download!- click to bring you to the bottom of the web page where you will find copies of medical forms, newsletters, and parent information/resources that are available for you to view at home. You may also download and print all forms to return to the Health Office. _________________________________________________________________________

Welcome Back!!  


September News...........       

Check out our website for the latest in Health Office news.  All important information and updates will be on our website and updated frequently.  Please refer to the website often!!

Let's stay healthy!!  Initial information from the Health Office at the beginning of each school year focuses on the importance of good hand washing to prevent the spread of disease and illness.   

Studies have shown that school absenteeism due to illness is reduced when children practice good hand washing.  Please teach, model, and encourage your child to wash their hands frequently and especially after coughing or sneezing, before and after meals, after using the bathroom, and after playing outside. Cover your mouth and nose with a tissue when you cough or sneeze!

Click HERE to read information on this website related to Classroom Infection Prevention!

Your child’s physician can help you determine if your child is able   to return to school, however it is important to make sure that they are truly feeling well and able to make it through 6+ hours of the school day. If they still seem tired, pale, with little appetite, not tolerating solid foods, and generally "not him/herself", please consider keeping them home from school.  Please read our guidelines to help you make that determination.

If your child still seems tired, pale, with little appetite, not tolerating solid foods, and generally "not him/herself", PLEASE do not send him/her to school.  Some viral illnesses may take longer before your child is well enough to return to school.


Classroom Infection Prevention guidelines:  Click HERE
24 Hour Rule of Thumb:  Click HERE 

Please be sure to call our absentee line when you child will not be coming to school (each day of the absence) by 8:30 am.  We also request that you report your child's symptoms if they are staying home with an illness on the absentee line.  This is very important to the Nurses as we can track illnesses in a particular grade or classroom and respond accordingly.  It is helpful for parents and teachers to be informed if there is a cluster of symptoms presenting in a particular group of students.  

We also encourage you to strongly consider keeping your child home if they appear to be ill.  By sending your child to school if you area concerned they are not feeling well, you are potentially exposing other students, and our staff, to a communicable illness.  This ripple effect exposes classmates and then their siblings and other family members to the illness. 


Health Screenings.......

State mandated screenings for Hearing, Vision, Height/Weight/BMI, and scoliosis will begin in October!! 

In October we will start with Hearing and Vision screening in our Kindergarten classroom and continue up through the grades.  We will then move on to the Height/Weight/BMI in only grades 1 & 4 and conclude with scoliosis in December for only Grades 5 & 6.  You will receive more information as we go along in regards to the BMI and scoliosis screening procedures. 


The Growth Screening Program is a mandated program of the MDPH for students in school in grade One and Four only.  In children and teens, the BMI is used as a tool to assess underweight, at risk,

and overweight children.  Children's bodies change over the years as they mature.  This is why BMI for children is gender and age specific and is plotted on a gender specific growth chart by pediatricians.  Children in Grades 1 & 4 will receive a letter from the Health Office with more information on Growth Screening and how it will occur in school.  You will also receive a document with Frequently Asked Questions (FAQ's) about Body Mass Index Screening.  

Click HERE to read the FAQ's of BMI 

Click HERE to read a Fact sheet provided by the MA Nutrition and Physical Activity Unit of MDPH




Grade 5 & 6 students will be participating in the annual Postural Screening for Scoliosis program.  This is a mandated program for students.  Students in these grades will receive a letter with information soon.  The program is scheduled for the week of December 8th during their gym class.  Details about the program and how to prepare will be in the letter to parents.

If you receive a referral letter as a result of the screenings, please contact your pediatrician and discuss scheduling a follow up exam as soon as possible. If you do not receive a referral letter, your child has passed the guidelines set by the Massachusetts Department of Public Health. 



Get Your Flu Shot!

Click HERE to bring you to the influenza updates on this webpage.  

Click HERE to visit the CDC's website for Influenza information and updates. 


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Other items.....

-Many students are coming to the Health Office requesting cough drops and "chap stick". While these measures are temporary, they can be helpful for some students. However, cough drops pose a risk for choking and should be given only when necessary to children in school.  Students must come to the Health Office if they are in need of a cough drop. You may send in your own variety or preference of cough drops/lozenges to be kept in the Health Office but students are NOT allowed to keep them with them during the school day to take with out supervision.  "Chap stick" is an item that students can carry in their backpack or keep in their locker to use as necessary throughout the day. Please consider providing your child with a tube of chap stick that they may apply as needed when appropriate during the school day.

