How US schools aim to handle swine flu

As several states begin receiving the swine flu vaccine, here is a Q-and-A on what parents can expect to happen at schools.

More than 700 schools shut their doors last spring, as the H1N1 flu virus hit the United States. Uncertainty over the severity of the disease and fears of a pandemic were widespread.

This fall, school boards plan to close only as a last resort, and they're instead focusing on prevention, containment, and common sense. The bottom line, they say, is that the illness has not been particularly severe, and there is no reason for alarm.

Still, rumors and fears are circulating both about potential dangers in a swine flu outbreak and about an overly vigilant government response that might trample individuals' rights.

Here's a breakdown of what parents can expect at schools this fall.

What preparations are schools making?

Schools are emphasizing the importance of hand-washing, asking parents to keep children home until they have had no symptoms for at least a day, and designating a room to isolate children exhibiting symptoms until parents take them home.

Many schools are installing hand sanitizers in every classroom and posting signs reminding students and staff about hygiene.

In Chicago, where last spring two schools shut down for at least a week, the district is monitoring patterns of absences and tracking them in a database that is provided daily to the city health department. The events last spring "made us put in place a response plan that we can now use for any emergency," says Monique Bond, spokeswoman for Chicago Public Schools. "That was the good thing that came out of this."

In many places, schools are making a big effort to ensure that students who need to stay home are kept abreast of what's going on in the classroom. In New York City, for example, homework and course work are being distributed in neighborhood centers for parents to pick up, says Brenda Greene, director of school health programs for the National School Boards Association (NSBA).

Districts plan to shut a school down only as a last resort, if too many students and staff become absent for the school to function. "It's best when children stay learning," says Justin Hamilton, a spokesman for the US Department of Education. "Last spring, we knew less than we know now, so out of an abundance of caution, people thought it better to close some schools down," he adds. But now, "if you can keep a majority of the building safe and healthy, you should stay open."

What if conditions worsen?

Most schools and health officials are working under the assumption that swine flu is not a particular cause for concern among healthy individuals.

But if assumptions were to change, the Centers for Disease Control and Prevention (CDC) has listed more-extreme measures that districts could consider. These include: taking students' temperatures at the door, increasing the physical distance between students in the classroom, and canceling large gatherings.

Will vaccinations be mandatory?

No. In general, vaccination requirements are made at a state level, but at this time, no state is requiring flu shots for either seasonal flu or H1N1.

No unvaccinated child will be denied entry to a school at this point.

The swine flu vaccine began arriving in several states this week, and wider distribution is expected later this month. The CDC recommends the vaccine for individuals between 6 months and 24 years old, among other groups.

Will schools be used as vaccination sites?

Possibly. With a mass vaccination program expected to roll out this fall, health officials are looking for convenient public places to administer shots. Schools are particularly attractive to some public health officials given that schoolchildren are among the targeted groups for vaccination.

"The [Education] secretary has been making the point that he feels schools should be part of the solution, but it's a local decision," says Mr. Hamilton of the Department of Education. "Some school districts have announced they're going to [host vaccination sites]. Others won't do it."

In most cases, vaccination sites have yet to be decided.

Any child would need a parent's consent before receiving a flu shot. Schools that act as vaccination sites may send home consent forms beforehand to streamline the process and determine how many students are likely to participate.

Can the government forcibly quarantine a child?

No. Despite some rumors circulating in the blogosphere, no one will be forcibly quarantined, although schools may require a child showing symptoms to stay in a quarantine room until the child can go home.

Who decides whether to close a school, and who handles policies related to a flu epidemic at school?

All school decisions are made locally, although the CDC issues guidelines that many districts follow. "What happens in one school or district is not necessarily what will happen in a neighboring district," says Ms. Greene of the NSBA.

How are colleges responding to cases?

The American College Health Association (ACHA) reported about 6,500 new flu cases on US campuses in just one week in September. But in general, cases have been relatively mild, and students have been able to return to classes quickly.

The tight living quarters of colleges can be a concern, but schools are responding to various flu challenges in innovative ways. A few schools with vacant dorms – including Emory in Atlanta and Carnegie Mellon in Pittsburgh – have set aside space for students with symptoms. Most colleges, however, are asking students to isolate themselves.

Colleges are giving thought to how to educate students about hygiene and other techniques aimed at prevention. At the University of Virginia in Charlottesville, officials have found they get the best response with signage in dorm bathrooms in what they call their "stall seat journal," says James Turner, executive director of UVa's student health department there and president of the ACHA.

Most campuses, he says, are likely to administer vaccines when they're available, but in no case will they require students to be vaccinated.

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