Influenza is one of the biggest causes of school absenteeism. And as teachers and principals often say, a child who isn’t in class cannot learn. But absenteeism is not the only reason to fear the new H1N1 flu virus spreading through schools this fall.
When children catch the flu they readily transmit it to their families and communities — perhaps because they aren’t always vigilant about covering their noses and mouths when coughing or sneezing.
As a group, children are two to three times more likely than adults to be infected by any flu virus each year. They harbor more live viruses in their respiratory secretions than adults do and for twice as long. It’s no wonder that schools are a perfect environment for a virus to spread, with 20 to 30 children in a classroom, and hundreds gathered in a cafeteria, gym or auditorium, touching and sneezing on one another.
Schools can take several measures to help keep flu from spreading: Hand-washing and coughing or sneezing into the arm or a tissue should be stressed. Hand-sanitizing gel dispensers should be available throughout schools for both staff members and students. Parents should be instructed to monitor their child for flu symptoms like fever, cough, sore throat, runny or stuffy nose, aches, fatigue, and even vomiting or diarrhea, and if they are present, keep the child home from school for 7 to 10 days.
And in cases of a widespread outbreak — if, for instance, there are confirmed cases of H1N1 flu in half the regions of a state — it may be wise to close schools for a few weeks until most of the children have recovered.
To make sure that such measures are taken in all schools, every county should create an influenza action team run by the local health department and including parents and school administrators. (The team should also include local doctors and nurses, government officials and the news media.)
In addition to seeing that schools work on prevention, these teams should monitor influenza activity in the community, especially absenteeism in schools, and remain alert to new information from the Centers for Disease Control and Prevention.
Since the novel H1N1 virus infection so far appears to be about as severe as ordinary seasonal flu, parents should seek a doctor’s help if the child seems to have a severe case or is at high risk for complications.
If an effective vaccine can be developed by early fall, it will also be a good idea to inoculate the students. The C.D.C. now recommends that virtually all children age 6 months or older receive an influenza vaccine. School-based vaccination programs may be a good idea, making it possible to inoculate large numbers of schoolchildren quickly with an H1N1 vaccine that’s separate from the seasonal flu shot. To make sure the community is prepared for such a program, school officials should encourage parents to talk with their children’s doctors about the best way to get their children vaccinated.
The silver lining in this approaching storm may be that multiple agencies will learn to work together to protect communities from pandemic flu.
James C. King Jr., a professor of pediatrics at the University of Maryland School of Medicine. His clinical research studies receive financing from influenza vaccine manufacturers.