TITLE:  A Student Survey About Cold and Flu Epidemics In Schools 

STUDENT RESEARCHERS:  Chris Chugden, Amber French, James Rees,
                      and  Whitney Stoppel 

SCHOOL:  Mandeville Middle School
         Mandeville, Louisiana
GRADE:  6
TEACHER:  John I. Swang, Ph.D.


I.  STATEMENT OF PURPOSE:

We would like to do a survey research project on what students 
know about cold and flu epidemics in schools.  We would also 
like to find out about the students' behavior at school which 
might expose them to germs that could make them sick.  We are 
concerned about this problem in our community's schools.  

II.  REVIEW OF LITERATURE:

Epidemics

Epidemiology is the medical science that includes the 
investigation of the incidents and spread of diseases in large 
areas with high population and the conditions that influence the 
harmfulness of infectious diseases.  Epidemiologists find new 
ways of disease prevention every day.  Many diseases such as the 
common cold and influenza (flu) are the most contagious to 
everybody.  Many people in the country get sick every day 
causing absenteeism in schools and businesses everywhere.  

Lately, scientists have been studying very fatal, noninfectious 
diseases such as AIDS and Ebola.  Epidemics can be prevented 
before the cause of the disease is found.  This is done through 
public health measures.  Telling people about the causes and the 
prevention of diseases is crucial in the control of epidemics.  
The surgical mask is the device which can be used to prevent the 
spread of germs that cause diseases such as the common cold and 
flu.  

Public Health

Public health organizations help keep the city or surrounding 
areas healthy.  The most important things to most of these 
organizations are germ-free food and water, effective sanitation 
systems, control and prevention of diseases, help to those who 
need health care, and laws that contribute to health.  The basic 
science for evaluating health problems is epidemiology.  

In the seventeenth century, William Petty and John Graunt 
(physicians) developed a numerical method that might give them 
health information on large populations of people.  To do this, 
they needed accurate data on the population, trade, manufacture, 
education, and diseases.  This marked the beginning of the 
quantitative studies of health and populations.

There are many organizations that help control diseases.  

The Center for Disease Control and Prevention in Atlanta, 
Georgia, USA  conducts research on the occurrences of diseases 
and develops methods to control them and prevent them.  It 
provides public heath information and aids in the training of 
heath workers.  It has nine major departments including the 
Center for Environmental Health and Injury Control and the 
Epidemiology Program Office.  

The United States Department of Health and Human Services is the 
federal government department that specializes in health care 
and social service programs.  This service has two predecessors, 
the Federal Security Agency, created in 1939, and the Department 
of Health, Education, and Welfare, created in 1953.  The 
Department of Health and Human Services took over both of them.  

The United States Food and Drug Administration controls the 
freshness, purity, and additives of foods and drugs sold to 
people.  This is done with laws and regulations.  

The United States Public Health Service is the main health 
service of the federal government and is one of the largest and 
most varied organizations.  It was founded in 1912, after being 
the Marine Hospital Service (1798-1902) providing medical 
service to seamen.  It gradually grew to include the supervision 
of quarantine laws, medical inspection of immigrants, and 
general investigations of public health.  It is now operating as 
a division of the Department of Health and Human Services.

The World Health Organization (WHO) was founded in 1942 to help 
ensure pure water supplies, sanitation systems, health 
education, health planning assistance, and health worker 
training to all the nations of the world.  It deals with 
international health issues.  

Common Cold

The common cold is a viral infection of the respiratory tract.  
The common cold is caused by many types of viruses.  It usually 
occurs in the nose, the throat, and the lungs.  Some of the 
symptoms are nasal congestion, coughing, sore throat, and fever.  

No cure has yet been found.  In the early 1950's, various asthma 
drugs were thought to help.  Many physicians believe this is not 
true if the illness really is the virus-caused cold.  Bed rest 
is commonly recommended by doctors.  Another thing that might 
help are taking medicines that focus on the symptoms of the 
common cold.  

