Health Services

End of Year Medication Pick up

If your child has any medication (prescribed or over the counter) that you wish to retrieve please pick up by the last day of school, June 4, 2019. 

Any medications not picked up will be disposed of appropriately as we cannot store medication over the summer in the clinic.

Please stop in and pick up any and all items by the last day of school.

Have a great summer break!


Nurse Donna

Med Alert Incoming Seniors for 2019-20

MEDICAL ALERT Incoming 12th Graders

Dear Parent:

It is time to remind all Black River parents of the importance in having your child (ren) obtain their vaccinations boosters. Keep in mind that most have not been vaccinated since kindergarten and it is so easily overlooked. If your child will be entering 12th grade in the fall of 2019, he/she MUST have a *Meningococcal vaccination series by September 12th, 2019 in order to remain in school.

Please make it your priority to check and confirm that your child’s vaccinations are current or brought up to date for their medical safety. 

Thank you,                                                                    

Nurse Donna

Med Alert Incoming 7th Graders

MEDICAL ALERT Incoming 7th Graders
Dear Parents/Guardians:
Beginning with the 2019-2020 school year, the Ohio Department of Health School Immunization
Requirements have been revised to include one dose of Meningococcal (MCV4) vaccine to be
administered before a student enters the seventh grade. Therefore, your current sixth-grader will need
to show proof of having received the Meningococcal (MCV4) vaccine before he/she can return to
school in the fall.
Your child also requires a dose of Tdap vaccine to be administered before a student enters the seventh
grade. This dose is intended to be administered as a booster dose for students who have completed
the required doses of the initial series of DTaP/DT/Td. Therefore, your current sixth-grader will need to have both upon returning to school this fall. This must be completed by September 12, 2019.
Thank you,
Nurse Donna 

Mono exposure 8th Grade Class

Mono, known as the “kissing disease,” is an acute illness caused by a virus and characterized by fever, sore throat that may resemble strep throat, fatigue, headache, and swollen glands (especially in the neck.) There may be a rash, more often in patients who have been treated with amoxicillin/ampicillin.

Mono may be very mild or severe. It is recognized more often in adolescents and young adults than in small children. It is a disease that may be difficult to identify and is usually diagnosed through

laboratory procedures.

Mono is not highly contagious. It is transmitted through close person-to-person contact. Incubation period is 10-50 days. Infectious period is uncertain, but may be as long as several months. Students with mono may need their school day or schedule modified due to fatigue or other symptoms/reasons identified by their physician. Students who participate in physical activity should provide an activity clearance from a licensed health care provider before returning to school-related physical activities.

To control the spread students should be instructed not to share items that may be contaminated with saliva such as lipstick and beverage containers. There is no specific treatment for Mono. Articles soiled with nose and throat discharge should be cleaned or disposed of. Students who cough or sneeze should cover their mouth with a tissue or if not available, cover their mouth in the crook of their arm.

As always, proper hand washing should be encouraged. If Mono is suspected, students should consult their health care provider.

Strep Throat In All Buildings

What is Strep throat?
Strep throat and Scarlet fever (a rash that sometimes accompanies strep throat) are caused by the beta hemolytic streptococcus, type A bacteria. The organisms are spread by contact with secretions from the mouth and nose of infected persons. The incubation is short, usually 2 to 5 days. Infected persons are considered contagious until 24 hours after antibiotic treatment is begun.
What are the signs and symptoms or strep throat?
The signs and symptoms include sore throat, fever, swollen glands under the jaw and in the neck, and pus pockets on the tonsils. Vomiting and stomach pain may also occur. Additionally, with scarlet fever there is a fine, red, sandpapery skin rash.
What should I do if I think my child has strep throat?
If a sore throat is suspected, if would be recommended to go ahead and seek medical care.
A throat culture will be done to determine the diagnosis. If the culture is positive, a ten-day course of an antibiotic, is prescribed. The child should be out of school until 24 hours of antibiotic therapy is received and condition improved to return to school. If the culture is negative, the cause is probably viral and the treatment is warm salt water gargles, force fluids, rest, and Tylenol.
Can strep throat be prevented?
YES! Frequent handwashing, plenty of rest, and adequate diet will to go far to protect your child against strep throat and other germs which tend to be more prevalent this time of year. Be careful not to share cups or utensils that can also lead to the spread of germs.