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NEW Sharps Disposal Program in Nahant!! 

Do you have needles or sharps to dispose of and are unsure where and how to dispose of them properly??  Call the Nahant Town Hall for more information or stop by during town hall normal business hours and pick up a free sharps disposal container.  Once the container is full, just return it to Town Hall and they will dispose of it for you.  Call 781-581-0088 for more information.  




Physicals........

Grade 3 Students will receive a letter this week regarding the mandated physicals required for all students entering fourth grade next September.  The physical exam must be performed within the present school year.  Physicals dated Sept. 1, 2015 or after will be accepted for this requirement. 

Grade 4 students have received a letter to parents with information regarding the mandated Fourth Grade Physicals which were due before entering fourth grade this September.  The exams should have taken place during the 3rd grade school year or over the summer prior to entering grade 4. The letter was sent home with your child at the beginning of their third grade school year to have plenty of notice and time to collect the information requested. The physical exam should also have an updated immunization list submitted as well.

Pre-School students are required to submit the most recent physical exam. Remember to send a copy of your child's latest physical to the Health Office after each annual visit. When your child is ready for Kindergarten it will be a lot easier for you as the majority of the necessary forms will already be completed and turned in!

Classroom Infection Prevention Guidelines

The Johnson School staff realize there are times when it is in the best interest of your child to keep him/her home from school due to illness.  We must try to provide a healthy environment for all students and staff members in the school.  Young children are notoriously good at spreading germs. Parents know their children best and can help to determine if the child is well enough to remain in school for a 6+ hour school day.  Therefore, the goal of the sick child guidelines is to assist the parent/guardian with the decision to keep their child home from school due to illness or infection.  **A note from your physician may be required for your child to return to school if diagnosed with a contagious illness or hospitalized due to an illness. (ex. influenza, pneumonia)  Please check with the school nurse prior to returning to school if you have any questions. 

Your child’s physician can help you determine if your child is able to return to school, however it is important to make sure they are truly feeling better and able to make it through 6+ hours of the school day.   If they still seem tired, pale, with little appetite, not tolerating solid foods, and generally "not him/herself", PLEASE do not send them to school.  With viral illnesses it may take longer before your child is well enough to return to school.


Sick Child Guidelines

Students should not attend school if:

·      The student has a temperature. The student may return to school after having a normal temperature for at least 24 hours while not taking any fever reducing medications (ex. Tylenol or Motrin).

·      Antibiotics are prescribed. The student may return to school after taking the antibiotics for a minimum of 24 hours and without a temperature over 100 degrees F for at least 24 hours without taking any fever reducing medications.

·      They seem tired/lethargic, pale, with little appetite, and generally "not him/herself”.

·      The student is vomiting. The student may return to school approximately 24 hours after sym

ptoms resolve, and is able to tolerate a normal diet.

·      The student has diarrhea. The student may return to school approximately 24 hours aftersymptoms resolve, and is able to tolerate a normal diet.

·      The student is diagnosed with a communicable disease or illness.   (ex: Influenza, Pneumonia, Strep Throat, Conjunctivitis, Pertussis, head lice, Chicken pox (Varicella), impetigo, scabies).  Please contact your school nurse before sending your child back to school.  

·      The student has an undiagnosed rash.  A rash may be indicative of many things, frequently of illnesses that are contagious.  Therefore, a student will be excluded from school until a physician evaluates and determines the nature and contagiousness of the rash.  A note is required from the physician upon return to school.

·      The student has severe cold symptoms, upper respiratory infection, a persistent cough, a runny nose that they cannot manage by themselves &/or contain with tissues, or other symptoms that would interfere with effective school participation.



Remember the 24 Hour rule of thumb!  

Return to school guidelines


                                                   

Students may return to school after the following:

24 hours without temperature (and without taking fever reducing medications such as Tylenol or Advil/Motrin)

24 hours without nausea, vomiting, diarrhea (and tolerating a normal diet)

24 hours of receiving medication (such as antibiotics, eye ointments

If your child still seems tired, pale, with little appetite, not tolerating solid foods, and generally "not him/herself", PLEASE do not send him/her to school.  Some viral illnesses may take longer before your child is well enough to return to school.


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Food Allergies Guidelines

Please remember that all of our classrooms are NUT FREE regardless of whether there is a student in that classroom/grade with a nut allergy. 