Recent studies show that schools and businesses have had high 
rates of absenteeism because of the common cold.  The average 
person gets two to three colds each year.  The labor force has 
over 150 million people absent each year!  This cost lots of 
money for the missed hours.  

Anyone is susceptible to the common cold.  Children and adults 
who are around other children, such as students and teachers, 
seem to be the most likely to get colds.  Cold viruses are in 
lots of places.  Common colds spread when people cough or 
sneeze.  Tiny moist droplets go in the air and are breathed in 
by others.  The germs then get inside the human's cells lining 
the respiratory tract.  

So far, scientists have found many ways to prevent the spread of 
colds but the virus is still active.  Some ways that students 
can help protect themselves from getting colds or the flu are 
washing their hands, keeping things like pencils and fingers out 
of their nose and mouth, not sharing eating utensils, not 
drinking out of the same can, cup, or bottle as someone else, 
covering their nose and mouth with their arm when they cough or 
sneeze,  ventilating their classroom, staying away from sick 
students, and staying home when they are sick so no one else 
will get their illness.    

Influenza
   
Influenza is a highly contagious illness of the respiratory 
tract.  It is caused by the influenza virus.  If you have a 
fever, coughing, and painful muscle aches, you might be getting 
influenza.  Influenza spreads very fast, attacking many people 
at a time.  This illness lasts anywhere from three to seven 
days.  It starts abruptly, with a 39.4 degrees Celsius (103 
degrees Fahrenheit) fever in adults and higher in children.  You 
also may be very weak.  Plenty of fluids and bed rest may help 
you get better.  

Influenza is very similar to the common cold.  Influenza is very 
bad and sometimes can be fatal.  Colds and the flu can be caused 
by direct contact such as being in places like movie theaters, 
theme parks, and other crowded areas.  When diseases like the 
flu are active (flu season) there are many absences in 
factories, businesses, and schools. 

Viruses and Bacteria
 
Little tiny parasites, that include RNA or DNA and a 
safeguarding coat of protein, make up viruses.  They are the 
tiniest living thing that can replicate.  Viruses differ in size 
and shape.  The three most common viral structures that exist 
are equilateral triangles, rod-shaped, and tadpole-shaped.  
Viruses spread from person to person.  When people cough and 
sneeze, they let out little tiny moisture droplets.  These 
droplets contain viruses or bacteria.  Other people breathe in 
these droplets and may become sick with the virus.  Epidemics 
caused by viruses come in waves and attack thousands of people.  
Viruses are blamed for the common cold and influenza.

Viruses go everywhere and invade cells.  If a virus gets in your 
body, it will use the cells dividing abilities to reproduce.  
Eventually the virus reproduces enough to make you sick.  
Viruses cause many diseases including chicken pox, flu, colds, 
measles, and AIDS.  Viruses are considered cell "hijackers" that 
kind of conquer the cells.  Sometimes a virus can reproduce 
enough to cause a disease like pneumonia.  Those diseases can be 
fatal.  

Bacteria can also make you sick.  Bacteria are everywhere and on 
everything.  Even some foods contain lots of bacteria.  Bacteria 
and viruses can attack at any moment and can take over cells 
very easily.  Antibiotics are made to prevent viruses and 
bacteria from reproducing.  These are used when cells can't 
fight off the infection.  Today, antibiotics are used very often 
to treat diseases.

III.  BIBLIOGRAPHY:

__________.  (1995).  "Epidemiology, Viruses, Common Cold, 
Influenza."  World Book Multimedia Encyclopedia.  Chicago:  
World Book, Inc.

__________.  (1994).  "Epidemiology."  Microsoft Encarta 1995.  
New York:  Microsoft Corporation.     
 
__________.  (1995).  "Influenza, Viruses, Spread, Common Cold."  
Infopedia Multimedia Encyclopedia.  New York:  Future Vision 
Multimedia, Inc.

