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Wednesday, August 12, 2009

Fairfax Schools Air CDC's Strategy for Swine Flu's Return

By Nelson Hernandez
Washington Post Staff Writer
Wednesday, August 12, 2009

The expected resurgence of swine flu this fall could lead some public schools to become mass inoculation clinics. Infected students could be forced to wear surgical masks and put in isolation rooms before being sent home.

But school officials predict that the wave of school closings that caused much angst in the spring is unlikely to be repeated.
"School closures aren't really on the table," said Fred Ellis, director of safety and security for Fairfax County public schools. Unless the virus, known as H1N1, mutates to become more severe, health officials said, they will try to keep schools open and prevent the spread of the virus through other means.

"We really want people to get sick and tired, as I know you already are, of hand-washing and coughing etiquette," Ellis told about 200 Fairfax principals who had gathered for a back-to-school briefing Tuesday. A school might still be closed if there aren't enough healthy teachers and staff members to run the school or bus drivers to transport students, Ellis said.

The session at Luther Jackson Middle School, in the Falls Church area, offered a window into the preparations underway across the country as school officials pore over the latest guidance from the Centers for Disease Control and Prevention in the weeks before classes resume.

In the spring, when little was known about how deadly the disease might be, the CDC's advice frustrated some health officials, school principals and parents. Initially, a school could be closed for a week or more because of a single confirmed case of swine flu, and it seemed that the entire school year could crash to a halt. But that directive quickly changed because the virus's effects appeared to be fairly mild.

The CDC's latest advice gives local school systems more flexibility in dealing with the illness and on closing schools.

Students and staff members who are sick should stay home and should not return to school until at least 24 hours after the fever has broken, the CDC says.

Under CDC guidelines, sick students who do go to school would be asked to wear a surgical mask and sent to a quarantine room to be watched over by an adult also wearing a mask. The students would remain quarantined until their parents picked them up.



There could be more changes to the guidelines, particularly after a vaccine begins to be administered to the public en masse.

At the University of Maryland School of Medicine in Baltimore, 66 adult volunteers have received the first of two doses of an H1N1 vaccine. The university is one of 10 sites for national clinical trials of the vaccine, which started Monday.

The goal of the clinical trials is to determine how strong a dose is required to protect different age groups. To that end, researchers will test for antibodies in the volunteers' blood to assess their immunity.

Once testing is complete, the vaccine is to be given to states and local governments and administered to millions of Americans, starting with vulnerable populations such as children and young adults, pregnant women and people with weak immune systems. But there is no timeline or firm idea of how the vaccinations will be administered.

"Right now, we cannot stand here and tell you what the vaccination plan is going to look like," Ellis said. "We have no idea."

One option discussed would use schools as mass inoculation clinics. But Ellis also said Fairfax County's plan for dealing with the virus is "flexible and fluid," one of several remarks that drew laughs.

The H1N1 vaccine will not be a substitute for seasonal flu vaccine, and health officials recommended that their employees and everyone else get both.

Seasonal flu shots will be free for all school employees.

At Tuesday's briefing, Fairfax principals wrote out questions on blue index cards for health and school officials to answer. There were queries about the vaccine's effects (it should be as safe as a seasonal flu shot); about how to clean rooms in schools (with standard cleaning products, because antibacterial soap isn't any more effective against a virus); and about who will pay for cleaning products (the school system).

As they left the meeting, the principals seemed ready to face what will come.

"I think people are much more comfortable at this point in time," said Theresa West, principal of McNair Elementary School in Herndon. "Last spring, nobody knew what was happening. There was fear, getting in planes and everything else. Information, it helps people be calm."