Schools can remain open if they have confirmed or suspected cases of flu caused by the H1N1, or swine flu, virus unless there are large numbers of students at high risk, or so many absences that the schools cannot function, according to federal recommendations issued last week.
The guidance was released at a joint news conference Aug.7 in Washington that included the secretaries of education, health and human services, and homeland security, as well as the head of the federal Centers for Disease Control and Prevention.
Decisions to close schools are generally made at the discretion of local officials. Hundreds of schools were disrupted last spring when officials closed them on the basis of federal recommendations that were eventually reversed. (“Swine Flu Disruption Has School Officials Looking for Lessons,” May 13, 2009.)
The CDC now believes this strain of flu is comparable in severity to what schools would encounter with a typical seasonal flu, which does not usually force school closures.
“It is now clear the closure of schools is rarely indicated, even if H1N1 is in the schools” said Dr. Thomas R. Frieden, the director of the Atlanta-based CDC.
Before his appointment, Dr. Frieden was the health commissioner in New York City, which saw thousands of swine flu cases last school year and, in some situations, closed schools. “Maybe we would have closed fewer if we knew what we know now,” he said.
The first cases of the H1N1 flu in the United States were clustered in schools. There were also concerns that young people were particularly susceptible to the illness.
But federal experts have come to believe that school closures are a less effective control measure and, though young people are more susceptible to the illness, their symptoms are generally mild.
The government recommendations for preventing the spread of the flu are to identify sick people early, send home children and employees with symptoms, and practice good hygiene, such as frequent hand washing and covering of one’s mouth when coughing or sneezing. Students and employees can return to school when their fevers have been gone for 24 hours, far less than earlier recommendations of seven days.
The CDC also is recommending that people between the ages of 6 months and 24 years old be among the groups to be vaccinated for the H1N1 virus. That vaccine is expected to be a two-dose regimen separated by at least three weeks, and will not replace the regular seasonal-flu vaccine.
U.S. Secretary of Education Arne Duncan has said schools could serve as vaccination sites.
