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Swine Flu Difficulty: How To Care For Ill Students

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  • Swine Flu Difficulty: How To Care For Ill Students

    Source: http://www.theday.com/re.aspx?re=af7...3-f46e485efc32

    Swine Flu Difficulty: How To Care For Ill Students
    Schools that have weathered outbreak worry second wave could swamp them
    By Judy Benson Published on 8/25/2009

    Orange - Campuses that have had an outbreak of swine flu, including the Coast Guard Academy in New London, are using that experience to plan for an expected second wave this fall and are urging other residential colleges and private schools to do the same.

    One of the toughest issues, campus health officials said at a state Department of Public Health conference Monday, is figuring out how to care for ill students. The virus, declared a pandemic by the World Health Organization, is causing a lot of illness in Southern Hemisphere countries and India, noted Matthew Cartter, state epidemiologist, and campuses should be prepared for a spike in cases this fall since children and young adults are the most susceptible.

    ?We're kind of waiting for that next wave to repeat,? said Lt. Charlene Criss, Coast Guard medical officer. ?If another 10 percent of our cadets get sick, we will be overwhelmed.?

    This summer, 33 first-year cadets in a class of about 300 became ill with swine flu, also called novel H1N1 influenza. Another eight older cadets working with the swabs also had the virus, along with four members of the medical staff and six support staff, Criss told the audience of health and public information officials from colleges and residential private schools around the state, meeting at Yale University's satellite campus.

    While some campuses may be able to send students home until they recover - as Fairfield University did when it had an outbreak in May - that's not practical for others like the academy, said Debbye Rosen, the state public health department official who moderated the conference. Students may be too far from home for their parents to be able to take them home in a private car, and traveling by plane or other mass transportation would risk spreading the virus.

    ?How will you isolate these students?? she asked. ?We can't send them all home.?

    The academy's infirmary has space for only 10 patients, but since more than three dozen were ill at the same time and needed to be isolated from other cadets, the academy set up a makeshift sick ward with more beds. Extra medical staff from the Coast Guard were brought in to help care for them.

    As soon as students came to the infirmary with symptoms including fever over 100 degrees, they had to wear a surgical mask and stay in the sick ward for seven days after recovery. Criss said the plan for how to deal with a comparable outbreak once the whole student body returns later this month - roughly 1,000 students in all - is being developed. Some of the protocols are already in place, she added.

    ?We'll be masking people right away? when they show symptoms, she said. ?We'd rather be a little bit aggressive and contain it.?

    While the academy is satisfied it contained the summer outbreak as much as possible, it is also looking to avoid some of the problems that occurred if there is a new outbreak, Criss said.

    ?Getting meals to them and getting their trash taken away was a much larger job? because of concerns among staff about getting sick, she said.

    ?We had cleaning staff who did not want to go where the sick students were,? she said. ?And we ran out of laundry repeatedly,? including sheets and pillowcases.

    The room where the sick ward was set up also didn't have adequate cooling for the hot summer weather, she added. Another problem was boredom. Most of the ill students felt better after three or four days, she said, but had to stay separated from the other cadets for seven days after they no longer had symptoms. Monitoring those students became important, she said, to make sure they weren't getting visitors or were continuing to wear their masks properly.

    Centers for Disease Control and Prevention recommendations updated since the Coast Guard outbreak state that anyone who has had the virus can return to school or work 24 hours after they no longer have a fever over 100 degrees or higher, rather than seven days after they are symptom-free.

    Other speakers urged fellow campus officials to prepare vaccination programs for students and staff for seasonal as well as H1N1 flu vaccine, and make sure to communicate a unified, accurate message frequently to parents, students and the media.

    ?The grapevine is instantaneous,? said Gary Nelson, director of Fairfield University's health center. ?I don't think we had pulled the nasal swab out of the second student's nose before the phones started ringing with parents and students.?

    At Yale University, there were 20 cases of swine flu among students attending summer programs, said Judith Madeux, deputy director of the campus health service.

    ?We expect to see more cases early in the fall,? she said, noting that Yale students come from more than 100 countries. Letters, e-mails and podcasts to students, staff and parents about how Yale will manage a flu outbreak have been prepared, and a flu hotline set up for students to call and talk to a nurse about symptoms.

    The campus is also planning seasonal flu mass vaccination clinics for students and staff as soon as possible and will do the same for H1N1 vaccine when it becomes available. Supplies are expected to be limited, however.

    Yale has also prepared flu care kits with medications, masks, packets of chicken soup or cocoa mix and other supplies to give to students, and has teams of students in graduate-level nursing programs who've agreed to help care for ill students in their dorm rooms. The school infirmary, she added, can handle only about 24 patients for a student body of 11,000.

    To feed ill students, Yale dining services will deliver simple meals of sandwiches and Gatorade to dorm rooms. The campus will also track the numbers of staff who call in sick and report flu symptoms, she added.

    "Regional"

    SWINE FLU INCIDENCE RATE BY AGE:

    (cases per 100,000 people)

    AGES 5 TO 24: 21.6

    AGE 4 AND UNDER: 17.2

    AGES 25 TO 49: 5.4

    AGES 50 TO 64: 3

    AGES 65 AND OLDER: 1

    Source: Matthew Cartter, state epidemiologist, Connecticut Department of Public Health
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