Since the H1N1 virus (a.k.a., swine flu) was detected in the U.S. in April 2009, the U.S. Centers for Disease Control and Prevention (CDC) reports that an estimated 1 million Americans have been infected with the virus. And media reports claim that between 30,000 and 90,000 people could die from H1N1. Sure, the numbers sound scary, but keep in mind that nearly 40,000 people die from the seasonal flu every year. In fact, experts claim that the vast majority of children who develop flu-like symptoms this fall will be miserable for a few days and then recover. Want to learn more about how H1N1 will (or won’t) affect your classroom? Read the following frequently asked questions—and our experts’ answers.

What can I do to reduce my chances of getting swine flu?

Stay away from people who are sick. The H1N1 virus spreads the same way that other flu viruses spread—when the cough or sneeze droplets of an infected person move through the air or when you touch surfaces contaminated with the flu virus and then touch your mouth or nose before washing your hands. Frequent and thorough hand washing is the most important thing you can do to prevent swine flu. “Make hand washing one of your first lessons at the start of the school year,” suggests Sandi Delack, President of the National Association of School Nurses. The CDC recommends washing hands with soap and warm water for 15 to 20 seconds, about the time it takes to sing the Happy Birthday song twice. And make sure the kids in your class have access to running water, soap or hand sanitizers.

“It’s important for kids to understand that one way they can get sick is by touching surfaces that are contaminated with germs and then touching their eyes, noses and faces,” says Lisa Barrios, Branch Chief of the CDC's Research Application Branch in the Division of Adolescent and School Health. “It’s also important for children to learn proper cough and sneeze etiquette.” Kids (and adults) should cover their mouths and noses with a tissue when they’re coughing or sneezing, then throw the tissue away. If a tissue isn’t available, they should use their arms—not the palm of their hands.

Another tip: clean keyboards, desktops and other surfaces that are regularly touched. “We want people to wash their hands every time they cough or sneeze, but having alcohol-based sanitizers available—and disposable wipes for surfaces—is the next best thing,” says Barrios.

Keeping a school stocked with cleaning products can get expensive, so remember that plain soap and water can work just as well for hands and surfaces as more expensive options.

What do I need to know about the swine flu vaccine?

Scientists isolated the H1N1 virus and modified it so it can be used to make hundreds of millions of doses of vaccine. This process is the same one used to make the seasonal flu vaccine. The only differences are the type of virus.

Experts expect the H1N1 vaccine to be available in mid-October, and the first in line to get vaccinated are pregnant women, caregivers for children under 6 months of age, healthcare and emergency personnel, people between 6 and 24 years old and people between 25 and 64 years old who have compromised immune systems and chronic conditions. (Unlike the seasonal flu, the risk of infection with H1N1 among people over the age of 65 is less than the risk for younger age groups.) According to the National Institutes of Health, early data suggest that a single 15-microgram dose of the H1N1 influenza vaccine is well tolerated and induces a robust immune response in healthy adults between the ages of 18 and 64 about 8-10 days after vaccination.

Dosing schedules are still being developed by the U.S. Food and Drug Administration (FDA); according to the CDC, the current recommendation is one dose for those 10 years of age and older. Until there is further data, the FDA has approved two doses for children 9 years and younger. For updates and more detailed information, please see the CDC’s H1N1 FAQ.

Even though experts are confident that the H1N1 vaccine will protect against the virus, according to Barrios, it’s important to remember that no vaccine is 100% effective or 100% safe. If you want to avoid both H1N1 and the seasonal flu, you need to get both vaccines.

“People should get the seasonal flu vaccine now (it’s already available), and they should get the H1N1 vaccine as soon as it becomes available,” says Barrios.

What should I do if there’s an outbreak at my school?

Keep up the routine cleaning and focus on enforcing hand hygiene and respiratory etiquette. “Then be on the lookout for people who are becoming ill during the school day and separate them from the people who are well,” says Barrios. “And get people who are at high risk (like the 10% of children in our schools who have asthma) into treatment as soon as possible if they become ill.” It’s very important that teachers talk to parents of kids who are more susceptible to H1N1, so they can get into early treatment if necessary.

School administrators are also re-thinking perfect attendance awards and other incentives that might encourage students and teachers to come into school when they’re sick. “We’re working with administrators to cut students and teachers some slack,” says Delack. “If they have the flu, we need them to stay home.”

Educators can also use their building or district administrators as resources for community updates and local health department recommendations.

If I feel like I’m getting sick, at what point should I go to the doctor?

If you’re experiencing fever, cough, sore throat, fatigue and body aches, stay home. “Don’t come back to school until you have been fever-free for 24 hours without medication,” says Delack. That will help keep H1N1 out of the classroom for the students and teachers who are in school. And don’t go to urgent care without calling a doctor first. You may not have H1N1, but you could be exposed to people in the waiting room who are infected. What’s more, you’re likely to wait for several hours only to be told the standard advice: lots of fluids, rest and over-the-counter flu remedies for your fever. That said, you should see a doctor immediately if you’re experiencing any of the following symptoms:

• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting
• Flu-like symptoms that improve but then return with a fever and worse cough

“With H1N1, we’re seeing a much higher rate of vomiting and diarrhea than with the seasonal flu,” says Barrios.

What drugs are prescribed for H1N1?

The CDC recommends two antiviral drugs for the treatment of swine flu: oseltamivir (Tamiflu^®) and zanamivir (Relenza^®). “The antivirals don’t just treat the symptoms, they also help prevent the flu from spreading and prevent serious flu complications,” says Delack. “But for the drugs to be effective, you have to take them within the first 48 hours of your illness—and follow the recommended course and doses.” The drugs are available by prescription only, they’re effective and they have a low risk of side effects. However, the recommended use of antivirals for treatment or prevention of H1N1 is mainly for those at risk for complications from infection.

Where can I get more information?

Here are a few of the major organizations that are regularly updating their H1N1 information:

• NEA HIN’s H1N1 January 2010 virus information update
• Swine Flu Information for Educators - NEA Health Information Network (HIN)
• Current H1N1 Flu Information - U.S. Centers for Disease Control and Prevention (CDC)
• Flu.gov - U.S. Department of Health & Human Services
• H1N1 Flu Page - U.S. Food and Drug Administration
• H1N1 Flu Information - U.S. Department of Education (ED.gov)

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