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In the the peak of the Cold War, fire drills and nuclear weapons drills were a frequent part of school safety protocols. In some schools in the west, earthquake drills were and still are part of the norm. But researches note that there are no known safety procedures in place in the case of bio-terrorism attacks, outbreaks of emerging infectious diseases or pandemics.

Recent pandemics such as the swine flu outbreak or the 2009 H1N1 influenza pandemic that lead to over 18,000 deaths world wide indicate the emerging importance of protecting students in case of such disasters and teaching them how to deal with them.

The study, led by Terri Rebmann, Ph.D., associate professor at SLU's Institute for Biosecurity, surveyed about 2000 nurses working in elementary, middle and high schools across 26 states.

Results showed that just 48 percent of schools address pandemic preparedness and only 40 percent of schools have updated their plans since the 2009 H1N1 pandemic that spread illnesses in more than 214 countries.

The study also found that 44 percent of schools do not participate in community surveillance that tracks the presence of a disease based upon symptoms reported by area residents. 

"There is a lot of research that shows influenza spreads quickly in schools because it's a communicable disease and kids interact closely," Rebmann said, as quoted from press report released by the Saint Louis Medical Center "Schools need to have a written pandemic plan in order to be prepared to put interventions into place quickly when an event occurs."

Researchers suggest, according to the report, that in order to have a strong pandemic preparedness program "school nurses should be involved in building and assessing the plan."

One of the most prominent findings of this study, Rebmann says, is that better prepared schools were the ones that involved their nurses in the disaster planning committee.

 "The school nurse is the best person in a school district to know about infection control and be able to make recommendations about the best interventions to implement during a biological event."