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Updated 05/21/2009 11:14 PM

DOH Updates Number Of H1N1 Cases Citywide

By: NY1 News

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The city health department says 56 people have been hospitalized with confirmed cases of H1N1 since the outbreak began.

The total number of cases in the city now stands at 240.

Health officials continue to stress that most cases have been mild.

School Closings

See NY1's full list of the city's flu-related closings.


Meanwhile, as four schools prepare to reopen Friday, nine others are closing because of concerns over the virus.

I.S. 5 and P.S. 9 in Elmhurst, P.S. 255 and P.S. 16 in Corona, are expected to open Friday morning after being closed for five days while crews worked to sanitize the buildings.

Helpful Links

The United Federation of Teachers has set up 11 hotlines in the five boroughs to gather information on school flu outbreaks and school closings.

The Department of Education is now posting daily attendance rates for every public school in New York City.


On Thursday, the DOE added P.S./I.S. 499 in Flushing, P.S. 111 in Eastchester, P.S. 143 in Corona, P.S. 203 in Bayside, M.S. 113/P 372 in Fort Greene and P.S. 73 in Maspeth to the list of schools closed due to a high number of absences.

Of the 36 currently closed schools, I.S. 238 is the only one with confirmed cases of H1N1.

Over the past few days, city leaders have responded to mounting criticism of how officials are going about deciding when to close schools in the wake of the H1N1 outbreak.

The Department of Education announced Wednesday that it would begin posting daily attendance numbers for every public school in the city on its website.

Mayor Michael Bloomberg said the decisions to close individual schools are not based on absenteeism, and Schools Chancellor Joel Klein described in a letter to parents how the city decides to close schools.

The city health commissioner looks for "clusters" of illness, as well as a spike in the number of students with fevers over 100.4 degrees Fahrenheit and other flu symptoms.

"We're posting now the absentee rates on the Department of Education website, but it doesn't really tell you anything," said Bloomberg. "The real issue is how many people are showing up in school with fever and that tends to be very low and people should be sending their kids to school if the kids don't have symptoms."

The mayor said the city also considers the severity of the flu in each community by monitoring hospitals.

Schools Chancellor's Letter To Parents

The following is a letter to school parents that Mayor Michael Bloomberg referenced during his Wednesday briefing:

May 20, 2009

Dear School Community,

Since the H1N1 flu, or "swine flu," first came to New York City in April, officials at the Department of Education and the Department of Health have been intensively monitoring the health of students and other members of the
school community. We have been working closely with principals and school nurses to keep students and other members of our school community healthy. Today, I would like to update you on this situation.

WHAT IS THE SWINE FLU?
This flu is caused by a newly identified virus called H1N1. Since April, it has caused outbreaks of flu-like illness in New York City and around the world. The symptoms are similar to regular seasonal flu symptoms. Most people who
become infected have fever, which is accompanied by cough, sore throat, fatigue, headache, and body ache. H1N1 spreads from person to person the same way seasonal flu spreads: when someone coughs or sneezes, he or she can infect someone else in close proximity. Shaking hands or other types of direct contact may also transfer the virus. So far, the symptoms of the new H1N1 flu have closely resembled those of seasonal flu and most people who become sick are recovering, but any influenza virus can cause severe illness, so we are taking aggressive precautions.

HOW ARE SCHOOLS MONITORING THIS SITUATION?
Principals and school nurses are on alert and are working with the Department of Education and the Department of Health to keep students and staff safe and healthy.

We have instructed schools to:
• Immediately separate students with flu-like illness.
• Send students who have symptoms to be evaluated by the school nurse
or school-based health center and then sent home if the nurse confirms
the presence of an influenza like illness.
• Inform parents that children with these symptoms should stay home
until they have been symptom-free for 24 hours. (Students with
persistent coughs but no other symptoms may return to school one
week after their symptoms started.)
If an unusually high number of students at a school become ill, the school's
nurse will contact our central School Health Office, which will work with the
Health Department to develop a plan for the school.

