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CDC: Keep Schools Open if Swine Flu Hits

New Guidelines Also Say Sick Kids Can Go Back to School 24 Hours After Fever Goes Away
WebMD Health News
Reviewed by Louise Chang, MD

Aug. 7, 2009 - Schools should try to stay open if swine flu hits, new CDC guidelines urge.

Schools and parents should do everything they can to limit the flu spread within schools. They should close only if the school isn't able to function or if the swine flu virus mutates into a more deadly form.

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Flanked by three members of the Obama Cabinet -- Health and Human Services Secretary Kathleen Sebelius, Homeland Security Secretary Janet Napolitano, and Education Secretary Arne Duncan -- CDC Director Thomas R. Frieden, MD, today announced the new guidelines at a news conference.

"We now know closure of schools is rarely indicated, even if flu is in the school," Frieden said.

Frieden was health commissioner of New York City when swine flu hit last spring, infecting some 800,000 people. "There were many schools that had many cases that we did not close," he said. "There were also more than 50 schools we decided to close -- and we might have closed fewer if we knew then what we know now."

Sebelius stressed the fact that so far, disease caused by swine flu is not more severe than disease caused by seasonal flu.

"What we are seeing looks like seasonal flu so far," she said. "Normally, parents would not keep their children home if some friend or classmate came down with the flu."

Closing schools causes severe social disruption. The new CDC guidelines leave decision-making up to local communities, but urge communities to weigh the very real harm of school closings against the potential harms of increased flu spread.

It's nearly inevitable that after weighing these risks and benefits, some communities will decide to close schools.

"We hope no schools will have to close, but realistically, some will close this fall," Duncan said. "It is important that our children continue to learn. Home schooling plans must be in place, whether for a few students or for the entire school."

Some schools, such as those for pregnant teens or for kids with disabilities affecting their lungs, might still have to close in order to protect those at highest risk of severe swine flu disease. These "selective dismissals" aren't intended to reduce flu spread in the community.

Some communities may, however, opt for "reactive dismissals," closing schools:

  • If there is excessive absenteeism among students or staff.
  • If large numbers of kids are visiting the school health office or being sent home during the day.
  • If the school isn't able to keep sick people out.
  • For other reasons that "decrease the ability to maintain school functioning."
  • Closed schools should also cancel school-related mass gatherings.

And if swine flu surveillance indicates that a more severe wave of flu is about to hit, communities should consider "preemptive dismissals." In this case, closed schools are also urged to cancel all school-related gatherings such as sporting events, dances, performances, rallies, and commencements.

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