Flu Fight 2013 Closes Schools, Halting Kids From 'Sharing Secretions'

Flu Victims 'Sharing Secretions' In Schools, Churches
FORT WORTH - APRIL 30: Fort Worth Independent School District custodian Necie Homer wipes down a classroom with disinfectant in an effort to stop the spread of the swine flu virus at Arlington Heights High School on April 30, 2009 in Fort Worth, Texas. FWISD officials closed all schools in Fort Worth late on April 29 in an effort to stop the spread of the virus. (Photo by Tom Pennington/Getty Images)
FORT WORTH - APRIL 30: Fort Worth Independent School District custodian Necie Homer wipes down a classroom with disinfectant in an effort to stop the spread of the swine flu virus at Arlington Heights High School on April 30, 2009 in Fort Worth, Texas. FWISD officials closed all schools in Fort Worth late on April 29 in an effort to stop the spread of the virus. (Photo by Tom Pennington/Getty Images)

Schools in Grayville, Ill., closed on Monday, and won't reopen until Thursday, after more than 20 percent of the town's elementary through high school kids came down with the flu.

From Minnesota to Oklahoma, schools have made similar decisions, while workplaces, hospitals, churches and sports teams are taking their own precautions in the face of what is likely the worst flu season in more than a decade.

"Kids are generous in sharing secretions," said Dr. Marty Cetron of the U.S. Centers for Disease Control and Prevention, who has three kids of his own.

When the flu strikes, kids tend to be the first sick due to their lower immunity and more frequent contact with others -- including the natural intermingling at crowded schools.

"Once the virus gets into schools, it spreads fast," Cetron added. "Then kids come home, creating a cascading effect in the community."

In a study published in October, Cetron and fellow researchers evaluated the approaches taken by two Texas school districts' during the 2009 H1N1 pandemic. One district temporarily closed schools early in the outbreak, while the other kept doors open throughout.

Cetron said the differences were "profound," including fewer self-reported emergency visits and influenza-like illness in areas where schools had closed, even if only for a week or so. The benefits also extended beyond the students to entire communities.

Based on his own research, Bruce Lee, an expert in infectious diseases at the University of Pittsburgh, said he's less optimistic about the flu-fighting strategy. Closures may not only fail to protect kids from the flu or thwart an outbreak, he said. They may actually "refuel the epidemic" once those kids return to school.

"We found school closures prohibitively expensive and not very effective," said Lee, whose research used computer simulations based on census data.

Lee's research suggests that once a virus has spread throughout a community, schools would have to remain closed for a long time -- say eight or nine weeks -- to offer any lasting protection from the flu. That means significant losses in teacher productivity and parents' work time.

Modeling studies like Lee's are important, said Cetron, but "don't replace real life," such as the experiences of students in Dallas and Fort Worth, Texas, during the 2009 pandemic.

"Even a short term dismissal could allow people to become educated, get vaccinated and develop some immunity," said Cetron.

Still, Cetron acknowledged that many other factors, such as the timing, strain and spread of the virus, play a role. Simply reacting to a flu outbreak, as Grayville and other districts have done this year, is less effective than closing schools before a large number of students fall ill. Closing schools is also not a "trivial intervention," and its disruptiveness may be even less appealing to school officials before an outbreak's impact has played out, said Cetron.

Researchers including Cetron are now collecting experiences of places like Grayville, Ill., to evaluate the success of various strategies, while also noting that there is no one-size-fits-all approach.

"If you've got a school that serves special needs kids, or a faculty with high proportion of people undergoing cancer therapy, you might need different approaches," Cetron said.

Both Cetron and Lee agreed that a whole suite of interventions should be employed within a community.

"Not practicing 'presentee-ism' at work when you're sick, and being cognizant of where you sneeze and what you do with your hands, makes a big difference," said Cetron. "First and foremost, protect yourself -- get immunized. And if you get sick, be a good citizen in your community and don't share the virus with others."

In many communities, other social institutions are also taking their own steps to guard against the flu.

Some hospitals, for example, are limiting visitors. Portsmouth Regional Hospital in New Hampshire is going as far as to keep kids out -- unless they're seeking treatment, of course.

