In its new guidelines about preparing for the flu, the Centers for Disease Control and Prevention suggests that in order to reduce the spread of germs, students and staff should:
- wash hands with soap and water for at least 20 seconds (the amount of time it takes to sing "Happy Birthday" twice);
- use alcohol-based cleaners containing at least 60 percent alcohol;
- cough into an elbow or shoulder if tissues are not available; and
- stay home until at least 24 hours after they no longer have a fever or signs of a fever, without the use of fever-reducing medications like ibuprofen or acetaminophen.
The CDC also recommends that schools move students and staff who become sick at school into a separate room until they can be sent home.
For severe flu outbreaks, the CDC suggests that school-age children stay home for five days from the time someone in their home becomes sick.
As the summer break comes to an end and schools begin to open around the country, parents are no doubt wondering whether their kids' schools will be affected by the H1N1, or "swine flu," virus this year.
Many school administrators say it's doubtful there will be school closures because of the virus. After hundreds of thousands of schools were idled by the threat of swine flu in the spring, the Centers for Disease Control and Prevention is taking a new approach with new health guidelines that put more of the burden on parents to keep sick kids at home.
Last spring was a nightmare for school districts in places like Fort Worth, Texas. After just a handful of cases of swine flu cropped up, local health officials told Superintendent Melody Johnson to send 80,000 students home.
"We were told to shut down four days," Johnson says. Then she was told, " 'No, you have to close seven days.' Then it was 10 days."
The system stayed closed for six days before the policy changed.
New guidelines recommend closing schools only in extreme cases.
The big push this year is focused on parents.
Belinda Pustka, superintendent of the Schertz-Cibolo-Universal City Independent School District in South Texas, closed her schools because of the swine flu in April. This school year, she's sending this message to parents: Just assume your child will have the flu at some time this year.
She tells parents to make arrangements for caring for sick kids now in case the kids are sent home.
Pustka says it's not always easy to get parents to keep kids home if the illness appears mild.
But health guidelines say students should remain at home for 24 hours after they no longer have signs of a fever — and that means without the use of fever-reducing medication.
Some educators say now that parents' alarm about swine flu has eased somewhat, it may be harder to convince parents to treat the disease seriously. But health officials say the disease still poses the risk of complications to schoolchildren with medical problems or to pregnant teachers.
That creates a challenge for the many public schools that deal with "medically fragile" students who have to be protected.
Dr. Corey Hebert, chief medical officer for New Orleans' Recovery School District, says he is telling schools to protect vulnerable children, "especially the children who are returning from recess or from P.E. They're sweating. They're dirty. They're not washing their hands."
The new guidelines recommend that kids who get sick at school be isolated until parents pick them up. The CDC also suggests that if swine flu or the regular flu virus appears, schools should divide students into smaller groups or increase the space between desks. Those may not be realistic options for the many districts that are already overcrowded.
Depending on how well these plans work out, schools could end up playing a key role, either in helping to spread the flu — or in stemming infection. A number of schools say this year they will play another role: They'll offer the vaccine for swine flu, once it becomes available.