Just as many institutions in the United States, we of The University of Montana monitor and manage threats to the health and safety of our community. Earlier this year, a new type of flu presented itself as a threat. So far the effects of H1N1 (formerly known as the swine flu) have proven similar to those of the seasonal flu, but planning, action and care continue to make certain we have made appropriate preparations.
In coordination with state and local health departments, the Curry Health Center serves as our designated surveillance site, testing patients, reporting results and coordinating planning responses. This flu will in all likelihood arrive on campus before vaccines specific to this strain become available.
The Centers for Disease Control and Prevention has offered some guidance to institutions and citizens for planning, treatment, and – most important – prevention. Personal responsibility remains an effective prevention strategy. Frequent hand washing, covering a cough, and avoiding classes or gatherings if you feel sick have become mandatory. For additional guidance and insight, consult http://www.cdc.gov/h1n1flu/schools/.
UM has numerous strategies in place to care for students, such as healthy food choices, quality medical care and an organized resident assistant network. We will continue the coordination and communicate developments as they occur.
If you have additional questions, please see the list of frequently asked questions and answers by the experts posted below. Feel free as well to send me a message (george.dennison@umontana.edu).
George M. Dennison
President
The University of Montana
Frequently Asked Questions About 2009 H1N1 Influenza
I heard the vaccine is now available to UM students who live in the residence halls. Is this true?
Yes, the Missoula County Health Department announced Tuesday, Oct. 6, that UM will receive all of the 600 to 1,000 doses of the live attenuated influenza vaccine, more commonly known as the nasal spray flu vaccine, available to Missoula. The Missoula Health Emergency Advisory Team decided the vaccine would be put to best use by vaccinating students living in UM residence halls. This will reduce the risk of an outbreak on campus, as well as reserve the injectible vaccine for high-risk individuals when it becomes available.
Faculty and students from the UM School of Pharmacy, working in conjunction with Curry Health Center, visited residence halls recently to vaccinate eligible students.
For additional information about the availability of the H1N1 vaccine in Missoula, call the Missoula County Health Department vaccine hot line at 406-258-INFO.
I heard this virus causes much milder illness than the usual seasonal influenza. If that’s the case, what is the big deal?
It is true that most people who become ill with H1N1 recover quickly, and that most hospitalizations and fatalities have involved those with other health problems. There are three factors that make H1N1 unique:
Very few people are immune to this virus. With seasonal flu many people have at least partial immunity as a result of past infection with similar viruses. So if many people are exposed, only a few will become ill and the overall impact to the community is small. With this virus essentially no one is immune, and it is likely that many people will become ill in a short period of time. There is some indication that those 65 and older may be less susceptible. So even if the infection is mild, many people may miss a week of class or work in a relatively short period and the collective effect on academic success and the local economy could be meaningful. Spreading out the infection over a greater period of time would help, but the impact would still be significant.
This influenza virus seems to infect children and young adults at a high rate. Seasonal influenza predominately infects the elderly and the ill, but this virus has shown a unique tendency to attack the young. One-third of H1N1 cases in Montana have involved children. And since crowding is another factor facilitating the spread of influenza, this has resulted in significant disruption in schools.
There is a chance the virus might become more aggressive. History tells us that sometimes new strains of influenza emerge fairly mild and evolve into something more serious. There is no way of knowing whether that will occur.
What can I do personally to reduce my risk?
Refresh your memory about the personal protective measures we can all take to reduce the risk of catching any respiratory infection, including influenza.
Wash your hands often. We tend to pick up these viruses from doorknobs, countertops, keyboards and other inanimate objects. Washing the virus off before you transmit it to your mouth or nose reduces your chance of becoming infected.
Cover your cough. Coughing sprays the virus into the air where others can inhale it and become infected. By covering your cough with your sleeve, you reduce the risk of passing on respiratory infections to others.
Minimize contact with infected individuals. During the cold and flu season, it may not be possible to totally avoid people with infection, but common sense will help reduce risk a lot.
If you become ill, stay home and don’t go to class or work. If the illness is mild, take care of yourself. If you feel you need medical care, call ahead and let your provider know you are worried about H1N1 They will know what to do.
Should I avoid travel to or from Missoula?
In the early phases of a pandemic, restricting travel to areas with high infection rates can slow the spread of the virus. Once the infection has spread worldwide, as is now the case, travel restrictions lose their value. Currently there are no travel restrictions recommended by the Centers for Disease Control or the World Health Organization. UM sees no reason to restrict travel to or from Missoula with one common-sense exception: Anyone who is sick should avoid travel with a team or group. We expect the same courtesy from visiting teams or groups.