We have 9 students at our school that are allergic to Nuts, Sunflower, Sesame and Poppy seeds, wheat, eggs, and many other food items.  St
rict avoidance of the allergen(s) is the ONLY was to prevent a life threatening allergic reaction. Due to the nature of peanut/nut products, it is more challenging to prevent contamination of surfaces in the classroom, cafeteria, bathrooms and other areas in the building. 

**
If the product states "may contain traces of nuts" or "manufactured in a facility which processes nut products", then those products would not be allowed in the classrooms as well. As an added safety measure, in the cafeteria students will be asked to sit at a designated table if their lunch contains any peanut/nut products. After eating, they will be given a moist towelette to remove any food particles from face and hands before leaving the cafeteria.  There are many new products available as "peanut butter alternatives", we would ask you to make sure the ingredients in these products are safe for our classrooms and for our students with life threatening allergies.   For example,  Sun butter products, which are made with sunflower seeds cause a concern for our students with allergies to them. The product contains no nuts, but still may not be appropriate for your child's classroom.  If your child brings in a peanut butter alternative for snack or lunch, you must label the outside of the bag to make our staff aware of the contentsIf it looks like peanut butter, we must treat it as peanut butter.  If you have any questions about ingredients, please call the Health Office and we can assist you.  

Click HERE to read the Nahant Public Schools- Life Threatening Allergy Planning Guidelines

Video to Teach Non-Food Allergic Families about Food Allergies
This 6 minute slideshow with audio is created to increase food allergy awareness in all parents in the school community. It highlights basic facts about food allergies and the constant need for prevention and preparedness. The presentation is designed to help foster an understanding and supportive community.

The awareness module for parents has options at completion, to learn more about prevention, preparedness, label reading, and how to give an EpiPen (you can get to these on the home page as well).
- The main site's link is:http://www.allergyhome.org/schools/

http://www.allergyhome.org is a great site to learn more about allergies, asthma, eczema and others

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Influenza, Measles and Meningococcal disease

Influenza

Here are several informative websites and sources. We hope they provide some guidance for you and your family during this flu season: 

Children, the flu, and the flu vaccine: a CDC guideline

MDPH flu information fact sheet with flu symptom checklist
MDPH back to school update for parents
CDC Flu guide for parents

Meningococcal Disease

At first, Meningococcal disease can look strikingly similar to a cold or flu, but in just a matter of hours it can be deadly.  Consider Vaccinating your child against Meningococcal Disease.   Read the commonly asked questions about the disease and find out more information.  Talk to your child's physician about the vaccination at your next visit.  

Measles Information:

{Information is obtained from the CDC website and literature distributed by the CDC, American Academy of Pediatrics and other medical sources}  

Link to CDC/AAP guidance handout for parents

Links to CDC website for measles information and symptoms

Link to CDC information for parents: "Measles and the Vaccine (shot) to Prevent it"

Measles is a highly contagious respiratory disease caused by a virus. It spreads through the air through coughing and sneezing. Measles starts with a fever, runny nose, cough, red and watery eyes (conjunctivitis), and a sore throat. It is followed by a rash that starts at the head and then spreads down over the rest of the body.  The fever can persist, reaching extremely high temperatures, the rash can last for up to a week, and the cough can last about 10 days.  About three out of 10 people who get measles will develop one or more complications including pneumonia. 1 to 3 out of every 1,000 children who get measles in a developed country like the US will die despite the best treatment. From 2001-2010, 1 out of 4 people in the US who got measles had to be hospitalized.  


The symptoms of measles generally appear about 7 to 14 days after a person is infected.  Two or three days after symptoms begin, tiny white spots (Koplik spots) may appear inside the mouth and on palate. Three to five days after symptoms begin, a rash breaks out. It usually begins as flat red spots that appear on the face at the hairline and spread downward to the neck, trunk, arms, legs, and feet. Small raised bumps may also appear on top of the flat red spots. The spots may become joined together as they spread from the head to the rest of the body. When the rash appears, a person’s fever may spike to more than 104° Fahrenheit.  After a few days, the fever subsides and the rash fades.  There is no drug to cure measles.

How Measles Spreads:

Measles spreads through the air by airborne respiratory droplets when an infected person coughs or sneezes. It is so contagious that if one person has it, 90% of the people around him or her will also become infected if they are not protected. Infected people can spread measles to others from 4 days before to 4 days after the rash appears. The virus remains viable for up to 2 hour on surfaces and in the air.  You can catch measles just by being in a room where a person with measles has been, even if the person has gone! 

