Prevention is the watchword as classes begin in Central Texas schools this week. School leaders, parents and local public health officials will be keeping a closer than usual watch on incidents of influenza-like illness. The World Health Organization (WHO) has predicted a resurgence of the H1N1 (swine) flu during the fall in addition to the traditional Type A flu that also is circulating.

"The situation regarding H1N1 influenza continues to evolve, so we are staying in close communication with federal and state organizations and the local health authority and we will be monitoring for influenza-like illnesses within the schools," says Stephen J. Pont, MD, MPH, medical director of the Dell Children's/Austin Independent School District Student Health Services. "Current recommendations are similar to those for seasonal flu, although more people may become ill with H1N1 because fewer have any natural immunity to it, since it is a brand new strain of the flu."

Like other school districts throughout Central Texas, AISD plans to beef up prevention education for students, teachers and families in addition to making sure primary prevention techniques including regular hand washing, use of tissues and hand sanitizers are in place. Classroom hard surfaces and commonly touched items (door knobs, counter tops, etc) will be cleaned regularly.

Practice Flu Prevention

"Expectations for H1N1 flu are evolving, but currently it is expected to be similar to the seasonal flu. The most important thing is to have good communication among area schools, the local health authority and federal and state health agencies. Rapid communication also will be important as we obtain new information," says Dr. Pont.

For right now, he recommends students adopt flu prevention practices to help students, staff, and families stay healthy during the flu season. The following tips from the Centers for Disease Control and Prevention work for both seasonal flu and H1N1 (Swine) flu:

• Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.
  
  
• Take everyday actions to stay healthy.
  
  
  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the used tissue in the trash.
    
    
  • Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
    
    
  • Avoid touching your eyes, nose or mouth. Germs spread that way.
    
    
  • If you get sick, stay home until you are fever-free for 24 hours without needing any anti-fever medicines such as Acetaminophen (e.g. Tylenol) or Ibuprofen (e.g. Motrin). **Do not give children aspirin** Limit contact with others to prevent infecting them.
    
    
• Follow public health advice regarding closures, social distancing measures, avoiding crowds, etc.
  
  
• Find healthy ways to deal with stress and anxiety.

H1N1 Symptoms

"Parents should watch children carefully to see if they develop symptoms," recommends Dr. Pont. "If your child has fever, keep him or her home from school until at least 24 hours after they no longer have fever. If anyone in your family has symptoms of the flu, it's a good idea to seek health care advice early because prescription antiviral medications may be able to reduce the seriousness and duration of the illness. Antivirals are only effective if used within 48 hours of the first onset of symptoms."

The primary symptoms of H1N1 flu resemble symptoms for other strains of influenza:

• Fever (greater than 100.3 degrees F) AND a cough or sore throat with no other known cause. People with low-grade fever (below 100.3 degrees F) probably do not have H1N1. Although some patients have not reported fever in connection with this strain, the vast majority of people have it. Coughs and sore throats on their own without the higher fever probably are symptoms of a cold, other viral infection or allergies.
  
  
• Body aches, headaches, chills and fatigue. These are other important symptoms that often accompany an H1N1 or seasonal influenza infection.
  
  
• Runny nose, nausea, vomiting and diarrhea. These symptoms can also be associated with influenza or other illnesses as well.

Information Is Key

"Dell Children's has a unique relationship with the school district because we provide health services to the 110 AISD campuses," says Dr. Pont. "It gives us a special opportunity to closely monitor, coordinate and manage developments throughout the system and not just at an individual school. During the spring flu outbreak, we initiated an enhanced monitoring system where absences were assessed according to cause. We put the monitoring plan in place in the spring during the initial outbreak of H1N1 flu and we were able to speed up the process by which attendance numbers are generated to assess for increased absences at AISD schools. This enhanced the surveillance of health encounters and sped up the reporting process. This is a fluid situation and things can change rapidly. If they do, we will know it. We have already begun monitoring attendance patterns and sick visits to the school nurses or school-based healthcare providers with the start of school this week."

He predicts schools will be an important part of the process once H1N1 and seasonal influenza vaccinations become available and encourages parents to keep up with changing recommendations.

The Seton Family of Hospitals has posted an information page on Flu/H1N1 that provides links to important CDC and Texas Department of Health information, including information about the progress on H1N1 vaccination plans. Check Texasflu.org for a comprehensive list of up-to-date information. The Austin ISD Web site has up to date information pertaining specifically to AISD.

Stephen J. Pont, MD, MPH
Assistant Professor of Pediatrics
Medical Director, AISD Student Health Services
UTMB-Austin Outpatient Faculty
UT-Austin Department of Kinesiology and Health Education

4900 Mueller Blvd, 3rd Floor
Austin, TX 78723
Phone: (512) 324-0165

Dr. Pont joined the ambulatory faculty of Dell Children's Medical Center this year. He earned a B.A. from the University of Texas at Austin and attended medical school at the University of Texas Southwestern Medical School in Dallas. Dr. Pont completed his pediatric residency training at Arkansas Childrens Hospital / University of Arkansas for Medical Sciences, Little Rock, AR and then completed an academic general pediatrics fellowship at Vanderbilt University Medical Center, Nashville, TN where he also received his M.P.H. Dr. Pont's interests include underserved populations and childhood obesity.