Some countries have established screening programs at airports in an effort to identify individuals with influenza-like illness as they enter the country. Ill travelers may be subject to quarantine until they recover. Those planning to travel overseas are urged to check current practices in the countries to which they plan to travel and to avoid traveling if ill.
What about a vaccine?
A vaccine for H1N1 is currently in test phase and will hopefully be available by late October. The government has indicated intent to make the vaccine available at no charge, but it will be the responsibility of local health departments to distribute the vaccine. Should the vaccine become available, UM will work with the Missoula City-County Health Department to obtain and administer vaccine to UM students deemed at risk. That coordination already has begun.
Currently the CDC has identified five at-risk populations: pregnant women, household contacts of children under 6 months old, children and young adults ages 6 months to 24 years, nonelderly adults with health problems that increase the risk for influenza complications and health care workers.
What about sick students in residence halls?
Current recommendations from the CDC call for individuals with influenza to isolate themselves until their fever has been gone for 24 hours. This obviously poses a challenge in residence halls, with roommates and community bathrooms. Based on recommendations from MCCHD, students with influenza will be asked to remain in their room as much as possible and to wear a mask when leaving the room to go to the bathroom. Dining Services has agreed to provide food to ill students to reduce the need to leave the room. Roommates of ill students will be instructed in personal protective measures.
How will we know if influenza is becoming a problem?
Curry Health Center was established as an official CDC surveillance site for influenza-like illness this summer – one of two such sites in Missoula. This will allow early detection of an increase in influenza like illness.
What about classes?
The provost has asked the deans to ensure that classes continue with a minimum of disruption. If many people become ill with influenza, UM may need to cancel some classes. During an outbreak the intent is to ensure that classes continue with a minimum of disruption. In most cases the normal attendance policies of individual instructors and programs will suffice to accommodate students who may become ill. Students with the flu are encouraged to remain home while sick to limit the spread of the virus, and they will not be required to obtain a doctor's note if they have missed a class because of the flu.
In the event a large proportion of the student body or the faculty becomes absent, a range of options are available to continue education. Those options will be put into place in a manner that best addresses the particular situation. For example, maximum use of technology will be implemented, including podcasting lectures in either audio or video format, posting materials and assignments to Blackboard, and using electronic communication to maintain course continuity to the extent possible. Alternative scheduling will be implemented that may result in evening and weekend sessions, extended class hours or even an extended semester to make up for missed time. In any case, the faculty will be asked to remain flexible and accommodating for issues such as making up missed work and assignment of incomplete grades.
Do I need to go Curry Health Center if I am only a little sick?
No. Only students who are very sick or have risk factors for complications should seek medical care. If you are only mildly ill you should stay home and take care of yourself. If you have the emergency warning signs of flu sickness, you should seek care promptly. If you get sick with flu symptoms and are at high risk of flu complications or you are concerned about your illness, call Curry at 406-243-2122.
Will the University close if influenza hits Missoula?
Although no one can predict what a significant pandemic might look like, it is very unlikely the situation would become so bad that the University would elect to cancel all classes. The experience on other campuses during the spring, when H1N1 first spread to the U.S., showed that cancellation of some public events was helpful in limiting the spread. But most colleges and universities were able to continue their academic activities with little interruption. University officials will actively monitor the situation in consultation with MCCHD to determine appropriate actions.
What Should I Do If I Get Sick?
If you get sick with flu-like symptoms this flu season, you should stay home and avoid contact with other people except to get medical care. Most people with 2009 H1N1 have had mild illness and have not needed medical care or antiviral drugs, and the same is true of seasonal flu.
However, some people are more likely to get flu complications, and they should talk to a health care provider about whether they need to be examined if they get flu symptoms this season. They are:
• Children younger than 5 years old, but especially children younger than 2
• People 65 and older
• Pregnant women
• People who have:
• Cancer
• Blood disorders (including sickle cell disease)
• Chronic lung disease [including asthma or chronic obstructive pulmonary disease (COPD)]
• Diabetes
• Heart disease
• Kidney disorders
• Liver disorders
• Neurological disorders (including nervous system, brain or spinal cord)
• Neuromuscular disorders (including muscular dystrophy and multiple sclerosis)
• Weakened immune systems (including people with AIDS)
Also, it’s possible for healthy people to develop severe illness from the flu, so those concerned about their illness should consult a health care provider.
There are emergency warning signs. Anyone who has them should get medical care right away.
The emergency warning signs in adults are:
• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting
The emergency warning signs in children are:
• Fast breathing or trouble breathing
• Bluish skin color
• Not drinking enough fluids
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Flu-like symptoms improve but then return with fever and worse cough
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