People in the United States still get measles, but it's not very common. That's because most people in this country are protected against measles through vaccination once they reach 12 months of age. However, since measles is still common in parts of Europe, Asia, the Pacific, and Africa, measles is brought into the United States by people who get infected while they are abroad.
Vaccine Recommendations:

boy getting shot from nurse

Click here for CDC vaccination recommendations

The MMR (Measles, Mumps and Rubella) Vaccine is the best way to protect against getting measles.  The risk of the MMR vaccine causing serious side effects is very rare.   Getting the MMR vaccine is much safer than getting measles!!

The CDC recommends all children get two doses of MMR vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Children can receive the second dose earlier as long as it is at least 28 days after the first dose.  

Your child's doctor may offer the MMRV vaccine, a combination vaccine that protects against measles, mumps, rubella, and Varicella (chickenpox).

Frequently Asked Questions about Measles:

Q: How effective is the measles vaccine?

A: The measles vaccine is very effective. One dose of measles vaccine is about 93% effective at preventing measles if exposed to the virus and two doses is about 97% effective.

Q: Could I still get measles if I am fully vaccinated?

A: Very few people—about three out of 100—who get two doses of measles vaccine will still get measles if exposed to the virus. Experts aren’t sure why; it could be that their immune systems didn’t respond as well as they should have to the vaccine. But the good news is, fully vaccinated people who get measles are much more likely to have a milder illness, and they are also less likely to spread the disease to other people, including people who can’t get vaccinated because they are too young or have weakened immune systems.

Q: Do I ever need a booster vaccine?

A: No. People who received two doses of measles vaccine as children according to the U.S. vaccination schedule are considered protected for life and do not ever need a booster dose.

Adults need at least one dose of measles vaccine, unless they have evidence of immunity. Adults who are going to be in a setting that poses a high risk for measles transmission, including students at post-high school education institutions, healthcare personnel, and international travelers, should make sure they have had two doses separated by at least 28 days.  If you’re not sure whether you were vaccinated, talk with your doctor. 

Q: Am I protected against measles?

A: You are considered protected from measles if you have written documentation (records) showing at least one of the following:

  • You received two doses of measles-containing vaccine, and you are a(n)—
    • school-aged child (grades K-12)
    • adult who was not vaccinated as a child and will be in a setting that poses a high risk for measles transmission, including students at post-high school education institutions, healthcare personnel, and international travelers.
  • You received one dose of measles-containing vaccine, and you are a(n)—
    • preschool-aged child
    • adult who was not vaccinated as a child and will not be in a high-risk setting for measles transmission.
  • A laboratory confirmed that you had measles at some point in your life.
  • A laboratory confirmed that you are immune to measles.
  • You were born before 1957.

Q: What should I do if I’m unsure whether I’m immune to measles?

A: If you’re unsure whether you’re immune to measles, you should first try to find your vaccination records or documentation of measles immunity. If you do not have written documentation of measles immunity, you should get vaccinated with measles-mumps-rubella (MMR) vaccine. Another option is to have a doctor test your blood to determine whether you’re immune, but this option is likely to cost more and will take two doctor’s visits. There is no harm in getting another dose of MMR vaccine if you may already be immune to measles (or mumps or rubella).

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Head Lice

Unfortunately many children will have at least one case of lice detected in the classroom before the year is over. We at the Johnson school want to help keep your child and our classrooms free of head lice.  We suggest you read the information on the links below and discuss it with your entire family.  This will tell you how lice live and breed and how they spread.

READ School Health Matters "Facts of Lice"!!  

Click HERE to read Head Lice Parent letter 
National Association of School Nurses head lice fact sheet



CDC's report on Traumatic Brain Injuries 

Nonfatal Traumatic Brain Injuries Related to Sports and Recreation Activities Among Persons Aged 19 Years United States, 2001 2009, published in the October 7th issue of CDC s Morbidity and Mortality Weekly Report, shows that the number of sports- and recreation-related Traumatic Brain Injury (TBI) emergency department visits varied by age group and gender: 

  • 71.0 percent of all visits were among males 
  •  70.5 percent of visits were among persons aged 10-19 years 
  •  Children aged 0-9 years commonly sustained injuries during playground activities or while bicycling
Learn More
**To read more information regarding MDPH public health advisory on sports related head injuries, click HERE or scroll down to read the information previously updated on this site.
CDC's head injury fact sheet for parents
CDC's head injury fact sheet for athletes
CDC's parent and athlete quiz 
CDC's website link for concussion and traumatic brain injury

Massachusetts Department of Public Health- new law on sports related head injuries from August, 2010
Click to read the advisory and information related to traumatic brain injuries:
MDPH Advisory 
New law on sports related head injuries

Information about Free online courses required for parents or legal guardians of children who participate in any extracurricular athletic activity.  


