Guidelines for School Responses to Influenza

1. Lisa C. Barrios, DrPH Guidance and Technical Assistance Lead H1N1 Community Measures Task Force September 15, 2009 CDC Guidance for State and Local Public Health Officials and School Administrators for School (K-12) Responses to Influenza during the 2009-2010 School Year

2. 2009 H1N1 Activity Influenza illness is ongoing in the U.S. As of September 4, 2009, state and local public health departments have reported 9,079 hospitalizations due to 2009 H1N1 flu 593 deaths CDC estimates >1 million cases between April and June 2009 in the U.S. 2009 H1N1 flu virus is the predominant flu virus in circulation worldwide.

3. 2009 H1N1 and seasonal flu will co-circulate during flu season. Timing, spread, and severity are uncertain. Every year in the U.S., about 5% to 20% of population gets the flu. More than 200,000 hospitalized. About 36,000 people die from flu-related causes. Best way to protect yourself and your loved ones is to get vaccinated for seasonal flu every year.

4. Provides guidance to help decrease spread of flu among students and staff. Balances goals of reducing number of people who become seriously ill or die from flu with goal of minimizing educational and social disruption. Recommends actions to take now. Suggests strategies to consider if severity increases. Provides a checklist for making decisions. Accompanied by supplemental materials. Technical Report Communications Toolkit

5. Key Points Currently, potential benefits of preemptive school dismissal often outweighed by negative consequences. CDC may recommend pre-emptive school dismissals in the future if severity increases. Guidance offers a menu of strategies based on spring/summer 2009 outbreak and additional interventions to consider if severity increases. Decisions should be made locally through collaborative decision making involving education and public health agencies, parents, and community.

6. Recommended school responses under conditions with similar severity as in spring/summer 2009: Stay home when sick Separate ill students and staff Hand hygiene and respiratory etiquette Routine cleaning Early treatment of high-risk students and staff Consideration of selective school dismissal

7. Recommended school responses under conditions of increased severity compared with spring/summer 2009: Active screening High-risk students and staff members stay home Students with ill household members stay home Increase distance between people at schools Extend the period for ill persons to stay home School dismissals Reactive Preemptive

8. Collaboration is Essential CDC U.S. Department of Education State and local public health and education agencies Schools Students, staff, and families Private sector Community-based and faith-based organizations

9. Deciding on a Course of Action CDC recommends a combination of targeted, layered strategies applied early and simultaneously Based on local information, and in close collaboration with local and state health officials CDC will monitor data trends and make recommendations but states and communities can expect to see variability