__________.  (1993).  "Epidemiology, Disease, Public health, 
Influenza."  The New Grolier Multimedia Encyclopedia.  New York:  
Grolier, Inc.

__________.  (1993).  "Viruses, Bacteria."  The Dorling 
Kindersley Science Encyclopedia.  New York:  Dorling Kindersley, 
Inc.

_________.  (1993).  "Public Health."  The New American Desk 
Encyclopedia.  New York: Concord Reference Books, Inc..  pp. 
1004.

_________.  (1994).  "Common Cold, Influenza."  The Concise 
Columbia Encyclopedia.  New York: Columbia University Press.  
pp. ___.

_________.  (1992).  "Surgical Masks."  The American Heritage 
Talking Dictionary.  New York: Houghton Mifflin Company.  

_________.  (1994).  "Epidemiology, Public Health."  Microsoft 
Encarta '95.  New York Microsoft Corporation.  

_________.  (1995).  "Epidemics, Viruses, Influenza."  The World 
Book Multimedia Encyclopedia - Blue.  Chicago: World Book, Inc..

_________.  (1995).  "Common Cold, Influenza, Viruses."  
Infopedia Multimedia Encyclopedia.  New York: Future Version 
Multimedia Computer, Inc..

IV.  HYPOTHESIS:

Our hypothesis states that the majority of students will be at a 
high risk of getting sick because of their behavior at school.

V.  METHODOLOGY:

First, we identified a problem within our community which was 
viral epidemics in schools during the cold and flu season.  Then 
we developed a statement of purpose.  Next, we wrote a review of 
literature about epidemiology, viruses, the common cold, 
influenza, diseases, and public health.  Then we interviewed 
numerous community health professionals and school officials 
about viral epidemics in schools (the St. Tammany Parish School 
Board School nurses, the St. Tammany Parish School Board Census 
Department, the St. Tammany Parish Health Unit, and the St. 
Tammany Parish Hospital Health Education Program).  From the 
information we gathered, we developed our hypothesis and a 
methodology for testing our hypothesis.  Next, we constructed 
our questionnaire on the students' knowledge and experiences 
with cold and flu epidemics in school.  Then we handed out the 
questionnaire to 117 randomly chosen 4th, 5th, and 6th grade 
students at Mandeville Middle School in Mandeville, Louisiana, 
USA.  Then we put it out on the Internet for students around the 
district, state, nation, and world to complete.  After the 
completed questionnaires were returned, we scored them and 
recorded the data on a data collection form.  After that, we 
analyzed our data using simple statistics, charts and graphs.  
Then we wrote our summary and conclusion where we accepted or 
rejected our hypothesis.  Finally, we applied our findings to 
our school environment.

VI.  QUESTIONNAIRE:

 1.  Colds and the flu are caused by _____.

____a. Bacteria
____b. Viruses
____c. Air pollution
____d. Sitting to close to the TV

 2.  Lots of students at my school get sick during the cold and 
flu seasons.

____a. True
____b. False

 3.  Do you use soap when you wash your hands at school?

____a. Yes
____b. No
____c. Sometimes
  
 4.  Does your teacher keep your classroom ventilated by opening 
a window or a door during the day?

____a. Yes
____b. No
____c. Sometimes

 5.  Do you stay home from school when you are sick with a cold 
or the flu?

____a. Yes
____b. No
____c. Sometimes

 6.  How often does another student cough or sneeze on you at 
school?

____a. At least once a day
____b. At least once a week
____c. All the time
____d. Rarely

 7.  Do you wash your hands with soap before you eat lunch at 
school?

____a. Yes
____b. No
____c. Sometimes

 8.  Do you wash your hands with soap before you eat a snack at 
school?

____a. Yes
____b. No
____c. Sometimes
 
9.  Do you cover your mouth and nose when you sneeze?

____a. Yes
____b. No
____c. Sometimes

10.  You can reduce the spread of germs by ______.

____a. Covering your nose and mouth when you cough or sneeze
____b. Washing your hands frequently
____c. Keeping your fingers, pencils, etc. out of your nose and
       mouth
____d. All of the above

