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YORKSHIRE AND THE HUMBER
HEALTH PROTECTION UNITS
SCHOOLS AND CHILDCARE NEWSLETTER
MMR Key to Prevent Mumps
Some Health Protection Units in Yorkshire and the
Humber have received a number of enquiries from
schools recently about mumps infection, affecting both
pupils and staff.
Mumps is an acute viral illness passed by direct contact
with saliva or droplets from the saliva of an infected
person. Mumps is a notifiable disease, which means
that a doctor who sees a patient whom they suspect
has mumps is required by law to report it.
Symptoms of mumps begin with a headache and fever
for a day or two before the disease is characterised by
swelling of the parotid glands (in front of the ears),
either at one or both sides of the face. However, at
least 30% of cases in children have no symptoms.
Mumps should not be treated lightly. It can be a severe
disease, with potential for serious side-effects including
viral meningitis, long term hearing problems and painful
swelling of the testicles in males and the ovaries in
females.
MARCH 2013
It’s
really
important that
children and
young people
are protected
by having two
doses of the
MMR vaccine,
which is safe
and effective
and
also
protects against Measles and Rubella. Those born
before1980 (>25 years old) will more than likely be
immune due to exposure to natural mumps virus.
It may take between 14-21 days before symptoms
appear after coming into contact with the virus, but
an infected person can pass the virus onto others
from 12 to 25 days after exposure to the virus.
Included below are some common questions that are
usually asked by schools and other childcare providers.
Further information on mumps can also be found on the
HPA website – www.hpa.org.uk
In brief for parents, carers and school/childcare staff:
Q. What is mumps?
A. Mumps is a viral illness passed by direct contact with saliva or droplets from the saliva of an infected person.
Symptoms of measles begin with a headache and fever for a day or two before the disease is characterised by swelling
of the parotid glands (in front of the ears), either at one or both sides of the face. However, at least 30% of cases in
children have no symptoms.
Q. What is the school/ childcare setting exclusion period for mumps?
A. 5 days from onset of swelling.
Q. What are the risks of mumps for pregnant staff at the school/ childcare setting?
A. It is theoretically possible for any virus to have an adverse effect on pregnancy, although the evidence for an
increased risk of fetal loss due to mumps in pregnancy is weak.
There are currently no recommendations for excluding women from such settings for the following reasons: (1) If
mumps outbreaks are ongoing in the community then excluding women from a setting such as a school or
university may not reduce her risk of contracting mumps (2) Most pregnant women will be immune to mumps (3)
The evidence that mumps causes problems in pregnancy is weak, and the evidence that exclusion of women is an
effective intervention is also weak. However, there may be specific circumstances that make the risk to a
pregnancy of contracting mumps higher for particular individuals. For further advice, schools and childcare settings
should contact their local Health Protection Unit (contact details included at the end of this newsletter).
Q. What should I do if I suspect I/ my child has mumps?
A. Contact your GP as usual.
Q. What can I do to protect myself and my family against mumps?
A. Children and young people should be protected by having two doses of the MMR vaccine, which is safe and
effective and also protects against Measles and Rubella. Those born before1980 (>25 years old) will more than
likely be immune due to exposure to natural mumps virus. If you are unsure that you/ your child is up to date with
Pageimmunisations,
1 of 5
their
you can check with your GP.
YORKSHIRE AND THE HUMBER
HEALTH PROTECTION UNITS
SCHOOLS AND CHILDCARE NEWSLETTER
Hands up for a better washing
technique!
A major part in the transmission of infection in all
healthcare environments continues to be played
by lack of hand hygiene. Hand washing is one of
the most important ways of controlling the
spread of infections, especially those that cause
diarrhoea and vomiting, and respiratory disease.
MARCH 2013
For children in Key Stage 2 and 3, HPA have also
created a web based student resource ‘e-bug’ which
promotes a wider concern with activities covering
useful ad harmful microbes, hygiene, prevention of
infection and antibiotic use. http://www.e-bug.eu/
Further information and resources, including the
poster
below,
can
be
found
at
http://www.hpa.org.uk/Topics/InfectiousDiseases/Infe
ctionsAZ/Handwashing/
Hand cleansing is a vital component in the
prevention of infection and is an effective way of
stopping infections passing from person to person.
Good hand washing practice removes bacteria that
live on your skin. Some bacteria live in the skin
crevices, sweat glands and under fingernails.
Since hand hygiene reduces the spread of microbes
and infection it has been shown that good hand
hygiene can also assist in reducing the level of
absenteeism in schools.
To reduce and even prevent the risk of infections
being transmitted throughout schools, children are
encouraged to use the 6 step hand washing
technique created by the Health Protection Agency.
The technique aims to eliminate all traces of bacteria
from the hands whilst also encouraging a thorough
and regular cleansing of the hands.
Routine washing of the hands with soap and water
carries the highest recommendation however hand
sanitizers are also effective and convenient when
there is no access to running water, such as in the
car, on the playground and in the classroom.