Fifth Disease

Fifth disease is a viral illness caused by parvovirus B19. Fifth disease is also known as "erythema infectiosum" and "slapped cheek disease." The clinical illness was described in the 1880s and was named fifth disease because of its position in the numerical classification of childhood illnesses associated with rashes (exanthems). Other numbered diseases included measles, scarlet fever, and rubella—and these did not get renamed until the molecular era, when it became possible to isolate viruses and bacteria. Fifth disease was number five of six diseases named. It is a very common infection, and almost 50% of adults have been infected with the virus but do not remember having it because it often does not cause symptoms.

What are the symptoms of fifth disease?

Though fifth disease generally occurs in children between 4-10 years of age, it can affect any age group, including adults. It most commonly occurs during the winter and spring. The illness classically begins with a low-grade fever and malaise (a sense of not feeling well). After about a week, this is followed by a characteristic bright red rash on the cheeks (the so called "slapped cheeks" rash). Finally, after three to four days, a fine, red, lacelike rash can develop over the rest of the body. This rash may last for five days to a week and occasionally comes and goes for up to three weeks. The other symptoms are usually gone by the time the rash appears, and patients with the rash are usually not contagious. Unfortunately, as with many other viral illnesses, the features and timing of the different stages of illness are not always predictable.

While the illness is not serious in children, around 5% of children and around 50% of adults with fifth disease can have joint aches and pains. This arthritis or arthropathy is more common in females than males and is usually temporary, lasting days to weeks, but may become a long-term problem for months. People with arthritis from fifth disease usually have stiffness in the morning, with redness and swelling of the same joints on both sides of the body (a "symmetrical" arthritis). The joints most commonly involved are the knees, fingers, and wrists.

What are the serious complications of fifth disease?

Rarely, patients develop erythrocyte aplasia. This is when the bone marrow stops forming a normal number of red blood cells. This complication is rare and usually transient but can be fatal. Patients who are immunocompromised (having an immune system that has been impaired by disease or treatment) are at a high risk of this complication.

Pregnant women (who have not previously had the illness) should avoid contact with patients who have fifth disease. The fifth disease virus can infect the fetus prior to birth. And, while no birth defects have been reported as a result of fifth disease, in 2%-10% of infected pregnant women, it can cause the death of the unborn fetus.

What is the treatment for fifth disease?

The treatment is supportive only. Fluids, acetaminophen, and rest are important. Antibiotics are of no use in the treatment of fifth disease since it is a viral illness. In those with persistent arthritis, anti-inflammatory medications such as ibuprofen or naproxen can be used.

How is the virus spread, and should I be isolated if I have fifth disease?

The virus of fifth disease is spread mostly by droplets. This means that when an infected person coughs or sneezes, the virus can be spread. However, once the rash is present, the person is usually no longer infectious and need not be isolated.

Fifth Disease At A Glance
  • Fifth disease is caused by a virus.
  • Symptoms include low fever, fatigue, a "slapped cheeks rash," joint aches, and a whole-body rash.
  • Diagnosis is made based on clinical features.
  • Rarely, fifth disease can have complications.
  • Fifth disease can cause a miscarriage.      

New hotline helps teens quit vaping

Great Article



HealthDay Reporter

THURSDAY, Jan. 31, 2019 (HealthDay News) -- E-cigarette use is surging among American teenagers, with millions of kids flirting with nicotine addiction by regularly vaping.

Unfortunately, these kids are going to face a rocky road if they try to kick their nicotine habit, experts say.

There are no tested or approved methods for quitting e-cigarettes, said Linda Richter, director of policy research and analysis at the Center on Addiction.