WHAT IS THE CITY DOING TO KEEP STUDENTS SAFE?
We are monitoring the situation closely and are looking for "clusters" of illness at particular schools. Sometimes, when a lot of children are sick, closing a school, keeping children home, and preventing them from interacting with each other can reduce further infection. Since April, we have decided to close more than a dozen schools. The Chancellor is responsible for
deciding when to close schools, based on the recommendation of the Health Commissioner. I want to make it clear that this is not currently a citywide problem and there is no need for a citywide solution. What we need is to monitor individual schools and take appropriate steps based on specific circumstances. Most of our schools remain relatively unaffected by H1N1.

HOW DO WE DECIDE TO CLOSE A SCHOOL?
The Health Commissioner is evaluating a range of factors as it considers whether it makes sense to recommend closing a school. Most importantly, he looks for "clusters" of illness, and determines whether closing a school could help to reduce the spread of infection. The number of students who are absent is not a trigger to recommend closing a school. We do
look for spikes in the number of absent students at a school. Most importantly, we look at the number of students who are visiting the nurse's office, and we keep track of the number of students with fevers over 100.4 degrees and another influenza symptom such as a sore throat or cough. A high absentee rate alone does not mean a school should close. If all the children who are sick are already home and the students in school are healthy, closing will not reduce the transmission of infection. We also take into account the severity of H1N1 flu in the community. The Department of Health and Mental Hygiene monitors all New York City emergency rooms and intensive care units to evaluate the severity of swine flu infections in the community. The Health Department is visiting many schools each day and making recommendations to the Schools Chancellor about how to handle individual situations.

WHAT CAN YOU DO AT HOME?
The best way to prevent the flu is to ensure that people with symptoms stay home. If your child has a fever, accompanied by cough or sore throat, please do not send him or her back to school until 24 hours after the symptoms are gone. Most people who get the flu do not need to seek medical care and do not need to be tested for H1N1 flu. The Health Department recommends testing only for people who are in the hospital. Most people who get the flu should stay home. However, those in high risk groups should seek medical advice immediately, if they have had close contact with someone who has the flu during the past week or they develop flu symptoms Those in high risk groups include:
• People over 65 or under 2 years of age;
• People with chronic lung, heart, kidney, liver or blood disorders;
• People with immune systems that are compromised (either due to
illness or medicines);
• Pregnant women; and
• People on long-term aspirin therapy.

HOW CAN YOU FIND ADDITIONAL INFORMATION?
We are keeping up to date information about this flu on the homepage of the DOE Web site at www.nyc.gov/schools. At this site, we have been listing schools that are closed and posting frequently asked questions and other important updates. We also have links to learning guides that can help students remain on track, even if their schools are closed. You can also pick
up one of these learning guides at the following locations:
• Brooklyn: 131 Livingston Street, Brooklyn, NY 11201
• Queens: 30-48 Linden Place, Queens, NY 11354; 28-11 Queens Plaza
North, Long Island City, NY 11101; or 90-27 Sutphin Boulevard,
Jamaica, NY 11435

CONCLUSION
We have taken-and will continue to take-the necessary steps to protect members of our community. I urge you to remain calm and continue working as our partners in keeping members of the school community safe and healthy.

Sincerely,
Joel I. Klein


H1N1 Flu Symptoms, Prevention

The Centers for Disease Control and city officials urge anyone who feels sick or has flu-like symptoms to stay home.

Symptoms include fever, cough, headache, fatigue, and in many H1N1 cases, nausea and other gastrointestinal symptoms.

As always, the best ways to prevent illness are by covering your cough and sneeze, washing your hands and using hand sanitizer.

HELPFUL LINKS:
NY1 report on how the H1N1 virus spreads.
City Department of Health page for H1N1 information, tips for health care professionals and educational materials.