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This is from the Chronicle of Higher Education, which is widely read among academics and administrators in universities.

9/18/09 8:54 AM

http://chronicle.com/article/Colleges-Face-Swine-Flu/48453/

Colleges Face Swine-Flu Challenge as Number of Sick
Students Surges
By Katherine Mangan

Fraternity and sorority recruitment had just wrapped up and
classes were about to start when the first wave of coughing and
sniffling students reached Washington State University’s health
center.

Over the next few weeks, more than 2,600 students either walked
in or called, complaining of fevers, body aches, nausea, and other
flu symptoms. No one knows how many of those students actually
had the H1N1 virus, commonly known as swine flu, because health
officials nationally have concluded that routine testing is too
expensive, time-consuming, and generally unnecessary when so
many people are ill with a virus that can usually be treated like the
typical seasonal flu.

Still, because of the early start of its academic year and the large
number of sick students, Washington State found itself at “ground
zero” of reporting on the swine-flu pandemic, President Elson S.
Floyd ruefully noted last week on the university’s Web site.

Although college officials around the country were expecting an
early and rough flu season, the fact that it hit so many campuses
while students were still unpacking has complicated the start of the
academic year.

Campuses like Washington State’s are struggling to isolate sick
students, many of them freshmen, in residence halls where
roommates and shared bathrooms are generally the rule.
Residence halls are full on the main campus, in Pullman, because
of a record enrollment of 19,500 students.

There and at other colleges that do not have the luxury of setting
up isolation wards, “flu buddies” are delivering meals to sick
friends, who are being instructed to stay in their dorm rooms or
apartments and wear masks when their roommates are around.
Vending machines dispense hand sanitizers as well as candy bars,
social events are being rescheduled outdoors, and everywhere
students turn they see posters exhorting them to wash their hands,
cough into their sleeves, and resist the urge to sip from a friend’s
drink.

Across the country, relatively few faculty and staff members have
fallen ill so far, partly because adults older than 52 may have been
exposed to a virus that gives them some protection against swine
flu. Still, there have been scattered reports of canceled class
sessions, rescheduled exams, and a shift toward advising students
via e-mail rather than face to face.

Professors have also been advised to relax attendance policies and
make more work available online for students who are too sick to
attend class.

‘Pretty Stressful’

Because of the attention paid to swine flu by the news media, along
with what some observers consider exaggerated predictions by
President Obama’s science advisers last month that the flu could
kill as many as 90,000 people this year, college administrators like
Mr. Floyd have had to spend time reassuring worried parents, even
in the absence of a health crisis.

“Our experience runs counter to an image that was fixed in the
public mind this spring, when initial reports of swine flu cases from
Mexico seemed to point to a much more dangerous virus,” he wrote
in his Web-site column last week.

In fact, the number of new cases at Washington State seems to
have dropped since the beginning of the semester. Most have been
relatively mild, and students have recovered in three to five days.
For some students, however, the flu packs a bigger punch.

Matthew O’Dore, a freshman at Washington State, came down with
the flu on August 22 after several days of socializing during
fraternity recruitment. Even though he had heard about the flu, he
admits that he brushed aside warnings and participated in games,
like beer pong, that involve drinking from communal cups of beer.

“I figured if I got it, it was no big deal, but it was 10 times worse
than I thought it would be,” he says. “I had every possible symptom
—coughing, throwing up, achy muscles and joints. I could barely
walk. My mom was freaking out because I was too tired to call her
back and didn’t feel like talking. She finally called the building
director to check up on me and make sure I wasn’t dead.”

After he woke up one morning shaking uncontrollably, his teeth
chattering, a friend took him to the campus health center. By then
his temperature was 103 degrees and he was severely dehydrated.
After three liters of intravenous fluids and a day on the antiviral
drug Tamiflu, he felt better. That’s when he realized how far behind
he was in his studies.

“I missed the entire week, and I have a lot of work to make up,” he
says, “so it’s pretty stressful.”