"The science of vaping cessation hasn't caught up with the tremendous rise in use," Richter said. "There really isn't much out there that's been proven."

Teens addicted to vaping must rely on methods that have been shown to help tobacco quitters, but it's not clear that those methods will be useful when it comes to e-cigarettes.

"It's shocking to a lot of people in the field that we were so close to, if not eliminating, then really reducing cigarette smoking and tobacco use among young people. They just aren't interested in cigarette smoking," Richter said. "This was really going to go away, and now we have this whole generation of kids addicted to nicotine again and we just don't know what we're going to do about it."

Nearly two of every five high school seniors have tried e-cigarettes during the past year, according to a federal survey. About 37 percent of 12th graders said they'd vaped within the past 12 months, compared to about 28 percent in 2017.

Many who vape may be addicted

Teenagers also are vaping regularly enough that hundreds of thousands are likely hooked on nicotine, said Dennis Henigan, vice president of legal and regulatory affairs at the Campaign for Tobacco-Free Kids.

"We're beyond speculating that this could all be very experimental use by kids. The data is in, and it's showing that between 800,000 and 900,000 kids who use these e-cigarette products are using them regularly -- 20 days out of a 30-day month," Henigan said. "That's not experimental. That suggests mass addiction."

The U.S. Food and Drug Administration is concerned enough that it held a public hearing earlier this month asking for expert input on what strategies or treatments might best help teens quit vaping.

"A few years ago, it would've been incredible to me that we would be here today discussing the potential for drug therapy to help addicted young people quit," FDA commissioner Dr. Scott Gottlieb told CNN after the hearing.

E-cigarettes contain large amounts of nicotine, and it can be hard for kids to keep track of how much they've vaped, said Robin Koval, CEO and president of Truth Initiative. There's concern that kids hooked on vaping will eventually start smoking.

"The evidence shows kids who would otherwise not have smoked who start vaping are four times as likely to go on and use combustible tobacco," Koval said.

Nicotine replacement therapy is a cornerstone for adults who want to quit smoking, but the gum and patches are not readily available to teenagers, she noted.

"For adults, lozenges and patches are available over the counter, but not for those who are under 18," Koval said.

Nicotine replacement therapy may not work for young vapers

A doctor can prescribe nicotine replacement therapy off-label for teens hooked on nicotine, Richter said, "but there isn't strong evidence they're particularly effective for kids. It's possible the level of nicotine in the nicotine replacement [products] are not high enough for people who are vaping."

Some adults also use antidepressants to help them quit smoking, but these medications are worrisome for teenagers, she added.

"There are concerns about giving antidepressants to kids," Richter said. "Some studies have shown it can increase suicidal thoughts in kids."

Smoking cessation programs might help, Richter suggested, but these also have not been tested when it comes to quitting vaping.

Koval said, on top of that, it's not clear whether kids addicted to e-cigarettes would see smoking cessation programs as a legitimate option.

"For young people, quitting vaping is not the same as quitting cigarettes," Koval said. "A lot of young people will say to us, well, I'm not a smoker. I would never smoke cigarettes. They don't want to be part of a quit program designed for smokers."

It's also easier for kids to maintain an e-cigarette addiction compared to a smoking addiction, Koval said.

"Cigarettes are hard for young people to use. You can't smoke in your classroom. You probably can't smoke in your room at home. They're harder to get," Koval said. "E-cigarettes are easy to conceal, so you can do them a lot more secretly."

New hotline helps teens quit vaping

To help teenagers quit vaping, Truth Initiative has come up with a first-of-its-kind program that offers support.

Kids who text "QUIT" to (202) 804-9884 will start receiving text messages offering assistance and guiding them to resources, Koval said.

"We'll enroll you and send you a series of messages every day that will help you set a quit date, help give you encouragement, tips and tools for how to quit," Koval said. "If you're feeling like you're craving, you can text us and we will immediately respond with some real-time help."

Koval and Richter said some other strategies that might help include:

  • Preparing to quit by leaving your e-cigarette at home during the day.
  • Identifying things in your life that prompt you to reach for your e-cigarette.
  • Figure out the types of cravings you have, and have strategies ready to counter your cravings.
  • Ask friends and family members to help you quit.

