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ADVANCE Perspective: Respiratory Views

CDC issues H1N1 guidelines for post-secondary education

Published August 21, 2009 3:15 PM by Vern Enge
In the midst of preparing for the 2009-2010 school-term flu season, the best advice seems to come from old stand-bys in the health care community. Among the ones most common to therapists and sleep techs are good hand hygiene, adequate bed rest, strict quarantine practices and not trying to rush the healing process along too fast.

We're all familiar with 24/7 in the health care community. It translates into 24 hours seven days a week. But in terms of flu epidemics it is important to remember that this flu season, 24 refers to 24 hours after the last symptom of the flu disappears before normal activities can be resumed and seven refers to a full seven days of rest and quarantine that may be needed from the offset of symptoms to the end of the flu, barring the use of any relief medications at the very end of the cycle.

Key to the flu guidance issued by the Centers for Disease Control and Prevention this week are pieces of advice for loosening some of the requirements for physician notes from both students and staff, because overloaded clinics may make obtaining such paperwork nearly impossible to obtain.

Currently the CDC is working with state and local officials to monitor the severity of flu in various communities and will make additional recommendations should the need arise.

So far, the current guideline is for post-secondary and institutions of higher education that have both residential students and non-residential students and staff. The advice trickles down to high schools, intermediate schools, junior high schools and elementary schools as well.

Here are the basic recommendations:

  • Those with flu-like symptoms should stay away from classes for at least 24 hours after they no longer have a fever or signs of a fever.
  • Review policies and procedures that make it difficult for individuals to stay away from the classroom.
  • Students should be sent home if they have the flu or moved to private rooms if in a dorm-type setting.
  • Students with private rooms should remain in their rooms and receive care and meals from a single person.
  • If close contact with others cannot be avoided, the ill students should be asked to wear a surgical mask during the periods of contact.
  • Institutions of higher education should consider providing temporary housing for ill students until 24 hours after they are free of fever.
  • Instruct students with flu-like symptoms to seek prompt medical attention, especially if they have a medical condition that puts them at an increased risk of severe illness from flu.
  • Promote self-isolation at home by non-resident students, faculty an staff.

Special considerations should be made for high-risk individuals. Early treatment with antiviral medications can prevent hospitalizations and death.

Groups at high-risk include: children younger than age 5; people 65 or older; children and adolescents receiving long-term aspirin therapy or at risk for Reye's syndrome or severe infection; pregnant women; adults and children with asthma, pulmonary, cardiovascular, hepatic, hematological, neurological, neuromuscular or metabolic disorders like diabetes.

But age is not alone an indicator. People over age 65 appear to be at lower risk of H1N1 compared to younger people. But if the older adults do get the flu, they are at an increased risk of having a severe illness.

People under age 25 are in the key group recommended for vaccination this season.

And, of course, cleanliness is next to Godliness as they say. Common surfaces like doorknobs, bathroom faucets, elevator buttons and tables should be cleaned on a routine basis. And sound respiratory etiquette itself is a good practice: covering mouths and noses with a tissue or hand when coughing or sneezing or using anything like a shirt sleeve if no tissue is available.

Disposable wipes are commonly used for cleaning surfaces and should be used in abundance in both public and private spaces.

While it is almost impossible in social setting to attain, individuals should be kept at least six feet between people at most times and public events like films, sporting events and lectures should be suspended or modified.

More importantly, any facility that is suspending classes should do so for at least five to seven days. Before the end of this period, the facility should collaborate with public health offices to reassess the epidemiology of the disease and the benefits and consequences of continuing the suspension or resuming classes.

Finally, the right decision-makers and stakeholders should be involved in making health care decisions. These include campus health services and mental health services, communications staff, food services, students, faculty and community representatives.

Whatever decisions are made, each community is asked to address the following challenges:

  • Concerns about flu
  • People who do not feel empowered to protect themselves
  • Lack of public support for the strategy
  • Secondary effects of strategies like job security, financial support, health serve access and educational progress.

The suggestions can make this flu season less volatile should the flu virus hit pandemic proportions.

For continuing coverage of H1N1, visit our swine flu resource center.

posted by Vern Enge


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