H1N1 - Letter to Parents

November 6, 2009

Prepared by Cheryl T. Samuels, Ph.D.
CEA Health and Safety Consultant

The following information is based in part on the H1N1 Guidelines, Important H1N1 Flu Prevention and Response Information for the CEA Community, which is being followed at each of the global campus sites and partner locations. Students, faculty and staff at these locations have been educated on the transmission, symptoms complications and ways to prevent the spread, and if disease does occur, how to minimize the spread of the disease, and what to do when classes must be missed due to the flu.

The CEA Health and Safety Consultant sends regular briefings on health related issues including the H1N1 flu to the Global Programs Directors and CEA staff. Helpful web sites for up to date information are www.cdc.gov/h1n1flu and www.flu.gov. These are very helpful resources and should be recommended to parents and staff if they have specific questions about the disease, the vaccines and the spread of the disease in the US. The www.who.org (World Health Organization) web site gives up to date information across the globe. Other helpful web sites in English are www.hnhs.uk (National Health Service in England) and www.ecdc.europe.eu (European Center for Disease Prevention and Control).

CEA Global Campus Actions

The following are what the CEA campuses and partner locations are doing to keep CEA students as healthy as possible in light of the wide-spread pandemic nature of the N1H1flu.

Actions at CEA Campus sites include:

• Distributing widely educational materials and information produced by public and national health organizations. These redundant messages in a variety of formats such as: hold messages, emails, text messages, print literature, video/audio, and social media.
• Ensuring the availability of information in multiple languages that represent the demographics of their campus.
• Keeping the campuses informed of local condition in your country/community.
• Keeping classrooms and facilities clean and sanitized daily. Hand sanitizers are available in areas where students congregate.

These regular messages below remind All CEA students, faculty and staff to take everyday actions to stay healthy.

• Since flu viruses spread from person to person by respiratory droplet transmission, cover your nose and mouth with a tissue when you cough or sneeze.
• Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water, especially after you cough or sneeze.
• Alcohol-based hands cleaners should also be used.
• Avoid touching your eyes, nose, or mouth. Germs spread that way.
• Other preventive measures recommended that can help prevent the flu included: do regular moderate cardio workouts; take a multi-vitamin daily; and get eight hours of sleep a night to help reduce stress, boost the immune system and ward off illness.
• Don't smoke. Smoking reduces your immune system's ability to fight diseases.
• Follow public health advice regarding class or campus closures, avoid crowds and take other social distancing measures.
• Find healthy ways to deal with stress and anxiety. Students are encouraged not to get behind in their course work when they are healthy so that they will be better able to deal with situation if they get the flu. (Parents should reinforce this as well.)

If a Student contracts the flu (seasonal or H1N1)

Educational materials throughout campus include information on symptoms (cough, sore throat and fever are most common) and list those conditions that predispose a person for high risk for complications (pregnancy, respiratory or heart problems, diabetes). They are also provided with CDC recommendations that they should stay home from school (for 24 hours after your fever resolves without the use of fever reducing medication) and limit contact with others to keep from infecting them. If sick, health care providers should be contacted immediately by phone since office visit may not be necessary for normally healthy students. If transportation to DR is necessary, use private car to avoid public transportation is recommended and facilitated by staff.

Based on current information, it is explained that the use of antiviral medication is generally recommended for only hospitalized patients with confirmed, probably or suspected H1N1 flu. Otherwise healthy persons do not require this treatment based on the mild, self-limiting nature of the infection. (HTH should cover antivirals for high risk patients)

A buddy system has been created to enable ill students to stay in their room with the assistance of a healthy student, usually a roommate caring for the ill student. The healthy student is educated to maintain a distance of 6 feet and both are educated about hygiene issues in a shared space. The exception to distance would be to deliver meals or medicine to the ill students at which point the helper should wear an approved mask and wash hands immediately after handling anything touched by the ill student. Masks are provided by campus staff.

Please note, if a student wants to be separated from a roommate who becomes ill with the H1N1 flu, that choice can be permitted. However, any additional expense for lodging during that period of time must be the responsibility of the student and/or their parents since there are no vacant facilities on site at CEA campuses.)

Each campus has developed a system for monitoring the student's health status daily. Students are to notify the Campus Directors office when they are ill and a person from that office will be assigned to check on the ill student by phone or email daily.

Seasonal Flu and H1N1 Flu Vaccines

Since seasonal influenza and novel influenza (H1N1) are expected to co-circulate this fall, CEA campuses are encouraging members of their campus communities to receive seasonal flu vaccine and H1N1 vaccines and notify them of locations of administration in the community, or when possible, on campus. However, national guidelines vary in counties when students are studying, and students enrolled this Fall will be informed if they are eligible for the vaccines in that country. Since most students will be returning to the US in December, students will be encouraged to have the vaccine if it is available to them as foreign nationals, or if not available to them, advised to have the vaccination immediately upon their return to the US.

Students enrolling in January, 2010 will be required to show documentation that they have had the H1N1 vaccine, or have recovered from the H1N1 flu, before departing for their CEA study abroad program.

There are two forms in which the vaccine can be administered. For healthy (not pregnant) individuals, the live attenuated nasal spray vaccine (LAIV) is recommended for those 2-24 years of age, are 25-49 years of age and living with infants younger than 6 months or are health care and emergency medical personnel. For all others, the flu shot vaccine is the administration of choice.

Pneumococcal Vaccine

Pneumococcal pneumonia complicating influenza likely contributed to a significant proportion of morbidity and mortality during past pandemics. CEA campuses will provide information to their campus community about the CDC recommendations on pneumococcal vaccine and encourage students to report any recurrence of disease or worsening of symptoms to both on-site staff and their local health care provider.

Academic Issues

Students are informed that it is their responsibility to notify their faculty members if they are ill and cannot attend class. Email is the preferred medium. Flu illness is considered an excused absence. However, course work must be made up as worked out with the faculty member for that course.

They need to keep up with the course work by communicating with their instructors via email or other technology available to them on campus. If an ill student is unable to fully keep up with the course work, email communication should be maintained in order to clarify with the instructor how the work may be made up. Faculty are expected to offer reasonable flexibility regarding required course attendance and assignment due dates in light of student illnesses. This includes provision for make-ups for missed exams (including finals) due to illness.

Also, faculty are being encouraged now, and trained as necessary, to enable them to use lecture and assignment capturing technologies such as WebEx and course management tools such as Moodle, if available, prior to the outbreak of wide-spread flu. In addition, if large numbers of students are absent from a particular course, staff will make provisions for note-takers who can be called upon when needed.

Class Attendance/Class Cancellation/Campus Closure

In the event that large numbers of students are ill or faculty are ill and not able to conduct the class, the CEA campus will have a notification system including multiple channels, in place to communicate this information to students and faculty. CEA staff will work closely and directly with their local public health officials to revise their plans, to make sounds decisions based on local conditions, and to implement strategies in a coordinated manner.