11.  I usually catch a cold or the flu from someone at school.

____a. Yes
____b. No
____c. Sometimes

12.  My parents make me go to school when I have a cold or the 
flu.

____a. Yes
____b. No
____c. Sometimes

13.  Do you ever share a drink with a friend at school by 
drinking out of the same bottle, cup, glass, or can.

____a. Yes
____b. No
____c. Sometimes

14.  Do you share snacks with your friends at school by eating 
out of the same bag or container.

____a. Yes
____b. No
____c. Sometimes

15.  Do you chew on your pencil, pen, or finger nails during 
class while at school?

____a. Yes
____b. No
____c. Sometimes

16.  Does your classroom ever get hot and stuffy in the winter 
time?

____a. Yes
____b. No
____c. Sometimes

17.  If a friend of yours comes to school sick, do you stay away 
from him/her?

____a. Yes
____b. No

18.  Do you ever share the same plate, fork, knife, or spoon 
when eating with your friends at school.

____a. Yes
____b. No
____c. Sometimes

19.  Do you lick your fingers after you have eaten a snack?

____a. Yes
____b. No
____c. Sometimes

20.  Everyone picks their nose with their fingers at one time or 
another.

____a. True
____b. False

21.  Everyone picks their teeth with their fingers at one time 
or another.

____a. True
____b. False

22.  Touching phones, computer keyboards, library books, 
doorknobs, desks, and chairs at school is a good way to 
contaminate your hands with the germs that can cause colds and 
the flu.

____a. True
____b. False

23.  Sometimes my mouth or cheek touches the water fountain at 
school when I am getting a drink because the water does not come 
out strong enough. 

____a. True
____b. False

24.  A team of students at Mandeville Middle School has designed 
a mask that may help keep you well during the cold and flu 
season.  The Designer Health Mask helps stop the germs that 
cause colds and the flu from getting to your mouth and nose 
where they can make you sick.  The Designer Health Mask is a 
surgical mask with art work drawn and painted on the front.  You 
can even design the art work for your very own mask.

Would you be willing to wear your very own Designer Health Mask 
at school during the cold and flu season, if it would help you 
stay well?

____a. Yes
____b. No
____c. Maybe, once I learn more about it.


VII.  DATA COLLECTION FORM:

 1.  Colds and the flu are caused by _____.

 844 a. Bacteria
 604 b. Viruses
  87 c. Air pollution
  29 d. Sitting to close to the TV

 2.  Lots of students at my school get sick during the cold and 
flu seasons.

1352 a. True
 216 b. False

 3.  Do you use soap when you wash your hands at school?

 592 a. Yes
 454 b. No
 515 c. Sometimes
  
 4.  Does your teacher keep your classroom ventilated by opening 
a window or a door during the day?

 605 a. Yes
 226 b. No
 736 c. Sometimes

 5.  Do you stay home from school when you are sick with a cold 
or the flu?

 799 a. Yes
 125 b. No
 645 c. Sometimes

 6.  How often does another student cough or sneeze on you at 
school?

 346 a. At least once a day
 214 b. At least once a week
 117 c. All the time
 892 d. Rarely

 7.  Do you wash your hands with soap before you eat lunch at 
school?

 309 a. Yes
 870 b. No
 390 c. Sometimes

 8.  Do you wash your hands with soap before you eat a snack at 
school?

 113 a. Yes
1168 b. No
 288 c. Sometimes

9.  Do you cover your mouth and nose when you sneeze?

1232 a. Yes
  61 b. No
 275 c. Sometimes

10.  You can reduce the spread of germs by ______.

 116 a. Covering your nose and mouth when you cough or sneeze
  47 b. Washing your hands frequently
  66 c. Keeping your fingers, pencils, etc. out of your nose and
        mouth
1338 d. All of the above

