Mrs. Black, School Nurse
732 681-5411 ext. 1101 - 732 681-5334 fax - Black@belmar.k12.nj.us
The Health Office at Belmar Elementary School services approximately 40 students a day following policies and procedures for the emergency care of the sick and injured. Required health screenings include height, weight and blood pressure annually on every student. Vision screening is required every other year for students in grades K-8. Auditory screening is required annually for students in kindergarten through grade three and in grade seven. Scoliosis screenings are performed on students 10 years old and up every two years. Referrals are made as needed. Other functions of the Health Office include health appraisals, health counseling, communicable disease prevention and control, and community service referrals.
The office is staffed by a school nurse licensed by the New Jersey Board of Nursing and certified according to the standard of the New Jersey Department of Education. Medical consultation is provided by the school physician.
Every year we receive reports of outbreaks of head lice in our community. The school can help by making you aware of these happenings so that preventive measures can be taken. It is important all parents understand that head lice infestation is not relegated to unclean homes and children. We ask the cooperation of parents that daily checks be made of their children’s hair to prevent an outbreak in our school. It is of the utmost importance that the school health office be notified if signs of head lice have been found.
WHAT DO HEAD LICE LOOK LIKE?
Head lice are difficult to see. They are tiny (like sesame seeds), wingless, bloodsucking insects that feed on the human scalp. They do not fly or jump, but crawl at high speed. The female lays small eggs (nits) which she glues to the root area of hair shafts with a sticky material. The nits are usually found at the back of the head or behind the ears and hatch in approximately ten days.
HOW CAN I TELL WHEN THEY ARE PRESENT?
A persistent itch is often the first sign, followed by infected scratch marks on the scalp, which may appear to be a rash. Close inspection of the root hairs towards the back of the head will reveal nits attached to the root areas of the hair shafts. Nits are tear drop shaped, white to brown or silver in color. Nits look like dandruff, but dandruff flakes can easily be flicked away with the fingers.
WHAT IS THE TREATMENT?
Please check with your physician for recommended treatment options. If over the counter products are recommended, follow instructions carefully. To insure a thorough job, wash your child’s clothes, bed sheets, combs and brushes; put toys and unwashables in plastic bags for at least two weeks; and vacuum. After treatment please bring your child to the health office before returning to class. Even if they have been treated the school nurse should be informed. All information is kept confidential.
A fact sheet from the New Jersey Department of Health regarding MRSA is attached. In addition, the following information is provided to help avoid incidents in our school community.
What can everyone do to help prevent the spread of staph infections?
1. Cover skin infections and all open wounds with clean bandages. Make sure your child wears clothing that covers the area.
2. If your child does have a skin infection or open wound, please notify the school nurse.
3. Encourage your children to wash their hands often with soap and water throughout the day.
4. Discourage children from sharing personal items.
5. Launder athletic uniforms and other athletic clothing in hot water and dry them in a hot dryer.
6. Sanitize athletic equipment after use.
What are we doing at school to help prevent the spread of staph infections?
1. If any staff member observes a child with an open wound, he or she will be referred to the nurse.
2. Encourage hand hygiene with soap and water before eating or after using the bathroom.
3. Clean and disinfect environmental surfaces.
STREP THROAT / SCARLET FEVER INFORMATION SHEET
GENERAL INFORMATION: Many human diseases are caused by a germ called streptococcus or strep for short. While there are many different varieties of strep, strep throat and scarlet fever are caused by the Group A Beta Hemolytic Streptococcus and its acronym is GABHS. This germ spreads among humans on saliva and other oral secretions which enter the air in droplet form and invade through the nose or throat. It can also be spread on the hands if they are not washed properly.
THE ILLNESS - STREP THROAT: When the germ invades the throat of a susceptible person, the most common location of the infection is the tonsils, or in a child without tonsils, the back of the throat. Initial symptoms are high fever and sore throat, usually beginning 2-4 days after contact. It is most common in school age children. The degree of illness varies from mild to severe. A child may have low fever, 101-102, for a day or two, recover spontaneously and suffer no complications. Another child may have 104-105, be severely ill, and suffer serious complications. In addition to fever and sore throat, there is loss of appetite, difficulty swallowing, drowsiness, nausea and vomiting. Examination of the child reveals large, bright red tonsils, usually covered with a purulent (pus) exudate. Pin-head-size red spots (tiny hemorrhages) may be seen surrounding the tonsils and extending onto the palate. The lymph nodes in the neck are often swollen and tender.
