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H1N1 & Seasonal Influenza:
Frequently Asked Questions & Answers For Parents & Families of Brown Students


H1N1 flu vaccine available to all enrolled Brown students, no age restriction.  Feb 1, 2010.

H1N1 vaccine is available to Brown students ages 25 years and older with certain chronic medical conditions  Dec. 16, 2009.  

H1N1 flu vaccine available to students on campus age 24 and younger- clinics December 1 through December 18 Dec. 1, 2009

 

A NOTE ABOUT VACCINE SCREENING

For both the seasonal flu vaccine and H1N1 flu vaccine, some people will need to be screened more carefully prior to receiving vaccine.  These include people with an allergy to eggs, people who have had problems after receiving seasonal flu shots in the past or anyone who is moderately or acutely ill at the time of the flu vaccination.  Health care personnel will provide screening at flu clinics.


H1N1 is a new strain of influenza virus with symptoms and behavior similar to the seasonal flu that infects people every year. As H1N1 is a new virus, humans have not yet developed immunity to it, so public health authorities anticipate a large number of people will likely be infected this fall and winter. H1N1 is prevalent in Rhode Island and patients with flu-like symptoms are presumed to have the H1N1 virus. At this time, the virus has behaved similarly to the seasonal flu, with the vast majority of patients recovering without any serious problems.

We will see more cases of ILI (influenza-like illness) and confirmed cases of H1N1 influenza in the coming weeks. This is to be expected given the nature of the virus and not a cause for alarm. Our efforts will continue to be focused primarily on trying to limit the spread of H1N1 during the course of the fall and winter and caring for students who become ill. The most important thing Brown community members can do to prevent the spread of illness is to practice good hygiene (washing hands, using cough etiquette, not sharing beverage containers, etc.) and self-isolating (staying home/out of class) if they are ill.

We expect that parents and family members may have questions about H1N1 influenza and about Brown’s plans for management on campus.  We have answered a number of questions below; additional information, including all communications to Brown students, is available on www.brown.edu/h1n1.  Additional student health information is available on www.brown.edu/health.

What are the symptoms of H1N1 influenza?

What does “ILI mean?

How does a student know if they have H1N1 influenza?

How are students with flu-like symptoms being cared for?

What is “FluWeb”?

What about classes students miss because they are sick?

What about exams, tests, quizzes?

What if a student’s roommate is sick with flu symptoms?

Will anti-viral medication be available to students?

If a student has a chronic medical condition, does the plan change? How?

What if students have questions after business hours?

What messages are being communicated to students on campus? 

More Brown Influenza A H1N1 Information

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What are the symptoms of H1N1 influenza?

The symptoms of H1N1 or seasonal influenza consist most commonly of sudden onset of fever (equal to or higher than 100-degrees F / 38-degrees C), body aches, cough and/or sore throat; may include also nausea, vomiting and/or diarrhea.  Students with these symptoms, and no other explanation for the symptoms, are presumed to have the H1N1 virus and are treated as if their influenza-illness is caused by H1N1.

Colds are common this time of year, causing sore throat, runny or stuffy nose; cold symptoms are usually milder than flu and do not come on as suddenly.  Fall is also an allergy season in Rhode Island with typical symptoms of sore throat, sinus congestion and sneezing.

The estimated incubation period (time from exposure to development of symptoms) for H1N1 influenza is unknown and could range from 1-7 days, more likely 1-4 days. (Centers for Disease Control and Prevention, Guidance for Clinicians). As with many viruses, it appears that patients can transmit the virus for about 24 hours before becoming ill.

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What does ILI mean?

 ILI is shorthand for “influenza-like illness” and is defined as fever (100F/38C or greater) plus cough and/or sore throat.  This is a way of referring to the symptoms of flu without needing to designate which virus is causing the symptoms.  

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How does a student know if they have H1N1 influenza?

H1N1 is prevalent in Rhode Island and patients with flu-like symptoms (fever of 100F/38C or fever symptoms plus cough and/or sore throat) are being presumed to have the H1N1 virus and are treated as if their influenza-illness is caused by H1N1.

Many viruses cause symptoms identical to H1N1, and students with ILI symptoms are unlikely to know which influenza virus they have; testing for virus type is not part of the medical treatment protocol.  Brown University Health Services (UHS) is part of the Rhode Island Department of Health (RIDOH) H1N1 surveillance network, which means UHS is asked to laboratory test three cases, and only three cases, of reported ILI each week.  We have been informed by RIDOH that approximately half of tests so far this semester have been confirmed as positive cases of H1N1 influenza.  It is important for all community members to know that testing is done for epidemiologic survey purposes only and is not utilized to diagnose or manage the patient's care. Accordingly, although there are many viruses which present with symptoms identical to H1N1, all students with ILI will be treated in the same manner regardless of whether an H1N1 test is conducted. 