11.  I usually catch a cold or the flu from someone at school.

 559 a. Yes
 289 b. No
 718 c. Sometimes

12.  My parents make me go to school when I have a cold or the 
flu.

 280 a. Yes
 718 b. No
 571 c. Sometimes

13.  Do you ever share a drink with a friend at school by 
drinking out of the same bottle, cup, glass, or can.

 575 a. Yes
 602 b. No
 392 c. Sometimes

14.  Do you share snacks with your friends at school by eating 
out of the same bag or container.

 740 a. Yes
 298 b. No
 527 c. Sometimes

15.  Do you chew on your pencil, pen, or finger nails during 
class while at school?

 608 a. Yes
 344 b. No
 617 c. Sometimes

16.  Does your classroom ever get hot and stuffy in the winter 
time?

 641 a. Yes
 427 b. No
 501 c. Sometimes

17.  If a friend of yours comes to school sick, do you stay away 
from him/her?

 658 a. Yes
 909 b. No

18.  Do you ever share the same plate, fork, knife, or spoon 
when eating with your friends at school.

 187 a. Yes
1187 b. No
 191 c. Sometimes

19.  Do you lick your fingers after you have eaten a snack?

1026 a. Yes
 205 b. No
 333 c. Sometimes

20.  Everyone picks their nose with their fingers at one time or 
another.

1130 a. True
 439 b. False

21.  Everyone picks their teeth with their fingers at one time 
or another.

1135 a. True
 430 b. False

22.  Touching phones, computer keyboards, library books, 
doorknobs, desks, and chairs at school is a good way to 
contaminate your hands with the germs that can cause colds and 
the flu.

1118 a. True
 450 b. False

23.  Sometimes my mouth or cheek touches the water fountain at 
school when I am getting a drink because the water does not come 
out strong enough. 

 764 a. True
 804 b. False

24.  A team of students at Mandeville Middle School has designed 
a mask that may help keep you well during the cold and flu 
season.  The Designer Health Mask helps stop the germs that 
cause colds and the flu from getting to your mouth and nose 
where they can make you sick.  The Designer Health Mask is a 
surgical mask with art work drawn and painted on the front.  You 
can even design the art work for your very own mask.

Would you be willing to wear your very own Designer Health Mask 
at school during the cold and flu season, if it would help you 
stay well?

 192 a. Yes
 945 b. No
 427 c. Maybe, once I learn more about it.

VIII.  ANALYSIS OF DATA:

A total of 1,733 students in grades 2 through 12 from 
California, Louisiana, Virginia, Illinois, Washington, DC, 
Mississippi, Wisconsin, Connecticut, Georgia, Washington, Iowa, 
Vermont, Massachusetts, Texas, Kentucky, Montana, New York, 
Nebraska, Kansas, Michigan, Oregon, Australia, New Zealand, and 
Brazil responded to our questionnaire.

A majority of 86% of the students responding to our 
questionnaire reported that lots of students at their schools 
get sick during the cold and flu seasons.  A majority of 82% 
reported that they usually catch a cold or the flu from someone 
at school.   

At Risk Behavior

A majority of 62% reported that they usually do not use soap 
when they wash their hands at school.  A majority of 80% 
reported that they usually don't wash their hands with soap 
before they eat lunch at school.  A majority of 93% reported 
that they usually don't wash their hands with soap before they 
eat a snack at school.  A majority of 62% reported that they 
usually share a drink with a friend at school by drinking out of 
the same bottle, cup, glass, or can.  A majority of 81% reported 
that they usually share snacks with their friends at school by 
eating out of the same bag or container.  A majority of 78% 
reported that they usually chew on their pencil, pen, or finger 
nails during class while at school.  A majority of 58% reported 
that they usually don't stay away from their friends if they 
come to school sick.  A majority of 87% reported that they 
usually lick their fingers after they have eaten a snack.  A 
majority of 72% believe that everyone picks their nose with 
their fingers at one time or another.  A majority of 73% believe 
everyone picks their teeth with their fingers at one time or 
another.  A majority of 61% reported that their teachers usually 
do not keep their classrooms ventilated by opening a window or a 
door during the day.  A majority of 73% reported that their 
classrooms usually get hot and stuffy in the winter time.  A 
small majority of 51% reported that they stay home from school 
when they are sick with a cold or the flu, but a majority of 54% 
also reported that their parents usually make them go to school 
when they have a cold or the flu.  

