A Message from the Department of Health

Dear School and Childcare Principals and Administrators:

The Centers for Disease Control and Prevention (CDC) have updated the interim guidance
(http://www.cdc.gov/h1n1flu/K12_dismissal.htm) for schools and childcare facilities regarding the prevention of the spread of the novel influenza A (H1N1) virus.

At this time, CDC and the Hawai'i Department of Health (DOH) recommend that the primary means to reduce the spread of influenza, whether seasonal or the novel H1N1, in schools is to:
* Focus on early identification of ill students and staff
* Remind students, faculty, and staff to stay home when ill
* Students, faculty, and staff with influenza-like illness (fever with a cough or sore throat)
should stay home and not attend school or go into the community (except to seek medical
care) for at least 7 days after symptom onset, even if symptoms resolve sooner
* Students, faculty, and staff who are still sick 7 days after they become ill should continue to
stay home from school until at least 24 hours after symptoms have resolved
* Students, faculty, and staff who appear to have an influenza-like illness at arrival or become
ill during the school day should be isolated promptly in a room separate from other students
and sent home as soon as possible.
* Practice good cough and hand hygiene etiquette

DOH concurs with the current recommendation by CDC to not close schools or cancel large gatherings. However, in view of upcoming graduation and commencement activities, as a means to prevent the spread of disease on and off campus, schools should strongly encourage persons with influenza-like illness to stay home and away from large gatherings.

Persons who are at high risk of complications from novel influenza A (H1N1) infection (e.g. persons with certain chronic medical conditions, persons aged less than 5 years or older than 65, and pregnant women) may want to consider their risk of exposure to novel influenza A (H1N1) if they attend public gatherings.

Please notify the DOH Disease Investigation Branch of unusually high absenteeism due to flu-like illness (10% or more of the school population and/or 20% or more in an individual classroom) at (808) 586-4586.

This is a rapidly evolving situation, made more confusing by the fact that seasonal influenza continues to also circulate in our population. Guidance will continue to be updated as more information becomes available. Please refer to the CDC novel H1N1 website for more information: http://www.cdc.gov/h1n1flu/. If you have any further questions, please call the DOH Swine Flu hotline at (866) 767-5044. We appreciate your assistance in ensuring the health of the children, educational staff, and communities of Hawai'i.

Sincerely,
Sarah Y. Park, M.D., F.A.A.P
State Epidemiologist