Microbiological failure? UK school forces teachers to shake hands with pupils to help kids feel respected

Trevor Noah of The Daily Show rarely shakes hands with guests or correspondants.

He’s big into the fist-bump.

Maybe Schaffner can design a study to figure out which is microbiologically safer.

It’d be another pop-culture hit.

Maybe someone has done it.

Whatever, the  handshaking policy introduced by a new principal has led to panic among staff and parents.

Some teachers at Tunbridge Wells Grammar School for Boys, southeast of London, are now arming themselves with hand sanitiser amid fears that shaking hands up to 150 times a day may cause them to pick up germs.

Principal Amanda Simpson is standing by her decision, which sees teachers shaking hands with every member of their class before each lesson.

One parent told local news website Kent Live that she was worried about the consequences of the mandatory handshaking.

“It will be interesting to see what happens if there’s an outbreak of Norovirus,” she said.

“I assume it was introduced because the new head wanted to introduce some element of respect – but I wouldn’t think that sort of thing would make any difference.”

Ms Simpson believes that starting every lesson “with a handshake and a smile” makes children feel welcome and appreciated.

She confirmed that hand sanitiser was available throughout the school for anyone worried about the spread of germs.

Check if there’s paper towels in the kids’ bathrooms: Evidence-based interventions of Norovirus outbreaks in China

In resource-limited settings where laboratory capacity is limited and response strategy is non-specific, delayed or inappropriate intervention against outbreaks of Norovirus (NoV) are common. Here we report interventions of two norovirus outbreaks, which highlight the importance of evidence-based modeling and assessment to identify infection sources and formulate effective response strategies.

norovirus-bathroomMethods

Spatiotemporal scanning, mathematical and random walk modeling predicted the modes of transmission in the two incidents, which were supported by laboratory results and intervention outcomes.

Results

Simulation results indicated that contaminated water was 14 to 500 fold more infectious than infected individuals. Asymptomatic individuals were not effective transmitters. School closure for up to a week still could not contain the outbreak unless the duration was extended to 10 or more days. The total attack rates (TARs) for waterborne NoV outbreaks reported in China (n = 3, median = 4.37) were significantly (p < 0.05) lower than worldwide (n = 14, median = 41.34). The low TARs are likely due to the high number of the affected population.

Conclusions

We found that school closure alone could not contain Norovirus outbreaks. Overlooked personal hygiene may serve as a hotbed for infectious disease transmission. Our results reveal that evidence-based investigations can facilitate timely interventions of Norovirus transmission.

BioMed Central Public Health

Tianmu Chen, Haogao Gu, Ross Ka-Kit Leung, Ruchun Liu, Qiuping Chen, Ying Wu and Yaman Li

DOI: 10.1186/s12889-016-3716-3

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3716-3

Norovirus? Look to the barf

We investigated an outbreak of norovirus that affected students and teachers of a high school in Lleida, Spain through various transmission mechanisms.

norovirus-2A case-control epidemiological study of the risk of disease and the relative importance of each mode of transmission was carried out. Cases and controls were selected from a systematic sample of students and teachers present at the school on 28 January. Fecal samples were taken from three food handlers and 16 cases. The influence of each factor was studied using the adjusted odds ratio (aOR) and the estimated population attributable risk (ePAR) with 95% confidence intervals (CI). We interviewed 210 people (42 cases, 168 controls). The proportion of symptoms in these individuals was nausea 78·6%, vomiting 59·5%, diarrhoea 45·2%, and fever 19·0%. The epidemic curve showed transmission for at least 4 days. The risk of disease was associated with exposure to food (aOR 5·8) in 66·1% of cases and vomit (aOR 4·7) in 24·8% of cases. aecal samples from 11 patients and two food handlers were positive for norovirus GII.12 g.

Vomit may co-exist with other modes of transmission in norovirus outbreaks and could explain a large number of cases.

Norovirus gastroenteritis outbreak transmitted by food and vomit in a high school

Epidemiology and Infection / Volume 144 / Issue 09 / July 2016, pp 1951-1958Copyright © Cambridge University Press 2016  DOI: http://dx.doi.org/10.1017/S0950268815003283 (About DOI), Published online: 13 January 2016

Godoy, M. Alsedà, R. Bartolomé, D. Clavería, I. Módol, P. Bach, G. Mirada And À. Domínguez

http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=10346522&utm_source=Issue_Alert&utm_medium=RSS&utm_campaign=HYG

When it’s not the potato salad, it’s the ham

I used to eat a lot of ham sandwiches. It was the only lunch meat I’d take to school from about age 8 until I finished high school.

It’s still my preferred quick-service deli sandwich meat.

And we bake one at home a couple of times a year, making one large enough to have a few days of leftovers.

Photo Courtesy- National Pork Board

Ham can be risky though. In 1997 Neil Young missed a bunch of shows after cutting his finger while making a ham sandwich.

According to a paper by Huedo and colleagues in Food Pathogens and Disease, a couple of years ago over 40 Italian school kids got sick with salmonellosis linked to ham.

