Our Plan for Managing H1N1 Illnesses
Note: the following e-mail was sent to all staff and students on 9/30/09.
Dear staff and students:
Health care providers throughout the Bay Area are seeing increased numbers of patients with flu-like symptoms assumed to be novel H1N1 (nH1N1, also known as swine flu).
Influenza-like illness symptoms include a fever (temperature of 100°F [37.8°C] or greater) and a cough and/or sore throat in the absence of a known cause other than influenza.
For most healthy patients the illness is not severe, does NOT require a doctor’s visit and resolves with rest and over-the-counter medications.
Individuals with chronic disease or who have reduced immunity should seek immediate medical care if they develop symptoms of an influenza-like illness. (See section 9 below, High-Risk Students and Staff).
Each one of us can practice the following healthy habits to help slow the spread of the flu virus. The following recommendations are based on advice from the San Francisco Department of Public Health (SFDPH), California Department of Public Health and the Centers for Disease Control (CDC) and assume that nH1N1 transmission and the severity of flu symptoms remain similar to those in Spring and Summer 2009.
1) Hand Hygiene and Cough Etiquette
- Wash hands frequently with soap and water or alcohol (>60%) hand sanitizer.
- Avoid touching your eyes, nose or mouth.
- Cover nose and mouth with a tissue when coughing or sneezing.
- Cough or sneeze into your sleeve if no tissue is available.
- Immediately dispose of used tissues.
2) Stay Home and Away From Classes When Sick (Flu-Like Illness)
- Stay home or in your dorm room.
- Stay away from classes, labs, library, parties, etc. and limit your interactions with other people (“self-isolation”) until at least 24 hours after you no longer have a fever, or signs of a fever, without the use of fever-reducing medicines.
- Stay away from others during this time period even if you are taking antiviral drugs.
3) Sick Notes
In line with the CDC’s guidelines and with the support of SF State’s provost, Student Health Services (SHS) will not be issuing any sick notes for flu-like illnesses. This policy will decrease the spread of flu-like illnesses to others. A PDF version of this campus policy, SF State nH1N1 Sick Note Memo, is available on the Student Health Services nH1N1 Web site, at http://www.sfsu.edu/~shs/H1N1_Flu/H1N1_Flu.html
Students should keep in touch with their professors regarding any new changes to their policies on missed classes, examinations and late assignments.
4) Get Vaccinated with Seasonal Flu Vaccine and nH1N1 Vaccine
A few doses of 2009 – 2010 Seasonal Influenza Vaccine are available at SHS during Immunization Clinics. This vaccine is also available at many pharmacies.
Students under age 25 should receive the nH1N1 flu vaccine, which campus is expected to have available in mid to late October.
The nH1N1 vaccine is intended to be used in addition to the seasonal flu vaccine.
For more information on nH1N1 vaccine see the Student Health Services nH1N1 Web site, at http://www.sfsu.edu/~shs/H1N1_Flu/H1N1_Flu.html
5) Get Ready, Be Prepared
- Buy a thermometer, stock up on hand sanitizers (>60% alcohol), cleaning materials, tissues and over-the-counter medications.
- Establish a “flu buddy plan” so that you and your buddies can support one another if any of you become ill.
6) Home or Campus Housing Care For Patients with Flu-Like Illness
- If you live on campus check with Residence Life about their comprehensive plan.
- If you live in Housing, have a flu-like illness and your home is relatively close to the campus, please return home to reduce the risk of making others sick.
- Travel home in a way that limits contact with others as much as possible, for example, by private car or taxi rather than by public transportation.
- If you have a flu-like illness, remain in your room. Advise Res Life and they will help coordinate the deliver of meals to your room.
- Keep in contact with Res Life, your buddies and your professors via e-mail, text messages and phone calls.
- Sick individuals who share a room should wear a face mask at all times when uninfected people are around them (within 6 feet). Housing will make simple masks (also called surgical masks or procedure masks) available for people who are sick.
- If you have a flu-like illness AND you are at high risk for complications of influenza, promptly seek medical attention. (See section 9 below, High-Risk Students and Staff)
- If you develop severe symptoms--such as increased fever, shortness of breath, chest pain or pressure, or rapid breathing--promptly seek medical attention.
See http://www.sfsu.edu/~shs/H1N1_Flu/H1N1_Flu.html#H1N1_Care for more information on caring for yourself.
7) Clean Your Rooms, Door Handles, Tables and Computers Regularly
Influenza viruses can live for many hours on hard surfaces which are contaminated by coughing and sneezing or the touch of an infected hand.
- Regularly clean high-use surfaces such as bathrooms, doorknobs, desktops and keyboards.
- Do not share food, drink, eating utensils or towels with others.
- Use alcohol wipes to effectively clean desktops, keyboards, telephones, etc.
- Use a hand sanitizer (alcohol >60%) frequently to reduce risk of transmission including transmission from hard surfaces.
8) Familiarize Yourself With the Signs and Symptoms that May Indicate Severe Disease Associated With Novel H1N1 Influenza
Patients who have any of the following should seek care from Student Health Services or other health care providers:
- Difficulty breathing or shortness of breath
- Pain or pressure in the chest
- Dehydration from vomiting and diarrhea
- Severe or persistent vomiting
- Sudden dizziness
- Confusion
- Shaking chills
- Are severely ill
- Flu-like symptoms improve, but then return with fever and worse cough
9) High-Risk Students and Staff
If you are at high risk for the complications of flu and have been exposed to flu or you develop symptoms of a flu-like illness, contact a health care provider as soon as possible. Early treatment with antiviral medications can reduce the risk of serious illness.
You are at higher risk of developing complications from flu if you have one of the following conditions:
- Asthma, other chronic pulmonary disease
- Heart disease
- Liver disease
- Chronic anemia
- Chronic neurologic/neuromuscular disease
- A metabolic disorder such as diabetes
- Reduced immunity, including reduced immunity caused by medications (eg. chronic steroids or cancer chemotherapy) or by HIV
- Eighteen years of age or younger and taking long-term aspirin therapy
- Pregnant
- 65 or older**
**People age 65 and older appear to be at lower risk of 2009 nH1N1 infection compared to younger people. But, if older adults do get sick from flu, they are at increased risk of having a severe illness.
More information about the nH1N1 flu, including who is at high risk, symptoms, self-care instructions, and signs of when to seek medical attention, can be found at the Student Health Services Web site, http://www.sfsu.edu/~shs/H1N1_Flu/H1N1_Flu.html This site is updated as new information is available. For more information about nH1N1 vaccine, visit http://www.sfsu.edu/~shs/H1N1_Flu/H1N1_Vaccine.html
Updates will also be made on this SF State News page: http://www.sfsu.edu/~news/2009/fall/8.html You may follow SF State News on Twitter (SFState_News) to receive active notification of updates.
-- Alastair Smith, M.D.
Director, Student Health Services