Healthy Behavior

A majority of 78% reported that they cover their mouth and nose 
when they sneeze or cough.  A majority of 76% reported that they 
usually don't share the same plate, fork, knife, or spoon when 
eating with their friends at school.  A small majority of 51% 
reported that their mouth or cheek doesn't usually touch the 
water fountain at school when they are getting a drink because 
the water does not come out strong enough.  A majority of 57% 
reported that other students rarely cough or sneeze on them at 
school.           

Factual Questions

A majority of 61% of the students did not know that colds and 
the flu are caused by viruses.  A majority of 85% knew that they 
can reduce the spread of germs by covering their nose and mouth 
when they cough or sneeze, washing their hands frequently, and 
keeping their fingers, pencils, etc. out of their nose and 
mouth.  A majority of 70% knew that touching phones, computer 
keyboards, library books, door knobs, desks, toilet flush 
handles, and chairs at school is a good way to contaminate their 
hands with germs that can make them sick.   

Designer Health Mask

A majority of 60% reported that they would NOT be willing to 
wear their very own Designer Health Mask at school during the 
cold and flu season.

IX.  SUMMARY AND CONCLUSION:

A total of 1,733 students from our school district and around 
the world responded to our questionnaire.

A majority of students do not use soap to wash their hands at 
school before eating lunch and snacks.  They share snacks out of 
the same bag and drink out of the same container with friends.  
They do not stay away from their friends when they come to 
school sick.  They chew on pencils, pens, and finger nails in 
class and lick their fingers after eating snacks.  They also 
believe that students pick their teeth and nose with their 
fingers.  

A majority of students report that they, and lots of other 
students, get sick at school during cold and flu seasons.  They 
try to stay home when they are sick, but their parents sometimes 
send them to school even though they are ill.  Their classrooms 
are not usually ventilated by their teacher and get hot and 
stuffy during the winter.

A majority would not be willing to wear a Designer Health Mask.  
Students in the lower grades tend to be more willing to wear the 
Designer Health Mask than students in the middle and upper 
grades.  This finding clearly demonstrates how important a 
health training program for the students' is.  Students must be 
educated about how a Designer Health Mask can help keep them 
well during the cold and flu season.

Finally, 83% of the students who responded to our questionnaire 
reported that they usually catch a cold or the flu from someone 
at school.  Therefore, we accept our hypothesis which stated 
that the majority of students will be at a high risk of getting 
sick because of their behavior at school.

X.  APPLICATION:

Now we know what behaviors and experiences students have at 
school that can expose them to germs which could cause them to 
get sick.  We can apply this to our school environment by 
starting a program that would get students in schools to change 
their behavior and to wear Designer Health Masks during the cold 
and flu season.  

We will distribute surgical masks to students and show them how 
to create  fashionable health masks decorated with art work of 
their choice.  This will hopefully motivate students to wear the 
masks during the flu and cold season.  

We will also produce an instructional video which will inform 
students about the different ways that they can help protect 
themselves from getting colds and the flu such as washing their 
hands, keeping thing like pencils and fingers out of their nose 
and mouth, not sharing eating utensils, not drinking out of the 
same can, cup, or bottle, covering their nose and mouth with 
their arm when they cough or sneeze,  ventilating their 
classroom, staying away from sick students, and staying home 
when they are sick so no one else will get infected from their 
illness.

© 1998 John I. Swang, Ph.D.