A multischool outbreak of salmonellosis caused by Salmonella enterica serovar Napoli was investigated in the province of Milan from October to November 2014, following an increase in school absenteeism coinciding with two positive cases. Epidemiological studies detected 47 cases in four primary schools: 46 children and 1 adult woman (51.4% males and 48.6% females, median age 8.9). From these, 14 cases (29.8%) were severe and resulted in hospitalization, including 6 children (12.8%) who developed an invasive salmonellosis. The epidemic curve revealed an abnormally long incubation period, peaking 1 week after the first confirmed case. Twenty-five available isolates were typed by pulsed-field gel electrophoresis showing an identical pattern. The isolate belongs to ST474, an ST composed exclusively of Salmonella Napoli human strains isolated in France and Italy. Antibiotic resistance analysis showed resistance to aminoglycosides, correlating with the presence of the aminoglycoside resistance gene aadA25 in its genome. Trace-back investigations strongly suggested contaminated ham as the most likely food vehicle, which was delivered by a common food center on 21 October. Nevertheless, this ingredient could not be retrospectively investigated since it was no longer available at the repository. This represents the largest Salmonella Napoli outbreak ever reported in Italy and provides a unique scenario for studying the outcome of salmonellosis caused by this emerging and potentially invasive nontyphoidal serotype.

Teach children to spot spoiled food?

In the same way that dying cancer patients in the UK are being held responsible for telling their doctors to wash their damn hands, Malaysian schoolchildren are being told they are the critical-controlpoint for school meals.

Sharvin A. Subramaniam told The Star Online, “It is also important

roti canai, school lunch, kuala lumpur, malaysia

roti canai, school lunch, kuala lumpur, malaysia

for parents and teachers to learn and teach students on food safety, especially on how to spot spoiled food that may cause food poisoning. This includes using your senses (sight, smell and taste) to determine whether the food is still good to be eaten.

“We should avoid food that has a slimy appearance, foul smell or tastes stale. These simple steps are easy to practise and must be taught to students.”

And often entirely useless.

100s sickened: Noro in water source of outbreak at Chinese school

In late 2014, a gastroenteritis outbreak occurred in a school in Shandong Province, eastern China. Hundreds of individuals developed the symptoms of diarrhea and vomiting.

norovirus-2Epidemiological investigation showed that food consumption was not linked to this outbreak, and unboiled direct drinking water was identified as the independent risk factor with a relative risk of 1·37 (95% confidence interval 1·03–1·83). Furthermore, examination of common bacterial and viral gastroenteritis pathogens was conducted on different specimens. Norovirus GI.1, GI.2, GI.6, GII.4, GII.6 and GII.13 were detected in clinical specimens and a water sample. GII.4 sequences between clinical specimens and the water sample displayed a close relationship and belonged to GII.4 variant Sydney 2012.

 These results indicate that direct drinking water contaminated by norovirus was responsible for this gastroenteritis outbreak. This study enriches our knowledge of waterborne norovirus outbreaks in China, and presents valuable prevention and control practices for policy-makers. In future, strengthened surveillance and supervision of direct drinking-water systems is needed.

A waterborne norovirus gastroenteritis outbreak in a school, eastern China

Epidemiology and Infection, 144, pp 1212-1219

Zhou, H. Zhang, X. Lin, P. Hou, S. Wang, Z. Tao, Z. Bi and A. Xu

http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=10250463&utm_source=Issue_Alert&utm_medium=RSS&utm_campaign=HYG

Over 300 ill with noro at UK school

Sick kids can spread gastrointestinal viruses around pretty quickly. I write from experience, my kids have brought home what was likely norovirus a couple of times from school/preschool and spread it to Dani and I.

10849902_719581291471357_3442145704847569295_n1-300x3001-300x300Once the perfect human pathogen is in a restaurant, grocery store, or cruise ship – or school – it’s tough to get it out without some illnesses.

According to the Courier, a school in the UK, Langlands Primary, has over 300 kids ill as the virus runs through the population

A council spokeswoman previously said: “Parents and carers are advised to keep unwell children at home until they are clear of the virus for 48 hours … The school remains open and senior staff will be teaching affected classes.”

The spokesman added: “The school is working with the local environmental health service to investigate the cause of this illness. We have arranged for additional cleaning to be carried out to reduce the risk of any further infection.”

Parents told The Courier they felt the school should have been shut to contain the outbreak.

Nada Wilson-Bruce said: “My son has it… really wish they would shut the school. He has been very poorly since the early hours of this morning and has been vomiting blood (he has had medical attention).

“Both of my children will stay off until I am convinced the outbreak has diminished.”

Jennifer Clark Mitchell added: “My son isn’t displaying any symptoms, but given the large outbreak he won’t be back until after Christmas.

“The school needs to be properly deep cleaned with strong disinfectant and remain closed for a couple of days to ensure all bugs have died.”

Part of the problem with noro (beyond the low mean infectious dose; environmental stability; and, 10^9 virus particles per gram of vomit/poop) is a vomit event can lead to particles floating through the air. And maybe moving 30 feet from the barf splatter.

