FAQ: Swine Flu On College Campuses

Schools are back in session across the country, and on some college campuses many students are already reporting sick, worried about flu-like symptoms. More than 2,500 students at Washington State University out west, for instance, are suspected of having H1N1 swine flu. But in the Boston area, colleges and universities are not seeing much of an impact — at least not yet.

Is the flu a problem on Boston-area college campuses this school year?

So far, most campus health clinics in the Boston area say they're not overly busy and they're certainly not overwhelmed with sick students. As of Friday, Boston University, for example, has only confirmed seven cases of students with flu-like illnesses, and that's out of more than 30,000 students. MIT has confirmed just three cases of the flu out of about 11,000 students. Brandeis University in Waltham has 12 cases among about 4,000 students. And Boston College has 14 cases among roughly 10,000 students, although only 4 or 5 of those are confirmed.

Why are colleges differentiating between "confirmed" and "unconfirmed" cases of the flu? And are the confirmed cases H1N1 swine flu, or are they regular seasonal flu?

The state is longer testing for swine flu because it was getting overwhelmed with samples. And the Centers for Disease Control is advising doctors to test for seasonal flu only if the sick patient has some underlying condition, such as diabetes or asthma, that could put him or her at higher risk. So there are many unanswered questions.

Confirmation is a difficult problem now because the guidelines are not to really test. But if someone comes in with flu-like symptoms, which are fever, sore throat and cough, we presume a person has H1N1 when that occurs.

--Dr. Tom Nary, director of health services, Boston College

Why are some colleges presuming that most flu cases are instances of H1N1 swine flu?

They feel confident presuming it's H1N1 because this would be unusually early in the year to see seasonal flu.

If Boston isn't seeing high numbers of students with the flu, why are we hearing about students flooding campus health clinics in other places?

The short answer is we're not sure, since there's still quite a lot we don't know about H1N1. But some of those colleges in other states started classes a few weeks earlier than colleges in the Boston area, so they've had more time for the virus to circulate. That means Boston campuses could see a higher volume of flu cases in coming weeks.

And just because students at places like Washington State University are going to the campus health clinic doesn't mean they actually have the flu. Some campus medical professionals say many students are more anxious than usual just because they're nervous that they may have swine flu.

Part of what we're seeing is people who otherwise might not come by but have a little cold and want to know, 'Is it the flu?' So the worried-well and the not-so-sick is part of the problem...and we're trying to calibrate this delicate message: It's not that we don't want to see you if you're sick, but if you have these minor symptoms you don't need to come in to see us. On the other hand if you do get sick — you know, temperature over 100.5 degreees and some other symptoms — we'll be happy to see you, but you know what? In most cases we may do nothing other than tell you you're sick and send you home.

--Dr. David Diamond, associate medical director, MIT

How are colleges treating sick students?

It varies. At Brandeis, if a student with the flu lives in a two-person dorm room, then the healthy student is actually being asked to find somewhere else to stay temporarily. But a person with the flu is most contagious in the 24 to 48 hours before symptoms appear, which means that by the time you're feeling sick you may already have infected other people. So, rather than uprooting the healthy student, most other schools are simply telling sick students to stay put or, if they live locally, to go home to their families for a while.

Among students who do have the flu, how sick are they getting?

They're not getting all that sick, relatively speaking. The main three symptoms are fever, a sore throat, and a cough, and sometimes also body aches and gastrointestinal upset. But the suspected cases aren't turning out to be as bad as some public health professionals thought they'd be last spring.

This is not a vicious flu. Most of the students that we have, and other colleges also, are ill for a very short time, 24-48 hours, they get better quickly, and the symptoms seem to be much less than what might be called the average seasonal flu.

--Dr. Tom Nary, director of health services, Boston College

What are the suggested precautions for preventing the spread of flu?

The main preventive measures continue to be washing your hands frequently and coughing or sneezing into a tissue, your shirt sleeve, or your elbow rather than into your hands. People who suspect they have the flu should stay home from work or school for at least 24 hours after their fever has ended — and that's without the help of fever-reducing medicine.

Public health professionals are also urging people to get vaccinated against the flu. The seasonal flu vaccine is already available in most areas, and the H1N1 vaccine is expected to be available in early October.