Brain Injury Association of Massachusetts link to information and video for "Play Smart: Understanding Sports Concussion!


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Tick- Borne Illnesses and Lyme Disease

How can you protect yourself from Ticks?  Click HERE to find out!

Check out the CDC's website for valuable information about Ticks, Prevention and Tick-Borne illness.

Lyme Disease information

The University of Medicine and Dentistry of NJ has developed new educational tools to teach children how to avoid tick-borne diseases and reduce pesticide use. The free tools are posted at the Lyme Disease Association website.

What Is Lyme Disease?
Lyme disease is an infection caused by bacteria called Borrelia burgdorferi.
 
How is it transmitted?
The bacteria are transmitted to people and animals by the bite of an infected black-legged tick, Ixo des scapularis, commonly called the deer tick. Although other types of ticks and some insects have been shown tocarry the Lyme bacteria, to date, transmission of Lyme through those vectors has not been proven.
 
The bacteria can also be passed through the placenta of a pregnant woman to the fetus—congenital transmission.
 
The DNA of the bacteria has been found in breast milk, but no transmission has been proven to date in humans.
 
The Lyme bacteria have been proven to survive blood banking conditions; however, to date, no transmission has
been proven through blood transfusions in humans. Studies have shown transmission through this route in mice in the lab.
 
Check out the Lyme Disease Association's website for great resources and printable materials to educate yourself about Lyme disease and other Tick-Borne Illnesses.  

EEE and West Nile Virus

Residents Reminded to Be Vigilant about Protecting Themselves from Mosquitoes and EEE and West Nile Virus

All residents are urged to continue taking personal precautions to protect against mosquito-borne illnesses, including Eastern Equine Encephalitis (EEE) and West Nile virus (WNV). These include using insect repellent, covering exposed skin when outside, and avoiding outdoor activities between the hours of dusk and dawn, when mosquitoes are at their most active.

Peak times for mosquitoes are from dusk to dawn. Use mosquito repellent any time you are outdoors, but especially during peak times. And remember, being outside even a short time can be long enough to get a mosquito bite. If weather permits, wear long-sleeves, long pants and socks. Use mosquito netting on baby carriages or play yards when your baby is outdoors.

Keep mosquitoes out of your house by making sure screens are repaired and are tightly attached to doors and windows. And prevent mosquitoes from breeding by removing standing water around your house from places like wading pools, recycle bins, and flower pots. Mosquitoes can begin to grow in any puddle or standing water that lasts for more than four days.

Choosing an Effective Repellent

When choosing a repellent, look at the active ingredient on the product label. Repellents that contain DEET work very well against mosquitoes. In general, higher concentrations of DEET don't work better, they simply last longer. You should use less than 30 percent DEET on kids and infants over 2 months. Don’t use any DEET on infants less than 2 months old. Whatever product you choose, be sure to read the label to see what the concentration of DEET is and how often it should be reapplied.

There some other products that are proven to be effective against mosquitoes. They are permethrin, picaridin or IR3535. A number of "natural" products are available for use as mosquito repellents, but tests show that most of these products do not provide the same level of protection or work as long. The exception is oil of lemon eucalyptus, which provides as much protection as low concentrations of DEET.  (information courtesy of http://www.mass.gov/eohhs/gov/departments/dph/)

Learn more about how to protect yourself at www.mass.gov/dph/wnv

Click HERE to read Public Health Fact Sheet for EEE

Click HERE to read Public Health Fact Sheet for West Nile Virus



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Body Mass Index (BMI) resources

We know you have questions regarding BMI data and how it affects your child. Massachusetts Department of Public Health requires screening for Body Mass Index in schools in grades 1, 4 , 7 and 10, and it should be part of your child's annual exam.  Here are some related links to websites that discuss BMI and it's implications to your child's health.

CDC's BMI letter to parents

CDC's BMI Fact sheet for parents

BMI related links

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Medical Forms Available for Download

MDPH Physical Exam Form