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A health alert is spreading through the Charles County school system almost as fast as a dangerous game.

School officials are alerting parents to a fad students are participating in, referred to as a knockout or pass-out challenge.

According to information provided by the school system, three students were sent to the hospital last week after participating in the challenge, where students are purposely making themselves pass out, and another challenge involving a common spice.

School spokeswoman Katie O’Malley Simpson wouldn’t give any details of the age of the students or the schools where incidents happened. She said Tuesday that all three are back in school.

The “cinnamon challenge” involves swallowing a certain amount of cinnamon and seeing how long the person can keep it down before the body rejects it.

Superintendent James E. Richmond wrote in a health alert statement from the school system, “Students are learning about these challenges through social media sites such as YouTube and Facebook, which are blocked at our schools but easily accessible through smartphones and outside computers.”

Richmond later noted that the school system urges parents to monitor what students are viewing on such sites to help “curb this dangerous behavior.”

Phylis Reinard, supervisor of health for the school system, said the health concern with students passing out, aside from the lack of oxygen to the brain, is the injuries that can occur from a fall once the student has passed out.

Reinard said while the body will naturally trigger the breathing response, there is always a possibility that the body won’t trigger itself to breathe after one passes out.

This appeared to be the case for one young man in Florida last year.

Jessica Maldonado, a parent of two students in Charles County, said Monday that her nephew, a 14-year-old boy from Florida, died last year from participating in such a game.

Maldonado’s nephew was alone, she said, when he attempted a similar game, known as the choking game.

Ruled an accident, Maldonado said her nephew’s death was the result of the game and that detectives told the family that if one holds a particular place on the neck, he can experience a high.

In her nephew’s case, the consequence of the game was death, she said.

“We don’t want this to happen to someone else’s family ... because of a stupid game that kids actually think is cool,” Maldonado said.

After hearing an automated message from the school system about the health concern last week, Maldonado said she sat her school-aged children down and told them if anyone asked them to hold their breath, not to.

And if anyone asked them to eat anything their mother didn’t approve of or send to school with them, like cinnamon, to not do it.

Her children are younger than 8. However, she said it was important to sit them down to explain the dangers.

Last Friday, one day after multiple incidents brought the game to school officials’ attention, principals from every public school in Charles County made an announcement about the health risk of these games.

With the cinnamon challenge, Reinard said the concern is not the students trying to ingest large amounts of cinnamon but the breathing problems associated with the challenge.

“It may not hurt you, but it’s very hard to get it to your mouth without inhaling it,” she said. Inhaling the spice, she said, could trigger breathing problems and put one in respiratory distress.

Reinard said she has found that cinnamon aggravates mucous membranes in the mouth causing difficulties with ingestion in large amounts.

The main concern, she reiterated, was inhaling the spice.

In Charles County last week, there were at least eight cases involving student at middle and high schools participating in these types of games.

Reinard said it is important to get parents involved as the school system is with the children for several hours of the day, but her fear is that students might attempt these games at home at times when no one is around to be there if something goes wrong.

Students participating in the games at school risk not only health concerns but also disciplinary action, since it is a disruption of the school day, school officials said.

On Monday morning, two students from Margaret Brent Middle School in Helen tried the knockout game and ended up in the nurse’s office, St. Mary’s County School Superintendent Michael Martirano said.

Four students from Margaret Brent were sent to the nurse’s office by a school administrator Monday morning after allegedly attempting the knockout challenge, said Trish Wince, supervisor of health services for St. Mary’s public schools. Those students were OK, she said.

Staff writer Jesse Yeatman contributed to this report.