Frederica Freyberg:
School is back in session and that means new books, locker assignments, and, yes, the threat of the H1N1 flu. UW-Madison is already reporting cases, this a month before the vaccine will be available. Public school nurses in districts across the state are being advised by Rachel Gallagher, the school nursing consultant for the Department of Public Instruction. And thank you for being here.

Rachel Gallagher:
Thank you.

Frederica Freyberg:
You are a very busy person.

Rachel Gallagher:
Yes.

Frederica Freyberg:
What do we know about the incidence of the flu in Wisconsin so far now that we have about a week of school under our belt?

Rachel Gallagher:
We really do not have any confirmed cases right now that we're looking at specific schools. There's been a trickle of cases statewide that are occurring, but we have not seen a huge swing in increases in cases at this time.        

Frederica Freyberg:
You say confirmed cases, but will there be confirmed cases? Is your guidance such that people need to be tested?

Rachel Gallagher:
No. If they have flu-like symptoms, we're requesting students stay home and many of those providers may or may not test. So, again, the symptoms that people really need to be aware of and be monitoring their children is cough, sore throat and fever. We've also seen some symptoms of nausea, as well as diarrhea with this, fever being the most consistent symptom that we're seeing. And, again, fever is really being defined as anything greater than 100 degrees Fahrenheit.

Frederica Freyberg:
And so to be safe, even if maybe it's not H1N1, children with any of these symptoms should stay home?

Rachel Gallagher:
They should be staying home. And in fact what we're recommending is that if a child with symptoms does come to school, that that child be excluded, isolated and sent home at that time.

Frederica Freyberg:
Now, as we know, there are some cases at UW-Madison and it seems, classes just started here too. Does this virus wait for people to be in close quarters and then it spreads?

Rachel Gallagher:
That's what we've seen. At this time it's the spread of this virus that is most concerning, not the severity. Again, this can change, because we know viruses do change.

Frederica Freyberg:
Do we expect this to hit at any particular time in the Madison schools?

Rachel Gallagher:
I do believe that when we see a mix of kids, that they go ahead and re-circulate, if you will, the viruses, and then they incubate. We could be seeing cases in the next week or two really surface if they're going to from the summer. Again, we know that typically influenza will see an influx or an increase in the fall, early winter and winter months.

Frederica Freyberg:
Now, if this really gets bad and there are lots of children infected at various school districts, what is DPI saying schools should do in terms of closing or not closing?

Rachel Gallagher:
The recommendation that we're really going by is that school districts should really be consulting with their local health departments to really determine from the health officer's point of view if there is severe or imminent risk of continuation of school. So based on numbers of children absent, the severity, if that should shift or change, number of increasing cases or are we on a decreasing slope. All of those factors will really influence the decision to close school.

Frederica Freyberg:
Now, will schools be required to report to parents or publicly the number of confirmed or suspected cases in schools?

Rachel Gallagher:
I don't believe that that's something that they really have the capacity to report. Again, keeping the public informed I think is certainly critical, that we want to have people circulating in different communities, and the local health department will really be the individuals that will have that intimate information about disease activity on a local level.

Frederica Freyberg:
What is the best advice to students and parents in the face of this H1N1?

Rachel Gallagher:
I really think that parents really should be monitoring their kids in the morning. So really take a closer look than you normally would. If they have any cold-like symptoms, do they feel warm, really take a close look at them. Also, really look at how we can prevent this disease from transmission. So, again, coughing, using our sleeve as a good way to really cover the nose and the mouth with any sneezes or coughs. Hand washing. You can't do hand washing enough. Very basic information, but, again, your most successful strategy for limiting transmission of disease. Keep your hands away from your eyes, your nose and your mouth, and really, when that vaccine is available, consider getting the vaccine.

Frederica Freyberg:
All right. Thank you very much, Rachel Gallagher, and good luck to you.

Rachel Gallagher:
Thank you.