'What if?': Area districts preparing for swine flu

Dozens of districts around the region may offer swine flu vaccinations in their schools.

The University of Delaware, which treated 1,080 students for flulike symptoms during a week in April, has begun placing hand sanitizers at 37 locations around campus. Last night, more than 150 dormitory resident assistants were trained about swine flu.

But with the spring epidemic virtually gone for the summer and a vaccine months away from delivery, many preparations for fall are of the "what-if" variety.

Yet guidance is coming daily.

The federal health and education secretaries yesterday publicized their recommendations to colleges: Get students to clean dorm doorknobs and remote controls, for example, and have someone else fetch a meal from the dining hall for a sick kid.

Also yesterday, the Pennsylvania Department of Health wrapped up a series of Web seminars for thousands of local officials, saying schools should be closed only when there are too few staff to run them. New Jersey is meeting with districts on Tuesday.

But some factors that must be weighed before setting plans in stone are not known.

While the first doses of swine flu vaccine - still in the testing stages - are expected to arrive in mid- to late-October, they won't get everywhere at once. And two shots will be needed, along with the usual one for the regular flu.

That flu can appear as early as November but sometimes, as in this past season, not until January. No one has any idea when swine flu will roar back, although experts believe that it will, probably in as moderate a form as in the spring.

The new flu is again expected to disproportionately infect children. A combination of young ages, close proximity, and constant touching makes schools (and, to a lesser extent, summer camps) ideal viral incubators.

Vaccinating school-age children and their parents is the most effective way to reduce transmission of any flu, researchers reported yesterday online in the journal Science.

Most decisions - about vaccinations, school closings, and other issues - are up to local officials and dependent on local conditions.

"In some circumstances, mass vaccination clinics would be appropriate," said Stephen Ostroff, director of the state health department's Bureau of Epidemiology. "In others it won't be."

For instance, in Philadelphia, which has about 450 public and private schools, "the staff isn't there for them to deliver the volume of vaccines that they would need," said Caroline Johnson, director of the city health department's Division of Disease Control.

So a swine flu vaccine - free in many cases - will largely be given through the same doctors' offices and clinics, including those at colleges, that do seasonal flu shots.

The West Chester Area School District normally gives seasonal flu shots in elementary schools to students who are not able to get them from their family doctor, spokesman Rob Partridge said.

Although nothing has been decided about H1N1, every West Chester school already has a nurse. Depending on timing and supplies, Partridge said, "the district's mind-set would be to prepare to make swine flu inoculations available."

New Jersey last year became the only state in the nation to require seasonal flu shots for entry into preschools and licensed day-care centers. But swine flu vaccination will be voluntary there and everywhere else.

Mandating the new vaccine would be premature, said state epidemiologist Tina Tan: "It doesn't exist yet."

Guidance on how schools should respond to infections continues to evolve.

At one point in the spring, for instance, the U.S. Centers for Disease Control and Prevention recommended that local officials consider closing a school in response to a single confirmed case.

If swine flu comes back in a form no more severe than before, closures are now recommended only as a last resort - and are no longer believed to make much difference in preventing the virus' spread in the community.