ALL SUMMER, experts have been warning of a likely surge in cases of H1N1 after schools and colleges reconvene. So far, there have been outbreaks of varying sizes, most notably in two schools in Cavan. In one about 17 children have fallen ill with the suspected virus. In the other, at least one case was confirmed when about 20 students presented with flu-like symptoms.
But overall, the first few days of school have not led to a significant change in the rate of infection in the community.
Meanwhile, the Department of Education has been working through the summer with the HSE, the Department of Health and Children and management unions to prepare for pandemic H1N1, according to Brian Brogan, who briefed the session.
But how do you stop a virus spreading like wildfire through Irish classrooms, particularly as we have one of the largest average primary school class sizes – 24.5 – in the OECD?
Good hand hygiene is recognised as an important factor in reducing the spread of the virus from person to person, but it has to be done properly, according to Dr David McCleery, chief specialist microbiologist with safefood.
“For proper cleaning there are actually two stages to it. One is to remove any organic matter or dirt, and then there’s the actual sanitising after that,” he explains.
“So if you have very soiled hands, if you have been handling something greasy or you have been out in the garden and you are covered in mud, and you then use these sanitisers they may not be effective because of the organic matter.”
But where hands are relatively unsoiled, alcohol or isopropanol-based sanitisers that kill bugs and viruses by drying them out are an option where circumstances dictate that you can’t access running water immediately, notes McCleery, who recommends that users follow the instructions on hand sanitisers for appropriate use.
But how that pans out on the ground can vary from school to school.
Parents have approached The Irish Timeswith concerns about being asked to put alcohol-based hand sanitisers into the bags of children as young as four and five, despite warnings on many packs to keep the bottles away from children and to ensure that sanitiser use by young children is supervised.
And in general, where hand hygiene measures are concerned, schools have been left to make it up as they go along, according to the Irish National Teachers’ Organisation (INTO), although those principals who contact the HSE are being told to trust soap and water. There’s no official objection to hand sanitisers, but they have not been officially recommended either, according to Peter Mullan of the INTO.
Speaking at last weekend’s annual general meeting of the National Parents Council, Dr Anna Clarke of the HSE told parents that washing hands with running water and soap was the most effective way of limiting the spread of infection in schools.
“Dr Clarke was not recommending hand sanitisers as an alternative to proper handwashing, and warned, in fact, that children might be tempted to use the product instead of proper hygiene,” says Aine Lynch of the National Parents Council.
“The parents at the conference were very reassured by that. Dr Clarke suggested soap, running water and a separate towel for each child. Hand sanitisers could be used for day trips or other situations where running water is not available.”
Despite this, many schools are investing in hand sanitisers, and they are not cheap. Principal Peter Darcy of St Mary’s Boys’ National School is prepared to spend the money, but use of the product is carefully monitored.
“Each teacher has been supplied with one for use in the classroom. We have been forewarned by our suppliers about overuse. For one thing, there’s a very strong smell of alcohol off them. You wouldn’t want to be pulled over by the gardaí on your way home from school!
“This is a boys’ school and you couldn’t leave the dispenser in the bathroom or at the doors – they’d be too tempted to mess about with the dispensers. Also, they’re expensive – about €6 a bottle, and we’re using one a week per class.”
Karen Dowling of Adept cleaning provides hand sanitisers to schools in the midlands and she issues extensive information to her clients about safe use of the product.
“This is a chemical, and you can never be too careful with chemicals. I tell all schools that the use of hand sanitisers should be monitored. They contain alcohol and while you would need to ingest a lot to have an adverse effect, you still have to take care. They can also damage polished floors if left to drip from wall dispensers.”
Principal Anne McCabe of Redeemers Girls School in Drogheda has chosen not to use hand sanitisers in her school; partly because of cost considerations, but chiefly because of advice she has received from the HSE.
“We’re looking at putting one hand sanitiser at the entrance for visitors, but for the kids it’s just plain soap and cold water – we have no hot running water at the school.
“Some children are bringing in their own sanitiser pumps, but the advice I’m getting from the HSE is that hand sanitisers are no substitute for thorough hand washing so we don’t encourage them, in case children think they can use the sanitiser instead of the sink,”McCabe says.
Rediscovering the art of good handwashing
One of the silver linings of the current H1N1 pandemic could be a step up in general hand hygiene, according to Dr David McCleery from safefood, who explains the correct way to lather up and remove dirt and germs.
“A good clean is under running water, with soap creating a lather all over surfaces of the hands and, in particular, between the fingers and the thumb – it takes around 20 seconds, or singing happy birthday twice – but how many people do that? It’s usually a quick splash and dash.”
And the normal principles still apply for when to wash your hands in the pandemic, he adds. “After using a toilet, before eating food, after touching something infectious, for example if you sneeze into a tissue you are supposed to dispose of the tissue and wash your hands afterwards.”
To school or not to school
Only a week after the children go back to school after two months free of sneezes and sniffles, despite the weather, two of my children wake up with streaming noses.
I normally take a laid-back approach to children and illness. If they feel up to playing, they are up to going to school. If they are up to arguing with their siblings over the remote control, I know they’re up to the play in the school yard.
However, with the school taking quite a robust approach to its swine flu prevention, I doubt my normal nursing standards. With all three children armed with hand sanitisers, personal hand towels and tissues at the behest of the school, I do not want to be the parent who sends a sniffling child into this sanitary building. Will the child be sent home? Will I be the parent who didn’t care enough? The one who put all other pupils and teachers at risk of infection?
So I take the easy option. I keep them at home, with their sniffles, their sneezes and their lack of hygiene (they are children after all), for four long days. They are well enough to be bored, well enough to fight, and well enough to do their mother’s head in. But, I thought, at least I am not the talk of the town.
Then to my horror, I realise the rumours have already begun – my children have swine flu. Sure why else would they be out of school for four days? Nuala Storey