With flu fizzling, health experts rethink school closures


WASHINGTON — With more data suggesting the swine flu outbreak may not be as deadly as first feared, U.S. health officials are reconsidering their earlier advice on when schools should be closed over health concerns about the virus.

"We are looking at our school closure guidance, and we're having very active discussions about whether it's time to revise that," said Dr. Richard Besser, the acting director of the Centers for Disease Control and Prevention, on Monday.

Current CDC directives suggest school closings of up to two weeks for confirmed or probable swine flu cases. Local school officials also can postpone or ban large school-related gatherings and social events where the disease could easily spread.

These precautionary guidelines were developed weeks ago when little was known about the new virus, and reports of hundreds dead and thousands sickened in Mexico caused panic around the world.

As of last week, more than 430 schools in 18 states were closed because of the outbreak, leaving more than 245,000 students out of class nationally — about one-half of 1 percent of U.S. enrollment.

Because the disease is attacking mostly healthy young people, school closings were supposed to keep students from infecting each other and then spreading the disease further into their communities.

Researchers have found, however, that the disease is already "pretty-well established" in areas where schools have been closed, Besser said.

"So closing schools as a means of not letting it spread through a community isn't very effective," he added.

Instead, officials are considering putting more emphasis on personal responsibility to help fight the disease. Following the lead of schools in Canada and in the Seattle area, Besser said parents should check children for flu-like symptoms before they go to school each morning and keep them home for at least a week if they appear ill.

He said teachers should do likewise and send ill students home in the same manner. At the same time, Besser said schools should help reinforce basic hygiene that can help slow the spread of the disease, such as frequent thorough handwashings, covering coughs with arms instead of hands and keeping fingers out of eyes, mouths and noses.

"These are things that schools can do," Besser said, adding that new guidance for schools could be expected as more information and research on the virus becomes available.

As the virus continues to spread internationally, researchers are becoming more confident that — in terms of its severity — the H1N1 virus is more like the seasonal flu rather than the Spanish fIu pandemic that killed 40 million to 50 million people in 1918.

"Each day makes us feel more comfortable about the progress of this outbreak," Besser said.

The World Health Organization reported Monday that 21 countries have reported 1,085 confirmed cases. Among those countries, Mexico still leads, with 590 confirmed cases and 25 deaths.

The U.S. has confirmed 286 cases in 36 states, with one death, according to the CDC. Besser said another 700 probable U.S. cases in 44 states are awaiting lab confirmation. Nearly 100 percent of probable cases have been confirmed, Besser said.

The disease continues to strike young people, with 62 percent of infections involving people under 18; the median age for victims is 16.

Officials continue to get encouraging news about the virus, which appears to be leveling off in Mexico City.

Studies have shown the virus lacks some of the characteristics associated with more serious strains in previous pandemics and it's still susceptible to antiviral medications Tamiflu and Relenza. In addition, the virus has shown no signs of mutating into a more severe strain.

"We haven't seen any changes that would cause alarm, so the viruses are remaining very consistent with respect to their genetic properties," said Dr. Nancy Cox, the director of the CDC's influenza division.

As the outbreak continues, officials will shift resources away from testing and more toward studying how the disease moves through the population, Besser said.

Researchers will be looking intently at the spread of the disease through the southern hemisphere, where winter is approaching.

Also, a new Ipsos/McClatchy Poll shows the public is split over the urgency of the flu outbreak, with 51 percent expressing concern that friends or family could get the disease, while 49 percent said they aren't worried.

The poll found strong support for the health community's response to the outbreak, with more than 80 percent expressing confidence in the way schools and local, state and federal health authorities are handling the outbreak. More than 90 percent of respondents said they hadn't or wouldn't change travel plans over the scare.


National Education Association information on schools a swine flu


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