Federal agencies that deal with the novel influenza A(H1N1) virus pandemic have issued guidance for dealing with flu in schools.
The main messages were controlling in-school spread by having sick students and staff stay home, covering coughs, and doing lots of hand washing; keeping school closings rare; and having students and staff return to school 24 hours after their fever abatesa switch from prior guidance that called for a universal 7 days at home when sick.
The Centers for Disease Control and Prevention developed the guidance, which was presented by Health and Human Services Secretary Kathleen Sebelius, Homeland Security Secretary Janet Napolitano, Education Secretary Arne Duncan, and CDC director Dr. Thomas R. Frieden during a teleconference.
Another facet of the government's pandemic-control plan is to step up the use of schools as sites for immunization clinics. "School-located vaccine clinics are very important, and we hope they will occur in many areas, but it's a local decision," Mr. Duncan said. "Vaccine is our best defense against the spread of flu," but school-aged children have not usually received flu immunizations in the past.
The CDC recently held a meeting with representatives from organizations of teachers, school nurses, and school counselors, and those groups gave "tremendous support" to school-based flu immunizations this fall, Dr. Frieden said.
The agencies released a set of written recommendations and resource materials for schools on the government's flu Web site, Flu.gov
The CDC guidance lists six recommended steps for K-12 schools to take for influenza control as the new term starts:
▸ Have sick students and staff stay home when sick until at least 24 hours after they no longer have a fever or signs of a fever without using fever-reducing medications, advice that applies whether or not antiviral drugs are used.
▸ When students and staff develop flu-like illness at school, they should immediately stay in a separate room until they go home. While waiting to go home, sick people should wear a surgical mask, and those who care for them people should also wear protective gear such as a mask.
▸ Wash hands frequently with soap and water and cover coughs and sneezes with a tissue or, if needed, a shirt sleeve or elbow.
▸ School staff should routinely clean surfaces that students and staff touch often.
▸ People at high risk for flu complications who develop flu-like illness should be seen as soon as possible by their health care provider; early treatment with antiviral medication is important.
▸ A community may decide to close a school in which most or all students are at high risk from flu, although not many schools are in this category.
The CDC also said it might make additional recommendations if novel H1N1 infections this fall turn out to be more severe than they were last spring.
Ms. Sebelius said that the H1N1 vaccine is expected to be ready for distribution by mid-October, and that members from her staff have met with state officials to plan the logistics of widespread immunization. She urged Americans to get their annual, seasonal flu vaccine earlybefore Octoberso that attention can focus on distributing the H1N1 vaccine once it's ready.
The H1N1 vaccine will likely require two separate immunization doses administered about 3 weeks apart, Dr. Frieden said. The guidance also downplays the need for widespread school closings. "It is now clear that closing schools is rarely indicated, even when H1N1 is in the school," Dr. Frieden said.