THE ILLNESS - SCARLET FEVER: This condition represents an individual hypersensitivity to the toxins secreted by the GABHS and occurs in a relatively small percentage of children with strep throat. It begins on the same day as does the strep throat or a day or two later. It consists of a fine pin-point rash that feels like “goose flesh” on an area of bright, red skin. It begins on the body. The rash fades on pressure. It lasts 2-7 days, depending on the severity of the disease, and is followed by peeling of the skin (fine flakes to large sheets). The tongue may become slightly swollen, red , and mottled (“strawberry tongue”) and may also peel. The disease can be suspected by the appearance of the throat plus the remainder of the symptoms but the only sure way to confirm the diagnosis is by throat culture. Results are known in 12-24 hours. Rapid-Strep Tests have been developed which can be read in one to two hours. If the test is positive, one can reliably assume the sore throat is due to GABHS. Negative rapid-strep tests are only 60-75% accurate, so there is a possibility for error.
COMPLICATIONS: The primary GABHS infection is almost always self-limited and most children get well in 3-7 days. Without treatment, however, two to three weeks later, a small number of children develop serious complications, the most feared of which are acute rheumatic fever and acute glomerulonephritis. Some patients develop a streptococcal toxic-shock syndrome: high fever, low blood-pressure, collapse and coma. This complication has a high mortality rate.
TREATMENT OF CONTACTS: The majority of children with strep throat/scarlet fever respond well to penicillin. To prevent complications, it must be given for 10 days if oral penicillin is used. For children allergic to penicillin, erythromycin for 10 days is usually prescribed. In rare cases, other antibiotics may be necessary. It is usually not necessary to treat contacts unless an epidemic is in progress (this is usually defined as 2-3 cases within 5-7 days). Should this occur, the family physician and the school consulting physician should be notified. Household contacts would be more likely to require preventive antibiotic therapy than would school contacts.
STREP CARRIERS: A small percentage of children carry the GABHS in their throat but are not clinically sick. These children rarely spread the disease to others and most pediatricians feel they are not in any danger of developing complications. Therefore, it is not necessary for these children to receive antibiotics.
RETURN TO SCHOOL: Following initiation of treatment, it usually takes about 36-48 hours for the throat culture to revert to negative. Therefore, children sent home from school on Tuesday who go to the doctor that afternoon to receive an antibiotic, should not return until Thursday or Friday, even though they feel well by Wednesday.
School Health Mandates
The Department of Health and Senior Services revised the administrative rules regarding two immunizations that affect students in Pre-K and two immunizations that affect 6th graders. Pre-K students upon entry into school must have at least one dose of the pneumococcal vaccine and a dose of the influenza vaccine given between September 1 and December 31. Students entering 6th grade must have one dose of Tdap given no earlier than the 10th birthday and one dose of the meningococcal vaccine. Immunization requirements for school attendance in New Jersey may be clicked on below for your review.
In order for a child to start kindergarten he/she must have four DPT (Diptheria Pertussis Tetanus) vaccines (the last dose given on or after the 4th birthday or any five doses), three Polio vaccines (the last dose given on or after the 4th birthday), two MMR (Measles Mumps Rubella) vaccines, three Hepatitis B vaccines and one Varicella vaccine. Also, a physical examination on the school physical form is required by your medical care provider, if an exam was not done for PreK. In addition to the pneumococcal and influenza vaccines required for Pre-K students, 4 doses of DPT, 3 doses of polio, 1 dose MMR and 1 dose Hib (Haemophilis B) are needed for Pre-K admission.
The state requires that notification be given to parents / guardians of the importance of obtaining subsequent medical examinations of the students at least one time during each developmental stage. It is recommended that an exam be performed during early childhood (preschool through grade three), preadolescence (grades four through six), and adolescence (grades seven through twelve). All physical examinations must be done in the medical home of the student.