Schools Are Underprepared for Pandemics and Natural Disasters: Study

Washington, DC, October 5, 2015

Missouri schools are no more prepared to respond to pandemics, natural disasters, and bioterrorism attacks than they were in 2011, according to a study published in the October issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC).

A team of researchers from Saint Louis University collected and analyzed survey responses from 133 nurses serving elementary, middle, and high schools in Missouri to determine whether schools were any more prepared for another pandemic than they were based on a similar study conducted in 2011. Pandemic preparedness is not only critical because of the threat of a future pandemic or an outbreak of an emerging infectious disease, but also because school preparedness for all types of disasters, including biological events, is mandated by the U.S. Department of Education.

Researchers found that on average, schools still reported having less than half of the measured indicators for preparedness. Although in general, schools were much better prepared for natural disasters than biological events, nurses agreed on the equal importance of being prepared for both. Particular gaps were found in bioterrorism readiness—less than 10 percent of schools have a foodservice biosecurity plan and only 1.5 percent address the psychological needs that accompany a bioterrorism attack. This part of the study expanded upon the 2011 study, which did not evaluate bioterrorism preparedness.

In addition, only 1.5 percent of schools require that staff receive an annual flu vaccine.

“Infectious disease disaster planning among Missouri schools does not appear to have progressed much over the last four years since a similar nationwide study was conducted, and most Missouri schools are not meeting many national and professional organization recommendations and guidelines,” state the study’s authors. “A critical finding from this study is that only a very small percentage of schools are addressing student psychological needs as part of disaster planning. Numerous researchers have emphasized the important role schools will play in meeting student and staff psychological needs during and after disasters.”

The researchers conclude that U.S. schools must continue to address gaps in infectious disease emergency planning, including developing better plans, coordinating these plans with local and regional disaster response agencies, and testing the plan through disaster drills and exercises. Whenever possible, school nurses should be involved in these planning efforts, as healthcare professionals can best inform school administrators about unique aspects of pandemic planning that need to be included in school disaster plans.

The full text of the article is available to journalists upon request; contact Liz Garman, APIC at +1 202 454 2604, to obtain copies.


Notes for Editors
Missouri K-12 school disaster and biological event preparedness and seasonal influenza vaccination among school nurses,” by Terri Rebmann, Michael B. Elliott, Deborah Artman, Matthew VanNatta, and Mary Wakefield appears in the American Journal of Infection Control, Volume 43, Issue 10 (October 2015), published by Elsevier.

Terri Rebmann, PhD, RN, CIC (*Corresponding Author)
Institute for Biosecurity, Saint Louis University
College for Public Health and Social Justice, St. Louis, MO
Michael B. Elliott, PhD
Department of Biostatistics, Saint Louis University
College for Public Health and Social Justice, St. Louis, MO
Deborah Artman, RN, MSN, MPH, APHN-BC, NCSN
School of Nursing, Saint Louis University
St. Louis, MO
Matthew VanNatta, MPH
Institute for Biosecurity, Saint Louis University
College for Public Health and Social Justice, St. Louis, MO
Mary Wakefield, MPH
Institute for Biosecurity, Saint Louis University
College for Public Health and Social Justice, St. Louis, MO

About AJIC: American Journal of Infection Control 
AJIC: American Journal of Infection Control covers key topics and issues in infection control and epidemiology. Infection preventionists, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of APIC, AJIC is the foremost resource on infection control, epidemiology, infectious diseases, quality management, occupational health, and disease prevention. AJIC also publishes infection control guidelines from APIC and the CDC. Published by Elsevier, AJIC is included in MEDLINE and CINAHL.

About APIC
APIC’s mission is to create a safer world through prevention of infection. The association’s more than 15,000 members direct infection prevention programs that save lives and improve the bottom line for hospitals and other healthcare facilities. APIC advances its mission through patient safety, implementation science, competencies and certification, advocacy, and data standardization. Visit APIC online at Follow APIC on Twitter and Facebook. Visit APIC’s Infection Prevention and You website at

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Media Contact
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+1 202 454 2604