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How are students with flu-like symptoms being cared for?

Brown, like most residential colleges, does not have the capability or available housing to move large numbers of either sick or well students. Because of this, residential students who are unable to leave campus (to return home or to a relative’s home), will need to stay in their bedroom, suite, or apartment until they have recovered. This plan has been reviewed and approved by the Rhode Island Department of Health (RIDOH) and is consistent with the guidelines RIDOH and the U.S. Centers for Disease Control and Prevention (CDC) have issued.

Sick students whose families live close enough to Brown to return home by car are encouraged to return home while they are ill; and to stay home until they have gone 24 hours without a fever, or signs of a fever, without the use of fever-reducing medicines. Use of public transportation while one is ill is discouraged.

Students who cannot leave campus are asked to stay in their room while they recover and until they have been 24 hours without a fever, or signs of a fever, without the use of fever-reducing medicines.  We are encouraging Brown students to participate in community caring by volunteering to take meals from the dining hall back to a sick friend.  A plan is also in place to provide a several-day supply of food to sick students staying in their rooms who are unable to make such arrangements; we are also providing a small refrigerator or microwave when needed.  We are checking on needs such as these when we talk with students (undergraduate, graduate and medical) once we know they are ill/once they submit a FluWeb report.

A Patient Education handout about H1N1 and what to do if you get sick is available on the Health Services website and is provided to students when they complete a FluWeb registration.

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What is “FluWeb”?

Because the numbers of sick students is expected to exceed what our usual processes can manage, we have created an on-line system for undergraduate, graduate and medical students with influenza-like illness (ILI) to report their missed class time and needs for assistance.  Students log in to the FluWeb website (www.brown.edu/fluweb) and answer a few questions, enabling us to know that they are ill with influenza-like symptoms and what needs they have (e.g., is a friend bringing meals to them, have they notified their faculty, do they need immediate assistance anticipating an exam they will miss).  Please note that no medical information is accessible from this reporting website.

Students who report through FluWeb receive a follow-up phone call to ensure that they are getting the care they need and to discuss academic plans.  Undergraduates receive a call from a dean in Campus Life or the Dean of the College office, graduate students from a dean in the Graduate School, and medical students from the office of Medical Student Affairs.

Students whose symptoms get significantly worse before they receive a return call or students with health questions can call Health Services at (401) 863-1330 for immediate assistance.

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What about the classes students miss because they are sick?

We encourage students to maintain their relationships with their faculty, and always recommend that students notify their faculty directly (with a brief email) if they are ill and will miss class.  Students do need to keep up with or make up material missed during their illness; the manner in which missed work is handled is, as always, specific to the faculty member and the course.

The FluWeb information will allow us to confirm for faculty that students’ missed class time was due to influenza illness.  Deans will be sending to each faculty member periodically lists of students in that faculty member’s courses who reported using FluWeb.  Faculty may call the Dean of the College office if they need immediate verification of a student’s flu-illness.  Typically, faculty might ask for a doctor’s or dean’s note when a student misses class or an assignment due to illness; given the number of students who may be sick, establishing an on-line system eliminates the burden required (for students, faculty, deans and health care staff) for hundreds of doctor’s notes. 

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What about exams, tests, quizzes?

Students can indicate in FluWeb that they have an hourly or midterm exam in the next several days, and deans will communicate immediately with faculty when a student’s illness will cause them to miss an exam.  The standard procedure will be used for requesting and determining whether to grant a final exam excuse; the office of the Dean of the College will communicate detailed information with students as the Final Examination Period approaches.  Information about Exam Excuses is available on the Dean of the College website (www.brown.edu/college).

You might wish to review the academic calendar available on the Registrar’s webpage www.brown.edu/registrar.

 

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What if a student’s roommate is sick with flu symptoms?

Brown, like most residential colleges, does not have the capability or available housing to move large numbers of either sick or well students. Because of this, students who are unable to leave campus (to return home or to a relative’s), will need to stay in their bedroom, suite, or apartment until they have recovered. This plan has been reviewed and approved by the Rhode Island Department of Health (RIDOH) and is consistent with the guidelines RIDOH and the CDC have issued.

Students with influenza-like illness are encouraged to wear a simple surgical-type mask when roommates are present, if they need to go down the hall to a residence hall bathroom, etc.  Using a surgical mask helps reduce the spread of h1n1 by preventing aerosol and droplets from becoming airborne during coughing or sneezing.  Surgical masks for ill students are available at Health Services and from residence hall Peer Leaders, are included in food packs delivered to those students who need them, and will soon be available at Dining Services when a well friend picks up a meal to take to a sick friend.

