Modesto Bee Article

By Ken Carlson, Modesto Bee Staff Writer
last updated: July 27, 2009

As children return to school for the spelling tests, the science labs and after-school clubs, area schools will be trying to keep them and staff members from getting swine flu.

Health officials worry that cases of H1N1 influenza could take off as classrooms fill with children coming back from summer vacation.

Schools are accustomed to dealing with seasonal flu. But H1N1 is different and experts believe it will be the dominant strain during the fall and winter flu season.

No one has immunity to the novel virus and H1N1 has tended to strike harder among young people and adults ages 20 to 55. The seasonal flu is usually more deadly to the elderly and the very young with pre-existing health conditions.

According to the federal Centers of Disease Control and Prevention, the highest rate of H1N1 infection has occurred in people 5 to 24 years old and that group has the second-highest rate of illness requiring hospitalization.

Children with conditions such as asthma or diabetes are at higher risk of serious flu complications, experts say.

Officials have tried not to trigger alarm, however, because the severity of H1N1 is about the same as seasonal influenza, which results in 36,000 deaths each year in the United States. Most people infected have mild to moderate symptoms and fully recover.

"There is not any evidence it is changing in terms of severity," said Dr. Randy Bergen, the clinical lead for Kaiser Permanente's flu vaccine program in Northern California. "I would anticipate the same degree of severity we saw when it broke out last spring and what we are seeing in the Southern Hemisphere."

Since emerging in Mexico last winter, the swine flu has spread worldwide, causing 477 deaths in the United States and putting more than 7,500 people in U.S. hospitals. In Stanislaus County, two adults have died and 36 people (with a median age of 30) have been hospitalized. There has been one death in Merced County and two in San Joaquin County.

For area schools, the state and federal guidelines have changed since the spring, when the first cases were recorded in California, said Dr. John Walker, public health officer for Stanislaus County.

Walker met with the Stanislaus County Office of Education on Thursday to discuss how schools should respond.

The focus is now on isolating students with flu symptoms, instead of closing campuses when cases emerge. If students appear to have the flu, school staff members are supposed to send them to the nurse's office, where they should be isolated from others until their parents take them home.

Under the previous policy, children suspected of having swine flu were kept home for seven days; the new policy could permit their return to school earlier. They can return to school 24 hours after the fever is gone and they have stopped taking fever medications for the same time.

At that point, the illness is no longer considered contagious.

Keeping sick kids at home urged

Schools also are expected to teach students to wash their hands regularly and use alcohol-based hand cleansers and to cover coughs with a sleeve or tissue. Schools also are telling parents not to bring their children to school if they come down with symptoms at home.

School officials said they are in agreement with the guidelines, developed by the CDC, the California Department of Public Health and the state superintendent of schools.

"We want a consistent response from schools across the county so parents aren't confused," said Jane Johnston, assistant county superintendent and liaison between Stanislaus County's school districts and the county health department.

Key Information

Stanislaus County health officials expect that cases of swine flu, or H1N1 influenza, will increase in the coming weeks and months. Here is what you need to know:

• The illness: H1N1 influenza is contagious. It's mainly spread by coughing or sneezing and infected droplets coming into contact with another person. People also can pick up the virus from a doorknob or other infected surfaces.

• Symptoms: Fever, cough, sore throat, body aches, headache, chills, fatigue. Patients may have diarrhea and vomiting. Symptoms are usually mild to moderate; most patients fully recover.

PRECAUTIONS

• Cover coughs and sneezes with an elbow, sleeve or tissue. Coughing into hands can spread germs to others.

• Wash hands often with soap and water, or use an alcohol-based hand sanitizer.

• Avoid touching your eyes, nose and mouth, even after washing your hands.

• Avoid close contact with sick people.

• Stay home if you are sick.

TREATMENT

Rest, stay hydrated and talk with your doctor about a fever reducer or prescription Tamiflu, which can control the virus. Seek immediate medical attention if you or a child have these warning signs:

• In children, fast breathing or trouble breathing; bluish or gray skin color; not drinking enough fluids; severe or persistent vomiting; not waking up or interacting.

• In adults, difficulty breathing; pain or pressure in the chest or abdomen; sudden dizziness; confusion; severe or persistent vomiting.

ON THE NET

www.stanemergency.com or www.cdc.gov/h1n1flu.

Source: Stanislaus County Health Services Agency; Centers for Disease Control and Prevention

Bee staff writer Ken Carlson can be reached at kcarlson@modbee.com or 578-2321.