Churches, too, are taking the cue, with many urging parishioners to stay home if they have the flu and avoid shaking hands during rite of peace. Some Catholic churches have also stopped offering a shared chalice during Holy Communion.

Also among the gathering places in which germs can fly: sporting events and grocery stores.

The Manhattan Soccer club is reportedly encouraging its players not to shake or touch hands with opposing players during games. Rather, during the traditional post-game lineup for high-fives, the club suggests that "the safest thing to do is touch elbows."

Cetron said he is all for creating new ways to minimize the sharing of secretions. "If you decide to do elbow bumps instead of handshakes, that makes good sense as long as you are not sneezing into someone's face," Cetron said.

Pam Rankin keeps similar considerations in mind while she works at the IGA Supermarket in Grayville, reports a local news station, WTVW. One of Rankin's kids, who attends a now-closed school, iscurrently sick at home with the flu.

"I don't want to spread it to the customers and have all them come down sick either," Rankin told WTVW. "We've been using hand sanitizers, sanitizing wipes, spraying over everything."

Before You Go

Hand Washing
There may be no more promoted solution to avoiding the flu this year (besides the flu shot, of course) than diligent hand washing. As many as 80 percent of infections are transmitted via contact like sneezing, coughing or touching surfaces that have been sneezed or coughed on, says Tierno, and then touching "your mouth, eyes or nose, which are the conduits of viruses into the body." He recommends scrubbing before eating, drinking or touching your face, and disinfecting shared surfaces in the home (like the bathroom) and the office, like phones, computers and fridge door handles.
While you're off in dreamland, your body gets to work repairing cells and injuries you may have incurred during the normal day's wear and tear, says Tierno. Getting your seven to nine hours a night means your body can repair and heal itself and ward off infections. "If you don't get the appropriate sleep, that system is not operating and you're on a steady decline over time," he says.In fact, skimping on sleep is as disruptive to the immune system as stress, according to a 2012 study. And earlier research suggested that sleep patterns may play a role in a gene that helps fight off bacteria and viruses.
Getting your blood pumping regularly can increase the activity of a type of white blood cells that attacks viruses. Shoot for an hour a day, says Tierno -- but not necessarily all at once. "Even if it's walking around the office, up stairs, down stairs, to and from work -- it doesn't have to be continuous," he says.
Getting the proper amount of the right nutrients and minerals as part of a healthy diet "leaves the body in optimal condition to fight the battle," says Tierno. This means cutting back on sugary, fatty foods and upping your intake of vegetables, fruit and lean protein, he says. One of those nutrients that gets a particularly healthy reputation during cold and flu season is zinc, and for good reason. "Zinc interferes with viruses gaining full access to our cells," he says. "Zinc may block certain metabolic activity." While it's not the end-all cure, foods rich in zinc, like oysters and wheat germ, may offer some protection.
The anti-microbial properties of this pungent bulb (and its relative, the onion) can fight off certain bacteria and viruses, says Tierno, as can the compounds in other herbs and spices, like thyme.It's likely due to the compound allicin, which seems to block infections. Try it in your next bowl of soothing chicken soup!
Thankfully, most of us are inhabiting cozy-warm homes this winter, but those cranking radiators come with a downside. Indoor winter air is much dryer than our bodies would like. Without sufficient moisture, says Tierno, "immune system cells can't optimally work," so it's important to stay hydrated. (A humidifier can also help.)
Skipping Happy Hour
Alcohol suppresses both the part of the immune system that protects you from coming down with something and the part that fights off the germs already in your system, so knocking a few too many back can put you at increased risk for catching the bug going around -- and having trouble kicking it.
A positive attitude can take you far -- even, maybe, to age 100. But along the way, a life of laughter and optimism could also help you sniffle through fewer bouts of the flu or colds. While there's much that's still not well understood about the process, it seems that certain immune cells are produced by a big belly laugh, says Tierno.
A favorite solution for de-stressing, massage can also help you stay physically healthy. While there's been little research into exactly how it works, massage certainly increases circulation, which may help promote the general "state of wellness in the body," says Tierno. "Nutrients are passed around better, the blood flow is better," he says. "It's a very useful thing to get a massage."
A 1999 study found that getting frisky a couple of times a week can boost immunoglobin A, an antibody that fights off colds. Just make sure your partner isn't already sick!

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