All students, including roommates and suitemates, are reminded to take important precautionary measures of thorough and frequent hand washing and sanitizing, not sharing computer keyboards, and not drinking from the same container as a sick person.  There are approximately 125 alcohol-based hand-sanitizer stations placed around campus.

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Will anti-viral medication (e.g., Tamiflu, Relenza) be available to students?

Health Services is following the guidance of the Rhode Island Department of Health (RIDOH) and of the Centers for Disease Control and Prevention (CDC).  Currently, the guidelines support providing post-exposure antiviral medications to people with the following conditions:

  • Chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological (including sickle cell disease), neurologic, neuromuscular, or metabolic disorders (including diabetes mellitus);
  • Immunosuppression, including that caused by medications or by HIV;
  • Pregnant women;
  • Persons younger than 19 years of age who are receiving long-term aspirin therapy.

Clinical judgment is an important factor in treatment decisions. People with suspected H1N1 influenza who present with an uncomplicated febrile illness typically do not require antiviral treatment unless they meet the criteria listed above.

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If a student has a chronic medical condition, does the plan change? How?

As noted by the U.S. Centers for Disease Control and Prevention (CDC) and Rhode Island Department of Health (RIDOH), those at high-risk for complications of influenza are people with the following conditions:

  • Chronic pulmonary (including significant asthma requiring daily medication), cardiovascular (except hypertension), renal, hepatic, hematological (including sickle cell disease), neurologic, neuromuscular, or metabolic disorders (including diabetes mellitus);
  • Immunosuppression, including that caused by medications or by HIV;
  • Pregnant women;
  • Persons younger than 19 years of age who are receiving long-term aspirin therapy.

University Health Services conducted a medical record review to identify Brown students known to have chronic medical conditions that may put them at increased risk from flu. Any student who has high-risk conditions who has not already made that known to Health Services should contact Jennifer Hodshon, Health Services Manager of Operations & Administration, at (401) 863-7880.

Health Services strongly recommends that students with a chronic condition receive the seasonal flu vaccine.  When the H1N1 vaccine becomes available later in the fall, students with chronic conditions will also be a high priority for that vaccine and will be contacted directly by Health Services when it becomes available.

Post-exposure antiviral prophylaxis (e.g., Tamiflu) can be considered for students at high-risk for complications of influenza who are close contacts of H1N1 cases (confirmed, probable, or suspected).  Close contact is defined as having cared for or lived with a person who is a confirmed, probable or suspected case of H1N1, 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. 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, office or classroom. 

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What if students have questions after business hours?

Nursing consultation is available at all times by calling Health Services (401) 863-1330.

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What messages are being communicated to students on campus?

Information is available and being updated regularly on the Health Services web site www.brown.edu/health.  The University’s central location for H1N1 information and links is www.brown.edu/h1n1. The messages to students are as follows:

Prevent illness

  • Wash your hands often with warm water and soap or an alcohol-based hand gel, especially after you cough or sneeze. (There are 125 hand-sanitizer stations placed around campus.)
  • Practice “cough etiquette.”  Cover your nose and mouth with a tissue when you cough or sneeze, and throw the tissue in the trash after you use it. If tissue is not available, cough into your sleeve/elbow, not into your hand.
  • Avoid touching your mouth, nose, or eyes as this is a common way for viruses to spread: from hand to mucous membrane.
  • Do not share beverage containers, drinking glasses, forks and spoons, phones, etc.
  • Avoid sharing your computer with others, keep the keyboard and mouse clean using a sanitizing wipe.

Be prepared

  • Be prepared in case you get sick and need to stay home for a few days.  Having a non-mercury thermometer, a supply of alcohol-based hand sanitizer, tissues and dry food items (instant soups, oatmeal, etc.) could be useful and help avoid the need to make trips out in public while you are sick and contagious.

Practice community caring

  • Cover your cough.
  • Wash your hands often or use hand sanitizer (there are 125 hand-sanitizer stations placed around campus).
  • Stay home if you are sick.
  • Volunteer to take a meal to a sick friend.

Get vaccinated

  • We expect H1N1 vaccination to become available to Brown students after Thanksgiving (see letter above).
  • Seasonal flu vaccine clinics are now complete.

If you get sick…

  • Stay home/out of class.
  • Register your illness with FluWeb.
  • Notify your faculty that you will not be in class.
  • Call Health Services at 863-1330 if you have medical questions/concerns.

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More Brown Influenza A H1N1 Information

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09.25.09