Alongside a step by step guide to hand washing, The
Health Protection Agency has developed a resource
pack as a means of teaching and promoting hand
washing within primary schools. Using an animated
character named Max the pack which focuses mainly
on Key Stage 1 pupils, was developed in discussion
with teachers, pupils and school nurses. It is an easy
to use self contained pack linking with various
curriculum areas, including PSHE, Science and Art
and Design.
Materials from the pack itself are downloadable from
http://www.hpa.org.uk/Topics/InfectiousDiseases/Infe
ctionsAZ/Handwashing/handwHandwashinginprimar
yschoolsresources/
Page 2 of 5
In brief for parents, carers and school/childcare
staff:

Handwashing is one of the most important
ways of controlling the spread of infections,
especially those that cause diarrhoea and
vomiting, and respiratory disease. The
recommended method is the use of liquid
soap, water, and paper towels.

Always wash hands after using the toilet,
before eating or handling food, and after
handling animals. Cover all cuts and
abrasions with waterproof dressings.

Washing hands frequently with soap and
water, especially after coughing and sneezing
will help reduce the risk from viruses.
YORKSHIRE AND THE HUMBER
HEALTH PROTECTION UNITS
SCHOOLS AND CHILDCARE NEWSLETTER
Latest on Flu
In the last edition of the newsletter issued ahead of
winter, we encouraged all children and staff in high risk
groups to take up the offer of a free flu vaccination
when offered by their GP.
Influenza, or ‘flu’ as it is commonly known, is caused by
various strains of the influenza virus. The usual
symptoms are fever, headache, aching muscles, sore
throat and cough, although diarrhoea and vomiting can
also occur in children. For the majority of people, flu is
an unpleasant, but not life-threatening illness. However,
it can be dangerous for certain groups in the
population, such as those with underlying health
conditions, those who have a weakened immune
system, the elderly and pregnant women – all of which
are invited to receive a free flu jab each winter by their
GP.
Influenza is spread from person to person by coughs
and sneezes that send droplets containing virus up into
the air. It can therefore spread rapidly within families
and childcare settings where people are in close
proximity. The flu virus can also live on a hard surface
for up to 24 hours. Adults are generally infectious for
the first 5 days of their symptoms but children may be
infectious from three days before they are ill to nine
days afterwards.
Since the last edition of the newsletter, Health
Protection Units across Yorkshire and the Humber have
been responding to outbreaks of flu in schools and
childcare settings, as is usual for this time of year.
Schools in West Yorkshire, South Yorkshire and North
Yorkshire and the Humber have been affected. In
December, an outbreak of influenza B was confirmed in
a school in the East Riding of Yorkshire. The outbreak
was first suspected due to high rates of absenteeism,
which prompted a call to the local Health Protection
Unit. At this point, national HPA surveillance systems
had identified 42 acute respiratory outbreaks occurring
in schools across the country during the same week
and 36.3% of children affected by influenza B were
known to be between 5-14 years of age.
It’s important to be aware that during a normal flu
season where outbreaks of flu are suspected within
schools, laboratory testing will not always be
necessary, particularly if flu is already known to be
circulating in the community. However, on occasions it
may be necessary for testing to be carried out where flu
is suspected – for example if flu is not yet circulating
widely in the community, or if health professionals
suspect that another cause of illness is possible.
Page 3 of 5
MARCH 2013
The rapid spread
of influenza was
highlighted in this
school by the
number
of
children
absent
with
sickness
which rapidly rose
to over 30%. In
addition,
the
number of staff
absent
with
similar symptoms
increased.
Fortunately,
the
Christmas
holidays proved an effective measure in preventing
further spread of the virus within the school. Because
the school contacted the HPU early, they were able to
receive advice on control measures to put in place and
contribute to important HPA local and national
surveillance systems that are used to inform decisions
on the management and treatment of influenza.
Everyone has a part to play in preventing the spread of
respiratory infections in schools and other childcare
settings. Children should be encouraged to ‘catch it, bin
it, kill it’ - catch coughs and sneezes with a tissue, bin
the tissue promptly and kill the germs by washing
hands frequently.
There is no recommended length of exclusion for a
child with respiratory infections but they should not
return to school or their childcare provider until their
symptoms have completely gone. If a child has flu
symptoms whilst at school their parent or guardian
should be asked to collect them as soon as possible.
There are no specific treatments and children affected
by influenza should be encouraged to rest and drink
plenty of water or other fluids. They should not be given
aspirin. If symptoms become severe or last more than a
week medical advice should be sought
In brief for parents, carers and school/childcare
staff:
Spring is just around the corner and levels of flu are now
beginning to decrease. The flu vaccine will be offered to
risk groups to offer protection during the 2013/14 winter
season, towards the end of 2013. If you/ your child has
a long term medical condition you should take up the
offer of vaccination each year. Pregnant women and
people over the age of 65 should also be vaccinated
each year.
