. >> reporter: for more than 15 years, sheila holcomb has been driving between five different schools. >> good morning. >> reporter: for her job as a school nurse in the fulsom cordova school district of california. >> did you bump your nose? >> reporter: and the number of students she cares for keeps increasing. >> better? my case load is just under 2,000. >> how many of you washed your hands before you came to school today? >> reporter: and now there is a new threat, school just started and this district already, more than a dozen students have confirmed swine flu. guidelines from the cdc and state health departments call for the school nurse to be the one who keeps up for the status of the epidemic in the community and identifies students who are truly at risk and must be isolated and sent home. but if there is no nurse? >> there will be secretaries or other nonmedical people that will have to try their best to handle it. >> reporter: the availability of school nurses varies enormously according to state laws and policies. vermont has one school nurse for ever275 students. while ut