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Are You Ready if Swine Flu Arrives at Your School?

Since the outbreak of swine flu in April 2009, cases of the novel H1N1 virus have been confirmed in all 50 states and continue to be reported all around the world. On June 11, 2009, the World Health Organization classified the pandemic as "Phase 6," meaning widespread human infection. While the death rate is low compared to the seasonal flu (302 people in the United States died from the illness as of July 24, 2009), the transmission rate for the H1N1 virus remains high: Reported cases in the U.S. total more than 40,000, which is considered to be only a fraction of the actual total.

The Food and Drug Administration has approved an H1N1 vaccine for widespread use, with a distribution date set for October 15, 2009. Kathleen Sebelius, the secretary of Health and Human Services, thinks that limited supplies may arrive even earlier than that. The Centers for Disease Control and Prevention (CDC) recommends that, among other high-risk groups, children between 6 months and 18 years receive the vaccination, based on their susceptibility to the H1N1 strain and close contact with their peers at school. With over 45 million doses expected by mid-October, vaccine shortages are not anticipated, but if they occur, vaccine providers will give priority to kids between 6 months and 4 years, as well as children ages 5-18 who have chronic medical conditions.

The seasonal flu vaccine is not expected to be effective against the swine flu, and ordinary retroviral drugs can only mitigate the symptoms, not stop the spread of the disease.

How Schools Can Prepare

With the school season in full swing, many parents are wondering how to prepare for more outbreaks. When the swine flu pandemic began, schools around the country, from Texas to Massachusetts, closed when cases were reported locally. The CDC recommends that schools do not close for cases of swine flu "unless there is a magnitude of faculty or student absenteeism that interferes with the school's ability to function." Nevertheless, it is reasonable to expect some closings to happen in the upcoming year, and the CDC is currently tracking school closings on its website.

Although it's up to each school district to determine its own response to the swine flu threat, many are installing hand sanitizers and redoubling efforts to encourage good hygiene. In addition, the CDC has recommended specific action items for schools. From their guidelines:

  • Students, faculty or staff with influenza-like illness (fever with a cough or sore throat) should stay home and not attend school or go into the community except to seek medical care for at least 7 days even if symptoms resolve sooner.
  • Students, faculty and staff who are still sick 7 days after they become ill should continue to stay home from school until at least 24 hours after symptoms have resolved.
  • Students, faculty and staff who appear to have an influenza-like illness at arrival or become ill during the day should be isolated promptly in a room separate from other students and sent home.
  • Aspirin or aspirin-containing products should not be administered to any confirmed or suspected ill case of novel H1N1 influenza virus infection aged 18 years old and younger due to the risk of Reye syndrome. Refer to pediatric medical management for guidance regarding use of any medications, especially those containing aspirin. (http://www.cdc.gov/h1n1flu/clinicians/)
  • Parents and guardians should monitor their school-aged children, and faculty and staff should self-monitor every morning for symptoms of influenza-like illness.
  • Ill students should not attend alternative child care or congregate in other neighborhood and community settings outside of school.
  • School administrators should communicate regularly with local public health officials to obtain guidance about reporting of influenza-like illnesses in the school.
  • Schools can help serve as a focus for educational activities aimed at promoting ways to reduce the spread of influenza, including hand hygiene and cough etiquette.


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