Published Online: May 1, 2009

More Schools Close, Swine Flu Cases Pass 100

Nearly 300 schools scattered around the country closed as the nation's swine flu caseload passed 100 Thursday, and U.S. authorities said they eventually could produce enough vaccine for everyone if necessary — but that shots couldn't begin until fall at the earliest.

The outbreak penetrated over a dozen states and even touched the White House, which disclosed that an aide to Energy Secretary Steven Chu apparently got sick helping arrange President Barack Obama's recent trip to Mexico but that the aide did not fly on Air Force One and never posed a risk to the president.

An estimated 12,000 people logged onto a Webcast where the government's top emergency officials sought to cut confusion by answering questions straight from the public: Can a factory worker handling parts from Mexico catch the virus? No. Can pets get it? No.

And is washing hands or using those alcohol-based hand gels best? Washing well enough is the real issue, answered Dr. Richard Besser, acting chief of the Centers for Disease Control and Prevention. He keeps hand gel in his pocket for between-washings but also suggested that people sing "Happy Birthday" as they wash their hands to make sure they've washed long enough to get rid of germs.

It is safe to fly, U.S. officials found themselves stressing after Vice President Joe Biden got off message Thursday. Biden said he'd discourage family members from flying or even taking the subway. The White House insisted the vice president meant to say he was discouraging just nonessential travel to Mexico, the hardest-hit area.

Advice for Schools on Swine Flu

President Barack Obama said Wednesday that schools should close temporarily if any students have confirmed or suspected cases of swine flu.

He was reiterating guidance from the federal Centers for Disease Control and Prevention and the Education Department.

Here are their recommendations for schools:

CLOSING

Schools and child care centers should close if they have a confirmed case of swine flu or a suspected case that is linked to a confirmed case. All school-related gatherings should be canceled, and parents and students should avoid gatherings outside of school as well.

Decisions about closing other facilities nearby should be left to local authorities. Big gatherings linked to schools or other places where swine flu cases have been confirmed should be canceled.

REOPENING

Schools and child care centers should consult with local and state health departments. They may consider reopening if no additional confirmed or suspected cases are found within seven days.

NOTIFICATION

Schools should inform students, parents and staff about the symptoms, which can include cough, sore throat, body aches, headaches and fever.

They should stress preventive measures such as washing hands frequently and covering your mouth when coughing or sneezing.

Students with flu-like symptoms should be referred to a health care provider. Experts say there is no need to single out students who have recently traveled to Mexico; they should only be asked to stay home if they have flu symptoms.

ISOLATION

Those who have the flu should stay home for seven days after the onset of the illness. But other so-called "social distancing" measures are not recommended.

QUESTIONS

The Education Department has created an e-mail address, osdfs.safeschl@ed.gov, for education leaders and school staff to ask questions and report any closings because of swine flu. The CDC Web site is www.cdc.gov. The Education Department Web site is www.ed.gov.

"It is safe to fly. There is no reason to cancel flights," Transportation Secretary Ray LaHood said. Not just planes but "all modes of transportation are safe in America," he added.

But anyone with flu-like symptoms shouldn't be traveling anywhere unless they need to seek medical care — the same advice that doctors give during the winter when regular flu kills 36,000 Americans each year.

"If you're ill, you shouldn't get on an airplane or any public transport to travel," CDC's Dr. Anne Schuchat told a congressional hearing. "If you're sick, stay home. I can't tell you how many times I've said that this week."

So far U.S. cases are fairly mild for the most part, with one death, a Mexican toddler who visited Texas with his family — unlike in Mexico where more than 160 suspected deaths have been reported. In fact, Schuchat said most of the U.S. cases so far didn't need a doctor's care.

Extraordinary Precautions

Still, the U.S. is taking extraordinary precautions, including shipping millions of doses of anti-flu drugs to states in case they're needed against what the World Health Organization has called an imminent pandemic, because scientists cannot predict what a brand-new virus might do.

The Health and Human Services Department said late Thursday the government was buying 13 million treatment courses of anti-flu drugs to replenish the U.S. strategic stockpile and help fight the swine flu outbreak. The U.S. on Thursday also began sending 400,000 treatment courses of the drugs to Mexico to help against swine flu there.

Health and Human Services Secretary Kathleen Sebelius said the government was spending an estimated $251 million to replace the 11 million treatment courses offered to states recently and to purchase 2 million more courses. Part of the additional 2 million treatment courses will replace the drugs sent to Mexico.

The U.S. has stockpiled about 50 million courses of anti-viral drugs and states have an additional 23 million. A treatment course is the amount needed to treat one person.

A key concern is whether this spring outbreak of swine flu will resurge in the fall.

Remember, CDC's Besser cautioned, not every pandemic is like the disaster of 1918. "There are some pandemics that look very much like a bad flu season," he said.

Scientists are racing to prepare the key ingredient to make a vaccine against the never-before-seen flu strain, but it will take several months before the first pilot lots begin required human testing to make sure the vaccine is safe and effective. If all goes well, broader production could start in the fall — if officials decide that's needed in addition to, or instead of, regular flu vaccine.

"We think 600 million doses is achievable in a six-month time frame" from that fall start, Health and Human Services Assistant Secretary Craig Vanderwagen told lawmakers.

"I don't want anybody to have false expectations. The science is challenging here," Vanderwagen told reporters. "Production can be done, robust production capacity is there. It's a question of can we get the science worked on the specifics of this vaccine."

School Closings Doubled

The number of closed schools more than doubled overnight to nearly 300 when the Fort Worth Independent School District in Texas announced it was closing its 140 schools, affecting about 80,000 students. High schools sports were suspended in Texas and Alabama.

"We do think it's very prudent to close schools when a case has been confirmed or is highly suspect," CDC's Schuchat told lawmakers Thursday.

Colleges are seeing cases too. Four were confirmed at the University of Delaware, and in Pennsylvania, Slippery Rock University will hold a separate graduation Saturday for 22 students who recently returned from Mexico and won't be beyond an incubation period.

"People went to Mexico for spring break, came back and now we're seeing second and third generation spread," said Dr. Dan Jernigan, CDC senior science officer.

Closing a school alone won't stop community spread.

"If a school is closed, it's not closed so kids can go out to the mall or go out to the community at large," Homeland Security Secretary Janet Napolitano said. "Keep your young ones at home."

That means businesses will have to handle parents who miss work, Biden reiterated: "And the hope is that the employers will be generous in terms of how they treat that employee's necessary action of taking that child home and not being at work."

The CDC confirmed 109 cases Thursday, and state officials confirm 24 more. Cases now are confirmed in: New York, Texas, California, South Carolina, Kansas, Massachusetts, Indiana, Ohio, Arizona, Michigan, Nevada, New Jersey, Delaware, Maine, Colorado, Georgia, Minnesota and Virginia.

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