By Rob Stein and Daniel de Vise
Washington Post Staff Writers
Wednesday, May 6, 2009
U.S. health officials yesterday retracted a recommendation that schools close for as long as two weeks if a student catches swine flu, a move that reflects growing confidence that the outbreak may be milder than initially feared, despite the death of the first American from the illness.
Because the flu does not seem to be commonly causing the severe illness first reported in Mexico, parents and teachers should instead watch children for any signs of the flu and keep them out of school for a week at any hint they are getting sick, officials said.
The shift in policy will ease the most tangible impact of the outbreak for most Americans. At least 726 schools nationwide that serve more than 480,000 students -- including a handful of schools in the Washington area -- have closed in the past week in an attempt to stem the spread of the virus.
"To be able to get back open and try to get back to normal is a relief," said Phil Barnes, a music teacher at Rockville High School, one of five Washington area public schools scheduled to reopen today after flu-related closures
Federal officials said they decided to reverse the previous recommendation because most cases in the United States so far have been relatively mild, a genetic analysis of the virus found no signs it was especially dangerous, and there was a recognition that closing schools could probably do little to prevent its spread.
Any schools that closed based on the previous guidelines are free to reopen as soon as they can, officials said.
"When you hear of the difficulties involved -- of children dropped at libraries because there's nowhere for home care, of people who could lose their job because they don't have sick leave -- these factors are really real, and we need to really feel that the public health benefit of that makes it warranted," said Richard E. Besser, acting director of the federal Centers for Disease Control and Prevention.
Besser stressed that people should continue taking common-sense measures, such as washing their hands frequently, and that sick adults should stay home from work for a week.
"Those measures that can be taken by everybody will help reduce the likelihood that individual people will get sick and, if they are sick, they will transmit it to others," Besser said.
The move is an indication that officials are becoming increasingly confident that the flu could turn out to be about as severe as a normal seasonal flu, at least in the short term.
"In seasonal flu time, the only time a school would consider closing is if enough of the teachers and enough of the population has frankly gotten the flu so they really can't function," said Health and Human Services Secretary Kathleen Sebelius.
Sebelius and other health officials stressed, however, that flu can take a serious toll. About 36,000 Americans die each year from the seasonal flu and perhaps 200,000 are hospitalized.
"Given what we know from seasonal flu, we would expect that we would continue to see additional hospitalizations, and it's likely we would see additional deaths," Sebelius said.
Texas officials said a 33-year-old teacher from Harlingen died yesterday from "complications from influenza" after falling sick April 14. She had not traveled to Mexico recently, and officials were uncertain how she became infected. The woman, who was pregnant, had an underlying health condition. The baby was delivered after she was hospitalized. "The baby is fine," according to Lionel Lopez of the Cameron County Department of Health and Human Services.
No additional public health measures were being recommended in response to the death, he said.
The virus also could mutate into a more serious form or return later in the year as a greater threat, Sebelius and others said.
"Although we have these encouraging signs, I want to be clear: This is not a time for complacency," Homeland Security Secretary Janet Napolitano said. "People are still getting infected and sick. . . . This is why we are preparing now for what may come in the future."
The change in policy came as the number of new cases continued to increase. The U.S. tally hit 403 confirmed cases in 38 states. Thirty-five patients have been hospitalized.
But the decision to reopen schools solved what had become a looming administrative problem for schools and parents.
In Texas, where nearly 73 percent of the affected students reside, officials were scrambling to decide when they might reopen.
"A lot of them have kids scattered everywhere," said Michael Peebles of the Texas Education Agency.
Locally, classes were expected to resume today at all five public schools in the Washington area that had closed because of probable flu cases: Rockville High School in Montgomery County; Montpelier, University Park and Vansville elementary schools in Prince George's County; and Folger McKinsey Elementary in Anne Arundel County. Our Lady of Victory in the District planned to remain closed for cleaning.
Laura Cooper-Martin, 17, a Rockville High senior, said a crush of tests had made it hard for students to enjoy unscheduled days off.
"Another random time of year, a lot of people would be excited about it," she said. "But right now, when everybody wants to be in school to prepare for these exams, we can't."
Melinda Moore, the mother of two students at University Park Elementary, worried that an extended closure might mean a longer school year, which might impinge on her plans for summer camp. But she thought school officials were right to close down.
"I would rather see them err on the side of caution," she said.
Meanwhile, new clues emerged that support the notion that the virus tends to produce relatively mild illness. A genetic analysis of the virus suggests it probably came into being sometime before mid-September. If it then started spreading person-to-person, it may have been present throughout the winter in Mexico and may have become visible only at the end of the flu season. The deaths in Mexico would simply be the expected mortality in a huge epidemic of more or less normal influenza.
"If this virus has been circulating in Mexico for several months, we can only presume that it wasn't killing everyone it infected," said Oliver G. Pybus of the University of Oxford, leader of one of four groups of biologists estimating the age of the virus. "It would be very surprising if this was a highly virulent virus that had been spreading since September but wasn't detected until April."
Staff writers Nelson Hernandez, Lori Aratani, Maria Glod, David Brown, Ceci Connolly, Jacqueline L. Salmon, William Wan, Michael E. Ruane and Spencer S. Hsu contributed to this report.