Germ warfare

When the flu season began, Suzanne Campbell, school nurse at Underwood Elementary School in Newton, posted information about symptoms in classrooms. She sent information home to parents, encouraging them to keep sick children out of school, and she advised staff members to get flu vaccines.

As for students, Campbell said the key ingredient in curbing the spread of the flu and other germs has been simple hygiene.

"It's just reminding them to wash their hands and wash their hands and wash their hands," she said.

School districts across the region say they have been paying careful attention to cold-prevention measures this season after a spate of influenza-related deaths across the country. Although the Centers for Disease Control and Prevention believes the outbreak may have peaked in some states, the agency reports that more than 90 children have died of the flu nationwide since October. Concerns were heightened locally last month when an 18-year-old student at Worcester State College died after coming down with the flu.

Although such tragedies prompted fears that this flu season could exact a heavy toll, many local school officials say they haven't been tracking any unusual outbreaks. But they also acknowledge that the season is not yet over.

"So far -- I'm knocking on the Formica on my desk -- we haven't seen it," said Stuart Peskin, principal of Bennett-Hemenway Elementary School in Natick. "People are taking it very seriously."

The CDC has begun promoting a "Germ Stopper" campaign that offers schools information on curbing the spread of germs. Those recommendations, as well as recommendations from the state Department of Public Health, mirror the practices of many local school districts, which emphasize frequent hand-washing and so-called "cough etiquette" -- coughing into your shirt sleeve or elbow rather than your hands. Many schools teach students proper hygiene techniques during special classroom presentations. This year, schools also report more frequent cleaning of surfaces like doorknobs and water fountains.

In some local districts, more teachers have taken advantage of flu clinics, officials say. More than 300 teachers in Newton were vaccinated, up from under 100 last year, said Linda Walsh, director of clinical service for the Newton Health Department. In Hudson, about 250 faculty and staff were vaccinated, up from 175 last year, said Kathy Hassey, the district's director of health services.

The state Department of Public Health primarily tracks cases of influenza in "high-risk" settings such as hospitals or nursing homes, said Pejman Talebian, the agency's immunization program manager. Susan Lett, medical director of the immunization program, said the agency has investigated 37 outbreaks this season, a typical number, mostly in nursing homes.

Lett said influenza is common among school-age children. The agency has received no calls from schools since classes resumed this month, she said. Campbell said there have been six confirmed cases among students at Underwood, and all have recovered.

Mary Patch said there have been some confirmed cases of the flu among students at Medfield High School, where she is a nurse. But like other nurses, Patch said the bulk of the illnesses at her school have been "flu-like." Students and teachers regularly come down with colds, but the flu is characterized by high fever, severe aches, and exhaustion, health officials say. Common cold symptoms, such as a runny nose, sneezing, and a sore throat, are sometimes associated with the flu.

Patch said she saw a higher rate of absenteeism just before the recent holiday vacation, and said the break "seemed to help a bit." Marcia Buckminster, director of school health services in Framingham, also said attendance rates in her district have been up since the vacation ended.

"It seems to have . . . abated," Buckminster said. "Things seem to be getting back to normal."

Although Sarah Dillaway made sure her three children got their flu shots this year, her 10-year-son, a student at Wilson Middle School in Natick, still came down with the illness and spent a week recovering. She was not worried about the flu, she said, but became concerned that his symptoms might be a signal of something more serious like meningitis. In general, she believes schools have been helpful in teaching students about keeping germs at bay.

"I think people are being more diligent, more conscientious," said Dillaway, who also has two children at Bennett-Hemenway.

Claudia Price, a preschool teacher at Bennett-Hemenway, said she has taught her students about germs and cold prevention, and her class has remained fairly healthy this season.

"Because we deal with a lot of children . . . we're very conscious of health and safety," she said.

Emily Shartin can be reached by e-mail at eshartin@globe.com.