 

‘We strongly advise you not to Google search ‘Hepatitis A’ as you may access inaccurate and possibly worrying information.’

I play hockey with a bunch of technology nerds and last night’s post game dressing room chatter included a discussion on recalled emails. Instead of the intended message of ‘oh, I made a mistake, don’t read that last one,’ it leads to increased attention and urgency in reading the recalled message to see what the sender didn’t want you to see.

Sort of like telling someone not to Google something likely leads to that person immediately Googling it.yorkshire-puddings

That’s what a school in the UK did in an effort to reduce panic after 20 cases of hepatitis A was identified in a couple of schools, according to the Yorkshire Evening Post.

An outbreak of Hepatitis A in two Leeds schools has seen national health chiefs offer mass vaccinations in the LS9 area.

Public Health England (PHE) stepped in after around 20 cases of the rare virus were confirmed in the area, sparking a vaccination program that will impact thousands of school staff and residents.

The YEP understands that the 630-pupil Richmond Hill Primary School, in Clark Lane, and 460-pupil Brownhill Primary Academy, in Torre Drive, are the two schools where all staff and pupils are being immunized.

A message put out to parents at Richmond Hill Primary School urges them not to “panic” over the situation. It reads: “We strongly advise you not to Google search ‘Hepatitis A’ as you may access inaccurate and possibly worrying information.”

PHE is working with Leeds City Council and the NHS in Leeds to vaccinate those most likely to have come into contact with the carriers. Around 300 people have taken up the vaccine when offered so far, and PHE is stressing that anyone who has not yet been offered the vaccination does not need it at the current time.

There were only 367 reported cases of Hepatitis A infection in England and Wales during 2010.

I Googled hepatitis A and found some good information sources.

Screen Shot 2015-11-12 at 5.42.28 PM

There’s a lot of norovirus in Nevada schools

The famed winter vomiting virus appears to be making life miserable for Nevada school kids. According to the Reno Gazette Journal over 1700 students in 20 schools have had the virus over the past 5 weeks and the outbreak appears to be spreading.

The case count might be real or it might be inflated due to self reporting (kids who want to stay home) or protective parents who don’t want noro in their house (keeping their kids home).

An outbreak of norovirus has reached such heights in local public schools that health officials stopped counting the number of people infected by the highly contagious illness, which causes days of diarrhea and vomiting.200187143-001

But the Washoe County Health District estimates – based on schools’ absenteeism and reported illnesses – that 1,760 students and staff have been afflicted at 20 schools and a few daycare centers, quadrupling the number of infections since the outbreak started at half as many schools on Oct. 1.

“We were hopeful it wouldn’t get to this point,” said county Director of Epidemiology Randall Todd, noting the virus’ rapid spread to a new school every few days.

The health district has advised the Washoe County School District and families to do three things at outbreak schools, which are concentrated in northern Reno, Spanish Springs and Sparks. The health district isn’t identifying the affected daycare centers.

Disinfect high-traffic areas of the school where surfaces are repeatedly touched, such as railings, desks, chairs and doors. Thoroughly clean and disinfect the area around a vomiting incident up to a 25-foot radius.

Wash hands frequently with soap and water — antibacterial hand-sanitizer does not kill the virus.

Sick students and staff must stay out of school for 72 hours after their last symptoms.

Such a “substantial outbreak” wouldn’t be possible if parents and staff were following all three protocols advised for outbreak schools, said Todd, positing that at least one recommendation isn’t being followed.

The health district hasn’t recommended closing any schools, and school officials said they don’t want to go there either for the sake of academics.

But they’re in luck. The week-long fall break starts Monday.

“We’re keeping our fingers crossed that fall break will give us the boost we need to put this behind us,” said Todd.

‘Elementary school kids, younger kids probably aren’t the best when it comes to hygiene’

We’ve successfully made it through a couple of months of school in our house without any illnesses. I’m not sure if my kids’ recent obsession with handwashing is a factor (I suspect it is) or whether we’ve just been lucky.

Kids and norovirus are a common pair. Last month an estimated 700 students missed school in Person County, NC with the virus (or stayed home to avoid it; only two cases were confirmed). Today, AP reports that 400 kids in northern Nevada at 11 schools likely have noro.norovirus-2

The Washoe County Health District said it believes the norovirus outbreak first started on Sept. 16 at a Reno elementary school, where 150 students and 11 staff members have reported symptoms, including nausea, vomiting, diarrhea and abdominal cramping.

As of Friday, the Washoe County School District reported that the outbreak had spread to 9 other elementary schools, a high school and some associated daycare centers. It has been centered in Reno, with one Sparks elementary school.

Most of the nearly 400 people affected have been elementary school children. The high school teachers who were sickened also traced their illnesses to the affected elementary school kids, whom they were related to.

“Elementary school kids, younger kids probably aren’t the best when it comes to hygiene,” said Phil Ulibarri, a county health department spokesman.

The school district has also been advised to thoroughly clean schools, which Ulibarri said means sanitizing a 25-foot radius where there is vomiting or diarrhea, including going as high as six feet up along walls.

Awesome, the Nevada folks are using the best available science.