School nurses may be the first line of defense for the swine flu as kids get back in school. Robert Bazell looks into whether there are enough of them to do the job.

"I'm headed over to my middle school which is about 800 students."

For more than 15 years Sheila Holcom has been driving between five different schools for her job as school nurse in the Folsom Cordova school district of California, and the number of students she cares for keeps increasing

"My caseload is just under 2 thousand," Shelia says.

And now there is a new threat. School just started and in this district already, more than a dozen students have confirmed swine flu. Guidelines from the CDC and most state health departments call for the school nurse to be the one who keeps up with the status of the epidemic in the community and identifies the students who are truly at risk and must be isolated and sent home but if there is no nurse?

Assistant of School Nurses, Sandy Delack says, "There will secretaries or other non medical people that will have to try their best to handle it."

The availability of school nurses varies enormously according to state laws and policies. Vermont has one school nurse for every 275 students while Utah as the worst ratio --one nurse for just under every 5000 students. Last spring when St., Francis prep in New York City was the first U.S. school hit with the virus, school nurse Mary Pappas was widely considered a heroine who played a key role in keeping the epidemic form getting even worse.

"I sent home 102 children the first day, and 80 the second day.” Pappas said, “You have to keep your cool. You all of a sudden represent the school to the parents"

Sheila Holcom can't be everywhere at once, but faces her enormous challenge with enthusiasm

"It's busy!” She says, “I'm tired when I get home but I love this work and wouldn't think of doing anything else!!"

She know the odds are she will have a very busy year