For further information on the vaccines and eligible
groups for vaccination, go to www.nhs.uk
YORKSHIRE AND THE HUMBER
HEALTH PROTECTION UNITS
SCHOOLS AND CHILDCARE NEWSLETTER
Major Step Forward in Tackling
Meningitis B
Meningitis group B is the most common strain of
meningitis in the UK, and so it’s a major step forward
and great news that the first ever MenB vaccine
against meningitis and septicaemia designed to
cover different strains of meningococcal B infection
around the world, has become a licensed product.
The vaccine license for ‘Bexsero’ from the European
Commission means that it can now be considered by
governments in the UK and Ireland for inclusion in
national immunisation programmes. This takes time,
so even now that the vaccine is licensed, it could be
a while before it is introduced to the UK immunisation
schedule, if approved by Government advisors the
Joint Committee on Vaccination and Immunisation
(JCVI). Evidence from a range of sources needs to
be considered, including information on the burden of
disease, the likely impact of the vaccine, and the
safety of the vaccine, as well as cost-effectiveness.
If the JCVI recommend introducing the vaccine into
childhood immunisation programmes in the UK and
Ireland, they will also advise on the most effective
immunisation strategy (what age groups will be
immunised). These decisions will be made by
considering scientific evidence on how well the
vaccine works in different age groups, and alongside
existing vaccines in the routine schedule, whether
vaccination prevents the bacteria from being passed
on, and the impact that the vaccine will have on
overall disease incidence.
The vaccine has been welcomed by professionals
and patient groups. A vaccine for Meningitis C was
introduced in 1999 and HPA figures show that 10
years following its introduction there were only 13
cases of Meningitis C in 2009 compared to 955 in
1999 - a decline of 99% largely due to the use of
meningococcal C vaccine.
For now, and even if the vaccine is introduced, it
remains crucial to stay alert to the signs and
symptoms of meningitis and to seek urgent medical
help if there is any concern at all. The disease can
progress rapidly.
Symptoms of meningococcal disease are nonspecific but may include a high temperature and/or
vomiting; severe headache; a stiff neck, aching limbs
Page 4 of 5
MARCH 2013
and joints; a
dislike
of
bright lights;
drowsiness
and/or
a
purple rash,
which does
not
fade
when
pressed; in
small
babies,
a
refusal to feed and a high pitched cry. Not all of the
symptoms may be present at once. Young children
may have less specific symptoms. These may
include irritability, lethargy, high-pitched crying, and
refusal to eat. The typical meningococcal rash
doesn't disappear with gentle pressure on the skin.
Not all people with meningococcal disease get a
rash or the rash may occur late in the disease.
Meningococcal bacteria are not easily spread from
person to person and the bacteria do not survive well
outside the human body. The bacteria are passed
between people in the secretions from the back of
the nose and throat. This generally requires close
and prolonged contact with a person carrying the
bacteria who is usually completely well. Patients with
meningococcal disease need urgent treatment with
antibiotics and treatment is usually started before the
diagnosis is confirmed by tests.
In brief for parents, carers and school/childcare
staff:
Early recognition of meningitis is important as the
disease can develop very quickly. We should always
be vigilant for the signs and symptoms of the disease
and seek urgent medical help if there is any
concern at all. Symptoms can include:





a high temperature and/or vomiting;
a severe headache;
a stiff neck, aching limbs and joints;
a dislike of bright lights;
drowsiness and/or a purple rash, which does not
fade when pressed;
 in small babies, a refusal to feed and a high
pitched cry.
Further advice and information about meningitis is
available by contacting NHS Direct, the 24-hour NHS
Helpline on 0845 4647 or www.nhs.uk, the National
Meningitis Trust helpline on 0845 6000 800 or
www.meningitis-trust.org or the Meningitis Research
Foundation on 080 8800 3344.
YORKSHIRE AND THE HUMBER
HEALTH PROTECTION UNITS
SCHOOLS AND CHILDCARE NEWSLETTER
MARCH 2013
How to Contact Us
West Yorkshire Health Protection Unit
6th floor South East
Quarry House
Quarry Hill
Leeds
LS2 7UE
Telephone: 0113 386 0300
Fax: 0113 243 8463
We need your views!
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we will be asking a single question in order for us to
compile your views on the newsletter and make any
improvements where necessary. It only takes a
moment, and we really appreciate your feedback.
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communication with parents? Click here to
answer
North Yorkshire and the Humber
Health Protection Unit
Block 2
Food and Environment Research Agency
(FERA)
Sand Hutton, York
YO41 1LZ
Telephone: 01904 468900
Fax: 01904 468051
South Yorkshire Health Protection Unit
Unit C
Meadow Court
Hayland Street
Sheffield
S9 1BY
Telephone: 0114 2428850
Fax: 0114 2428874
This newsletter is produced for staff working in nurseries, schools and other childcare settings.
If you wish to use some of the information from the newsletter to communicate with parents and
carers, please use the text from the orange boxes that have been included for this purpose.
PLEASE NOTE: From 1 April 2013, the Health Protection Agency will cease to exist and all the
Health Protection Agency’s functions will transfer to a new agency called Public Health England.
Our email addresses will change to [email protected] but all other contact details will
remain the same. We will keep you informed of any newsletters to be produced in PHE that would
be of interest to you.
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