More information

The Truth Initiative has more about quitting e-cigarettes.

SOURCES: Linda Richter, Ph.D., director, policy research and analysis, Center on Addiction, New York City; Dennis Henigan, vice president, legal and regulatory affairs, Campaign for Tobacco-Free Kids, Washington, D.C.; Robin Koval, CEO and president, Truth Initiative, Washington, D.C.; CNN

Last Updated: 

Hand, Foot and Mouth~All Buildings Currently "Informational Only at this time"

Hand-foot-and-mouth disease In Your Child’s School


Hand-foot-and-mouth disease is a mild, but highly contagious viral infection common in young children. Hand-foot-and-mouth disease is characterized by sores in the mouth and a rash on the hands and feet. It spreads from person to person, usually through unwashed hands or contaminated surfaces. The most common cause of hand-foot-and-mouth disease is coxsackievirus infection.



The signs and symptoms of hand-foot-and-mouth disease include:

§  Fever

§  Sore throat

§  Painful red blister-like lesions on the tongue, mouth, palms of the hands or soles of the feet                   

§  Headache

§  Fatigue

§  Irritability in infants and toddlers

§  Loss of appetite

The usual period from initial infection to the onset of signs and symptoms (incubation period) is three to seven days. Fever is often the first sign of hand-foot-and-mouth disease, followed by a sore throat and sometimes a poor appetite and the feeling of being sick (malaise). One or two days after fever begins, painful sores may develop in the mouth or throat. Rash on the hands and feet can follow within one or two days, and may also appear on the buttocks. Hand-foot-and-mouth disease may cause all of the above signs and symptoms or just a few of them.

Treatments and drugs

There's no specific treatment for hand-foot-and-mouth disease, and antibiotics aren't effective because it's a viral infection. The illness simply must run its course. To help lessen discomfort, doctors often recommend:

§  Rest, increase fluids- milk-based fluids may be easier to tolerate than acidic liquids, such as juice or soda. Over-the-counter pain relievers, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others), if needed

Signs and symptoms of hand-foot-and-mouth disease usually clear up in seven to 10 days.


Certain precautions can help to reduce the chances of infection with hand-foot-and-mouth disease:

§  Wash hands carefully.

§  Disinfect common areas.

§  Teach good hygiene.

§  Isolate contagious people.

Because hand-foot-and-mouth disease is highly contagious, people with the illness should limit their exposure to others while they have active signs and symptoms. Hand-foot-and-mouth disease is most contagious during the first week of illness. However, it may spread for weeks after signs and symptoms have disappeared. Keep children with hand-foot-and-mouth disease out of child care or school until fever is gone and mouth sores have healed. If you have the illness, stay home from work. 

Influenza A & B -Currently in ALL Buildings

What are the symptoms of the flu?

Flu symptoms include:

  • A 100oF or higher fever or feeling feverish (not everyone with the flu has a fever)
  • A cough and/or sore throat
  • A runny or stuffy nose
  • Headaches and/or body aches
  • Chills
  • Fatigue
  • Nausea, vomiting, and/or diarrhea (most common in children)

Do I have the flu or a cold?

The flu and the common cold have similar symptoms. It can be difficult to tell the difference between them. Your health care provider can give you a test within the first few days of your illness to determine whether or not you have the flu.

In general, the flu is worse than the common cold. Symptoms such as fever, body aches, tiredness, and cough are more common and intense with the flu. People with colds are more likely to have a runny or stuffy nose.

When should I seek emergency medical attention?

Seek medical attention immediately if you experience any of the following:

  • Difficulty breathing or shortness of breath
  • Purple or blue discoloration of the lips
  • Pain or pressure in the chest or abdomen
  • Sudden dizziness
  • Confusion
  • Severe or persistent vomiting
  • Seizures
  • Flu-like symptoms that improve but then return with fever and worse cough

Nurse Donna