Dear Wesleyan students, faculty, staff and parents,
As of this writing, we have no known cases of H1N1 on this campus. We expect that we will have cases soon and that H1N1 will be an issue this semester and likely the whole of the academic year. Because most cases thus far have been equivalent to seasonal flu in terms of intensity, we expect the impact it causes to be manageable. We have a solid plan in place which is well supported at all levels of the university.
We have compiled a set of recommendations for H1N1 mitigation in frequently asked questions format and published them online at emergencymanagement.blogs.wesleyan.edu. We will update this website as new information becomes available.
More detailed information about H1N1 is available at www.cdc.gov/h1n1flu/, and www.ct.gov/ctfluwatch.
How does H1N1 spread?
Like other flu viruses, novel H1N1 influenza spreads from an ill person to others mainly through coughing or sneezing.
What are the symptoms of H1N1?
Symptoms of the flu may include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Influenza-like illness is defined as a fever plus cough and/or sore throat. Some people with influenza will not have fever. Absence of fever does not mean absence of infection. If in doubt, call your health care provider to discuss your symptoms. Students are encouraged to call the Davison Health Center flu line (860) 685-2653 Monday-Friday 9-4 and the 24-hour line (860) 685-2470 at other times.
How is H1N1 diagnosed?
Current practice guidelines per CDC and the Connecticut Department of Public Health are for clinical diagnosis of H1N1 infection. Testing is being reserved for hospitalized and severely ill patients and for investigation of local outbreaks. The diagnosis of H1N1 will be made on the basis of symptoms and physical exam findings. Influenza-like illness is defined as a fever of 100° F [37.8° C] or greater plus cough and/or sore throat. Some people with influenza will not have fever. Absence of fever does not mean absence of infection. In many cases, the diagnosis may be able to be made over the telephone. The criteria for diagnosis are deliberately broad. Some people will meet these criteria and turn out not to have H1N1. In the interest of public health and per recommendations, we will treat people who meet these criteria as if they have H1N1 until they meet the clearance criteria which are absence of fever (100° F [37.8° C] or greater), or signs of a fever, without the use of fever-reducing medications for at least 24 hours.
Is anyone at special risk of complications from H1N1 infection?
Pregnancy and other previously recognized high risk medical conditions from seasonal influenza appear to be associated with increased risk of complications from this novel H1N1. These underlying conditions include asthma, diabetes, suppressed immune systems, heart disease, kidney disease, and neurocognitive and neuromuscular disorders. Speak with your health care provider and determine whether or not you qualify as high risk of complications from H1N1 infection.
How can transmission of H1N1 be controlled?
The four main tools available at this time are hand hygiene, respiratory etiquette, routine cleaning and self-isolation of those who are ill.
Hand hygiene
Influenza may spread via contaminated hands or inanimate objects that become contaminated with influenza viruses. CDC recommends that students, faculty, and staff wash their hands often with soap and water, especially after coughing or sneezing. Alcohol-based hand cleaners may also be effective. Soap, paper towels and sanitizers are critical for proper hand hygiene and are available throughout the campus. The number and location of waterless hand sanitizer dispensers is being reviewed and augmented with a goal toward having them at all key traffic points.
Questions or concerns about cleaning or sanitation issues related to H1N1 may be directed to controlH1N1@wesleyan.edu.
Visit: www.cdc.gov/cleanhands for more information on hand hygiene.
Respiratory etiquette
Influenza viruses are thought to spread mainly from person to person in respiratory droplets of coughs and sneezes. This can happen when droplets from a cough or sneeze of an infected person are propelled through the air and deposited on the mouth or nose or are inhaled by people nearby. CDC recommends:
- covering the nose and mouth with a tissue when coughing or sneezing
- throwing the tissue in the trash after use
- wash hands promptly after coughing or sneezing
- if a tissue is not immediately available, coughing or sneezing into one’s arm or sleeve (not into one’s hand) is recommended
Visit www.cdc.gov/flu/protect/covercough.htm for more information on respiratory etiquette.
Routine cleaning
CDC recommends frequent cleaning of bathrooms and other frequently used areas, and provision of adequate supplies of soap and paper towels. We have reviewed and adjusted campus cleaning schedules in accordance with these recommendations. These recommendations have been reviewed in detail with Physical Plant and appropriate training and supplies are being provided to housekeeping staff. Students living together should regularly clean frequently used surfaces such as doorknobs, refrigerator handles, remote controls, computer keyboards, countertops, faucet handles, and bathroom areas.
Self isolation
If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.) Keep away from others as much as possible to keep from making others sick.
Is there a vaccine against H1N1?
There is no vaccine available right now to protect against the 2009 H1N1 flu virus. A vaccine is currently in production, and initial doses of this vaccine are expected to become available for the public later in the fall. CDC’s Advisory Committee on Immunization Practices (ACIP) has recommended that certain groups of the population receive the 2009 H1N1 flu vaccine when it first becomes available.
These initial target groups include pregnant women, people who live with or care for children younger than 6 months of age, healthcare and emergency medical services personnel, people age 6 months through 24 years, and people age 25 through 64 years who have underlying medical conditions that put them at higher risk of complications from influenza. Most college students are included in these initial target groups and should be among the first to receive the 2009 H1N1 flu vaccine. We are working closely with state and local public health officials to develop a vaccine implementation plan. We will update the community when this planning is completed.
