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Back to School: Dealing with swine flu

Consumer Reports News: August 31, 2009 01:46 PM

Every year, I’ve found myself having to make a quick early morning decision about whether a slight fever, a sniffle or a cough was enough to keep one of my children home from school. But this year, that decision will be impacted by swine flu outbreaks as the nation tries to tamp down an expected increase in disease this fall.

Over the summer swine flu lingered in camps and other places where young people congregate. And because this flu seems to spread most easily among the young, an upswing in infections is expected to coincide with back-to-school season. Those under 5, and people of all ages with other underlying health conditions, such as asthma, diabetes, neuromuscular disorders and heart disease, as well as pregnant women and girls, face an increased risk of complications from the flu.

During the initial outbreak last spring, there was some confusion about school closings, as health authorities and communities at large tried to learn about the disease and implement pandemic flu plans. Over the summer the Centers for Disease Control and Prevention updated its guidance for K-12 schools dealing with flu this year. The new recommendations try to balance the threat of flu, with the social disruption of closing schools. More responsibility for averting outbreaks will be sought from parents, who are being asked to think about those kids at greater risk before dropping off a feverish child at school.

The CDC’s new guidance favor other preventative measures over school closures, which are to be reserved for extreme outbreaks, or when there are a number of high-risk students or staff, as might be the case at a school for pregnant girls, for example. Instead of school-wide dismissal, administrators and parents are advised keep sick children home until their fever has subsided for at least 24 hours—that should be without the help of fever reducing medications like acetaminophen or ibuprofen. Schools are also advised to make sure to assign staff to care for sick children, and separate those who get sick from others until their parents can pick them up.According to the guidance, schools are also encouraged to:

Promote good hand washing—washing for at least 20 seconds with soap and water—and provide the supplies, which may include alcohol-based hand sanitizer, and the time for students and staff to do so frequently;

Educate and remind students to cover their coughs and sneezes with a tissue or their sleeve, and to provide easy access to tissues;

Revise policies so they don’t penalize children who stay home sick, by canceling perfect attendance awards, for example;

Regularly clean surfaces that are likely to have frequent hand contact

Provide masks and other personal protective equipment to sick students and their caretakers until they can be sent home;

Limit the number of people who interact with sick children;

Encourage sick students and staff at higher risk to see a doctor as soon as possible to prevent complications.

Expect the unexpected

Flu viruses are notoriously unpredictable, and they’re subject to change—for the worse or better—without notice. The CDC has further guidance should the disease become more severe. But we’ve already heard about complaints to the CDC that some schools are going beyond even the more strident guidance, so expect the unexpected. Decisions about the actual steps your school takes are made at the local level. To learn about your school’s pandemic and emergency plans and get involved in your community, communicate frequently with school administrators and teachers—as well as your children—so you know what is actually going on.

What you can do

Expect that your child will be sick at some point during the school year. Make plans now for how you’ll care for your children if they need to stay home for up to a week. Talk to friends, relatives and neighbors, who might be able to help out with day care. Talk to your employer about taking time off should you need to care for your child, or about options for telecommuting. Make sure you have the supplies to deal with the flu, including a thermometer, fever reducers (acetaminophen and ibuprofen), diarrhea medications, drinks with electrolytes, as well as preventative supplies, such as tissues, alcohol-based hand sanitizer to use when soap and water isn’t available, and face masks with a rating of at least N-95*.

Update your emergency contact lists at home and at your school. Have a place in your house where you can separate a sick child from the rest of the household and pick one person to care for the sick in your home. Finally, consider vaccinating your family when a vaccine becomes available. I’m certainly planning to do so.

—Orly Avitzur, M.D., medical adviser, Consumer Reports

Keep up with our swine flu coverage and recommendations. And you can follow the CDC's updates on Facebook and Twitter.

Photo courtesy of alextakesphotos

* Update for November 2, 2009: A 2009 study finding that N-95 respirators were superior to surgical masks at preventing the spread of flu was retracted by the authors after a flaw in the methods was discovered. The authors now say there is no significance difference between N-95 respirators and surgical masks, confirming another recent study that found they were equal.

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