Oregon Public Broadcasting

In a few days, high schools across Multnomah County will be bustling with teenagers.

School nurse, Barbara Mabe, says returning students will see at least one big difference, about six weeks into the year.

Barbara Mabe: “I know that we’re going to be having immunization clinics in the high school. The recommendation is two shots, um we’ll need to have parental permission and this’ll be set up through Portland Public Schools.”

The details for immunizing grade schoolers and kids who aren’t in public school are still being worked out.

There’s all this emphasis on schools because H1N1’s highest risk group is young people – ages five to 25. The availability of a vaccine is just one difference with last spring.

Joseph Hunter: “There’s been a dramatic shift in their first level response.”

Joseph Hunter is the superintendent of the Central School District in Polk County. That’s where school and health officials closed schools last year because of swine flu cases.

Joseph Hunter: “In the spring, when this first came on, the expected response was immediate closure. The existing stance now is that the expectation is that you do not close.”

But Hunter says administrators need to be flexible, as circumstances change.

School nurses expect to repeat a familiar mantra: wash hands, cough into your sleeve, get vaccinated, and keep away from sick people.

But Multnomah Education Service District nurse consultant, Susan Darnell, says they’re also working against social customs.

Susan Darnell: “We’re a nation of families and friends – we shake hands and if we give hugs. Kids are doing that in schools. But if someone’s not feeling well, they really need to distance themselves.”

There can also be a gap in understanding, especially with little kids. Here’s how Darnell would talk to a grade schooler.

Susan Darnell: “If you’re with somebody who’s coughing, or they don’t feel well, you need to take one giant step, and then another giant step, and then a third one – and that’s how far away you should be from that person.”

That approach might not go over so well at Franklin High School.

Ann Giresbrecht is one of the campus nurses.

Ann Giresbrecht: “We’ve been talking about this with students since the day they entered kindergarten. So our challenge is to spark it up, and put a twist on it, to get their attention.”

A “flu fighter” curriculum is available for health classes, and posters are coming, too. But nurses wonder if schools need to do more.

Barbara Mabe wants the schedule adjusted so that kids will wash their hands at least once.

Barbara Mabe: “Lunchtime is a very, very valuable time slot for teenagers, they don’t want to miss any minutes on their lunch, but I do think if we could get them to wash their hands before they ate lunch, it would be good one washing a day."

Federal health guidelines also suggest more rigorous cleaning of school facilities, and limiting how close students are to each other. But Portland doesn’t plan to change how it cleans school buildings, or ease up on class size.

Again, Ann Giresbrecht. Ann Giresbrecht: “Overcrowded classrooms – that’s an attempt to push blame someplace else, for what we have to deal with. Because we all live in a society where we encounter lots of other people, every day.”

Nurses say the key rests with families. Parents need to vaccinate their kids and keep sick children kids at home.