What do you recommend about the regular flu vaccine?
We highly recommend students, faculty and staff younger than 30 obtain a regular flu vaccine as soon as possible. We recommend that students, faculty and staff older than 30 wait and get the usual seasonal flu vaccine in mid-late October. This is because younger people generate a more enthusiastic, longer lasting immune response and would maintain immunity all the way through to March even if they get the flu shot now.
As in previous years, we have scheduled large-scale vaccine clinics on campus. In keeping with the above recommendations, we have shifted the dates earlier this year as follows:
- Monday, September 21 from 12:00pm to 4:00pm
- Wednesday, September 23 from 12:00pm to 4:00pm
- Tuesday, October 13 from 4:00pm to 7:00pm
- Saturday, October 17 from 10:00am to 1:00pm (faculty, staff and dependents only)
All clinics will be held in 108 Usdan. The Visiting Nurse Association will bring at least 500 doses per clinic which is about 1,300 more doses than we have used in past years. The cost to students will remain at $37 (no increase from last year) and faculty and staff that are Cigna eligible will get it for free as a benefit.
As a student, what do I do if I become sick while at school?
CDC recommends that individuals with influenza-like illness remain at home and away from other people until at least 24 hours after they are free of fever (100° F [37.8° C] or greater), or signs of a fever, without the use of fever-reducing medications. Because we wish to limit transmission, we highly recommend that students leave campus if they develop a flu-like illness or stay off campus until they recover if they become ill while off-campus. To this end, we recommend that students attempt to develop a plan to temporarily relocate to a local private home. Ideally, students would get to this location by means other than public transportation.
Students who are unable to leave campus should remain in their own rooms and receive care and meals from a single person, if possible. Some rooms are not conducive to self-isolation, particularly ones with common bathrooms shared by many other students. We do have a plan to temporarily relocate some ill students to more appropriate housing, if this becomes necessary. Ill students should limit their contact with others and, to the extent possible, maintain a distance of 6 feet from people with whom they share living space. Students should identify a “flu buddy”, a designated caregiver if one or the other becomes ill.
Students with flu-like illness should notify their family and their Class Dean. We encourage students to call the Davison Health Center flu line (860) 685-2653 Monday-Friday 9:00am to 4:00pm and the 24-hour line (860) 685-2470 at other times to discuss their illness, if appropriate, and especially if symptoms are severe or if they need to discuss relocation. We strongly recommend that students call to discuss whether or not they are ready to discontinue self isolation. We strongly encourage students with flu-like illness who feel they need medical care to call DHC or their other health care provider rather than arriving as a walk-in so as to limit spread to others.
Visit www.cdc.gov/h1n1flu/guidance_homecare.htm for more information on caring for sick people in the home.
As a member of the faculty or staff, what do I do if I become sick?
CDC recommends that individuals with influenza-like illness remain at home and away from other people until at least 24 hours after they are free of fever (100° F [37.8° C] or greater), or signs of a fever, without the use of fever-reducing medications. Because we wish to limit transmission, we highly recommend that faculty and staff leave campus if they develop a flu-like illness or stay off campus until they recover if they become ill while off-campus. Normal sick leave policies apply.
Faculty or staff that go or stay home due to flu-like illness should notify their direct supervisor and health care provider, preferably by telephone or email. Questions for Human Resources may be directed to jhicks@wesleyan.edu or pmelley@wesleyan.edu.
Visit www.cdc.gov/h1n1flu/guidance_homecare.htm for more information on caring for sick people in the home.
What is the role of antiviral medications (Tamiflu)?
Current recommendations are to reserve these medications for those at high risk of complications of H1N1 as defined above. Local availability of these medications may be limited.
What do I do if I am a close contact of someone who gets ill?
If close contact cannot be avoided, the person who is sick should wear a surgical mask during the period of contact. A stock of such masks is being purchased and a distribution plan is in development. Close contact, for the purposes of this document, is defined as having cared for or lived with a person with influenza-like illness or having been in a setting where there was a high likelihood of contact with respiratory droplets and/or body fluids of such a person. Examples of close contact include kissing, sharing eating or drinking utensils, or having any other contact between people likely to result in exposure to respiratory droplets. Close contact typically does not include activities such as walking by an infected person or sitting across from a symptomatic patient in a waiting room or office.
Current treatment recommendations do not include treatment for close contacts. Those who have been close contacts of someone with influenza-like illness should monitor themselves for symptoms. In the event symptoms develop, they should follow the above advice.
How long do we expect there to be special concern about H1N1?
After a novel influenza virus such as H1N1 passes through the population several times, sufficient community immunity develops that it begins to act more like a seasonal influenza. This is the predicted course of events for this virus subtype. However, it is still early in this pandemic and uncertainties remain.
Who should I contact if I have additional questions?
Joyce Walter, Director, Davison Health Center jwalter@wesleyan.edu
Davis Smith, Medical Director, Davison Health Center pdsmith@wesleyan.edu
