Feds revise swine flu guidance

In a departure from previous guidance on the issue, the U.S. government on Aug. 7 said schools should close this fall only if large numbers of students have swine flu, and schools could allow their sick students to return 24 hours after a fever is gone.

The decision whether to close always rests with local school officials, but educators have been looking to the federal government for advice about the new flu strain that has caused a global epidemic.

The advice on sick kids returning is a change from previous recommendations that people with swine flu should stay home for at least a week.

As the virus spread to students last spring, more than 700 schools in 25 states temporarily closed their doors. The new flu is expected to hit schools again this fall. But the Obama administration is hoping to minimize school closings–and the disruptions they cause for families.

Homeland Security Secretary Janet Napolitano offered the new advice on school closings, while the guidance on students returning came from Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.

Unlike regular seasonal flu, this virus has not retreated during the hot and humid summer months and so far has infected more than 1 million Americans, officials say.

“We hope no schools have to close, but realistically, some schools will close this fall,” Education Secretary Arne Duncan said this week during a forum with administration officials that was broadcast online.

“I’m dealing first and foremost as a parent,” Duncan said Aug. 7 on a nationally broadcast news show. “I want to keep my children safe and keep them learning.” He said officials are asking parents to “use common sense” and encourage their children to vigorously wash their hands several times a day and take other safety precautions.

“We want to provide as [many] facts as we can” to local officials, he said. “Basically, this will be a tiered response. If there’s a handful of children at a school who might be sick, we want the parents to keep them home. If the numbers escalate dramatically, then we might have to close the schools.”

Duncan said officials anticipate the vaccine will be available by mid-October and that they want schools to be principal sites for getting the shots.

Students got an unexpected vacation last spring, but many parents scrambled to find child care.

School officials had been acting on advice from the CDC, which at first said schools should shut down for about two weeks if there were suspected cases of swine flu.

Then the CDC changed course, saying schools did not need to close because the virus was milder than feared. Instead, parents were told to keep sick kids home for at least a week.

Duncan said at a swine flu summit last month that closing school should be “a last resort, not a first resort.”

He said earlier this week that school districts should use common sense. “If you have one child sick, that’s one thing. If you have a whole host of children getting sick, that’s another,” Duncan said.

Although this particular flu virus is new, the matter of school closings is not. Every winter, regular flu outbreaks prompt a relatively small number of schools to close for a few days because of high absenteeism among students or staff.

In addition to new guidance for when to close, the CDC and Education Department said this week they have set up a new monitoring system to track school closures across the country.

The new guidelines also recommend schools have plans in place to deal with possible infection. For instance, people with flu-like illness should be sent to a room away from other people until they can be sent home. And schools should have contingency plans to fill important positions such as school nurses.

If the H1N1 flu virus causes higher rates of severe illness, hospitalizations, and deaths, school officials could add to or intensify their responses, the guidelines say. Under these conditions, the guidelines advise parents to check their children every morning for illness and keep their children home if they have a fever.

In addition, schools could begin actively screening students upon arrival and send ill students home immediately. If one family member is ill, students should stay home for five days from the day the illness develops, the guidelines say.

“Influenza can be unpredictable, so preparation and planning are key,” said Dr. Frieden. “We can’t stop the tide of flu, but we can reduce the number of people who become very ill by preparing well and acting effectively.”

Still up in the air is whether schools will be turned into vaccine clinics, though Health and Human Services Secretary Kathleen Sebelius has said that seems logical. “We’re seeing schools as potential partners,” she said at the forum with Duncan.

Children are on the priority list for the first doses of swine flu vaccine, but because of the time needed for testing and manufacturing, inoculations can’t begin until school has been in session for more than a month; the government is aiming for Oct. 15. Many questions remain, including whether people will need one shot or two for protection. That’s in addition to the regular winter flu vaccine that is also recommended for children.

States and school districts should be preparing for the possibility of mass vaccinations, federal officials have said.

They also should make plans to keep kids learning when schools do close, Duncan said, such as by setting up online-learning contingency plans.


New federal flu guidelines for schools

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