Updated Federal Guidelines for 2009 H1N1 influenza in schools

Updated federal guidelines offer state and local public health and school officials a range of options for responding to 2009 H1N1 influenza in schools, depending on how severe the flu may be in their communities.

The guidance says officials should balance the risk of flu in their communities with the disruption that school dismissals will cause in education and the wider community.

The guidance from the Centers for Disease Control and Prevention (CDC) was announced today at a joint news conference by Health and Human Services Secretary Kathleen Sebelius, Education Secretary Arne Duncan, Homeland Security Secretary Janet Napolitano, and CDC Director Thomas R. Frieden, M.D., M.P.H.

The school guidance is a part of a broader national framework to respond to novel H1N1 influenza, which includes encouraging people to be vaccinated against the virus and to take other actions to avoid infection. The CDC anticipates more illness after the school year starts, because flu typically is transmitted more easily in the fall and winter.

“We’re going to continue to do everything possible to keep our children – and all Americans – healthy and safe this fall,” Secretary Sebelius said. “But all Americans also have a part to play. The best way to prevent the spread of flu is vaccination. A seasonal flu vaccine is ready to go, and we should have one for the 2009 H1N1 flu by mid-October.”

“The federal government continues to coordinate closely with state and local governments, school districts and the private sector on H1N1 preparation as we head into the fall flu season—and the upcoming school year,” said Secretary Napolitano. “Readiness for H1N1 is a shared responsibility, and the guidance released today provides communities with the tools they need to protect the health of their students and teachers.”

For an outbreak similar in severity to the spring 2009 H1N1 infection, the guidelines recommend basic good hygiene, such as hand washing. In addition, students or staff members with flu-like illness (showing symptoms of flu) should stay home at least 24 hours after fever symptoms have ended.

“We can all work to keep our children healthy now by practicing prevention, close monitoring, and using common sense,” Secretary Duncan said. “We hope no schools have to close. But if they do, we need to make sure that children keep learning.”

The 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. Schools should have plans for continuing the education of students who are at home, through phone calls, homework packets, Internet lessons and other approaches. And schools should have contingency plans to fill important positions such as school nurses.

If H1N1 flu 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 the children home if they have a fever.

In addition, schools could begin actively screening students upon arrival and sending 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.”