Counting Coughs

Most colleges across the country have stopped testing students for
H1N1 and instead are tracking the number of students with flulike
symptoms. Because more than 90 percent of the flu cases being
reported to the federal Centers for Disease Control and Prevention
now are H1N1, campus officials are generally treating all cases as if
they were.

Students generally are not being given prescription flu medications
unless their cases are serious, because the limited supplies of the
drug are being reserved for elderly and other high-risk patients.
Washington State has cut down on the number of sick students
crowding into its health center by distributing electronic
questionnaires that allow students to assess, by themselves, the
likelihood that they have the flu.

Unless their symptoms are severe, “we tell people to stay hunkered
down in their rooms, push the fluids, and take it easy,” says
Eleanor Finger, director of residence life. Students are also being
told not to attend class until at least 24 hours after they have had
no fever without taking fever-reducing medication.

Ms. Finger followed those instructions herself when she came down
with the flu this month.

A student group called the Cougar Health Awareness Team has
been combing the Washington State campus, handing out more
than 2,000 free kits containing tissues, pain killers, throat
lozenges, hand sanitizers, sport drinks, and self-care tips.

Sick students are instructed to call the residence-life office every
day to report how they’re doing. If they don’t call, a residence-hall
supervisor checks on them.

College health authorities estimate that 95 percent of campuses
have to rely on students to “self isolate” in their residence halls,
and they say that many students are not doing that. “There have
been clinical surges of massive proportions at certain schools and
selective reports of noncompliance with self-isolation rules,” says
James C. Turner, president of the American College Health
Association. “Some students say they’re feeling OK and they’re
going to class.”

At Washington State and other campuses nationwide, the flu has
been particularly rough on freshmen. Many arrived early for
campus orientation or fraternity or sorority recruitment and
immediately jumped into a swirl of social activities.

“These students were right in the transition to college and hadn’t
met a lot of people when they got sick,” Ms. Finger says.

Not All Cases Mild

Nationally the number of suspected swine-flu cases continues to
surge. The college-health association issues weekly bulletins based
on data from colleges that are voluntarily reporting cases of
“influenza-like illness.” Last week, a total of 6,432 new cases were
documented on 253 campuses, representing around three million
students. That is up from just under 5,000 new cases the week
before. Eighty-three percent of the colleges reported cases,
compared with 72 percent the previous week. Since the reporting
began, on August 22, a total of 13,434 cases have been reported
and 27 students have been hospitalized.

While most cases have been relatively mild, a small number of
cases have been severe. As with any flu outbreak, the illness can
even be fatal.

Last week officials at Cornell University, where more than 600
suspected cases have been documented so far, reported that a 20-
year-old student had died of complications from the H1N1 virus.

On September 5, an 18-year-old freshman at Troy University, in
Alabama, died after receiving a flu diagnosis. It was not clear
whether those students had underlying medical problems.
Rates of the disease were highest in the Southeast and Midwest,
according to the survey, which does not include data from several
states, including Washington.

The University of Georgia has seen 619 suspected or confirmed
cases among its 34,000 students. A spokeswoman for the campus
health center says six of its approximately 200 staff members have
been out either with the flu themselves or caring for family
members with flu. She is unaware of any widespread illness among
faculty and staff members.

Mr. Turner, of the college-health association, says reassuring
parents remains an important part of campus health-officials’ jobs
this fall.

“We are getting a lot of calls from parents who are panicking
unnecessarily because of the intense media coverage, much of
which is overblown,” says Mr. Turner, who is also director of the
University of Virginia’s department of student health.

Parents want to know why their children are not being tested for
the flu or given flu medication, why they can’t have private rooms,
why there aren’t enough hand sanitizers on the campus, he says.
The next big challenge he and his colleagues face is vaccinating
tens of thousands of students for both seasonal and swine flu ahead
of the next wave of cases. The first swine-flu vaccines are expected
to arrive on campuses next month.