Schools Won't Close for Swine Flu, Putting Pregnant Teens at Risk

The government issued a bit of good news today with regard to swine flu: Most schools with outbreaks won't need to be shuttered this fall. Last spring, more than 100 school systems in 14 states temporarily shut their doors, leaving 160,000 kids home and working moms scrambling for babysitter coverage. There's no longer any reason to shutter schools because the H1N1 virus that causes swine flu is not as deadly as was feared. "Most U.S. cases have not been severe and are comparable in severity to seasonal influenza," the Centers for Disease Control and Prevention stated in its new recommendations, released today. "At this time, CDC recommends the primary means to reduce spread of influenza in schools and child care programs focus on early identification of ill students and staff, staying home when ill, and good cough and hand hygiene etiquette." Sick individuals shouldn't return to school for at least 24 hours after their fever breaks, the CDC adds.

It also says that local authorities should determine when and if any schools should be closed; for example, they may want to consider closing schools where pregnant students make up the majority of the population because pregnant women are more at risk of severe complications from H1N1 infections.

But this last point is probably moot, since most pregnant teens attend regular public schools these days. "The majority of those I treat are still in their [regular] school, which means they're in an environment where the flu is going to be more rapidly spreading," says Paige Long Sharps, an obstetrician-gynecologist who runs an adolescent clinic at Montefiore Medical Center in the Bronx, N.Y. "Kids aren't as hygienic. They don't cover their mouth and nose with a tissue when they sneeze nor wash their hands frequently." And as a mother of a teenage girl, I know how much teens love to hug their friends.

Sharps says schools should consider installing hand sanitizer dispensers outside every classroom. Hospitals now have them, and she recently added them outside her exam rooms in her private office. "I notice a lot of my teenage patients using them," she says, "not just the doctors and nurses." It's probably a good idea for pregnant teens to get the H1N1 vaccine, as a government panel recently recommended, but the school year will begin at least a month or two before the vaccine, which is currently being tested, becomes widely available.

In the meantime, moms should consider sending pregnant teens to school with hand sanitizer in their backpacks, Sharps advises. The CDC recommends that pregnant women and teens who develop flulike symptoms—fever, sore throat, diarrhea, cough—be treated immediately with an antiviral drug like Tamiflu. And doctors shouldn't rely on the results of rapid flu tests when determining whether to treat pregnant women. A new report shows these tests detect the virus only 40 to 70 percent of the time.

• Related news: How to deal with swine flu during pregnancy.