Returning to School/Work

Returning to Work or School
Guidance for Adults and Children with Seasonal or Novel H1N1 Influenza

V.4 Revised August 21, 2009

These guidelines will be revised as situation evolves.

To date, most illness from the novel H1N1 influenza virus has been mild to moderate, but, as with seasonal influenza, there have been cases of very severe illness and several deaths in Texas. Some persons are at higher risk of severe disease or complications from influenza (see Box 1). To prevent spread of illness, it is important to follow preventive measures to avoid catching the flu and also measures to keep from infecting others. For more information on preventing influenza, taking care of an ill person at home, and other influenza issues, go to Families and Individuals on the www.texasflu.org site.

These Return to Work or School guidelines address the timing of returning to work or school after an influenza-like illness. The cautions apply whether a person has seasonal influenza, novel H1N1 influenza or a similar flu-like illness (see Box 2 for symptoms of influenza). If the novel H1N1 virus (or other seasonal influenza virus) changes significantly in severity, DSHS and CDC may make different recommendations as the situation evolves.

Note: “Stay at home” means persons should not congregate with friends, participate in other school or community activities, or be sent to a different day care. An ill person may leave home for medical appointments but should wear a mask (surgical mask is sufficient) while traveling to and from and during a medical appointment.

Table 1. Guidance for adults with flu-like illness on return to work or school

Condition

Exclude from work or school

Ill and treated with antiviral medication*

Until there has been no fever (>100°F) for 24 hours without fever reducing medications. ** 

Ill and not treated with antiviral medication*

Until there has been no fever (>100°F) for 24 hours without fever reducing medications. **

Persons who have traveled to area where novel H1N1 or seasonal flu has been confirmed and who have no symptoms

0 days, monitor for illness

* Those working in a health care setting should be excluded for 7 days from symptom onset or until the resolution of symptoms, whichever is longer. Refer to www.cdc.gov/h1n1flu/guidelines_infection_control.htm for more information.
** If influenza severity increases, people with flu-like illness may be asked to stay home for at least 7 days, even if they have no more symptoms.

Table 2. Guidance for persons younger than 18 years old with flu-like illness on return to work or school

Condition

Exclude from work or school

Ill and treated child or youth

Until there has been no fever (>100°F) for 24 hours without fever reducing medications**

Ill and not treated child or youth

Until there has been no fever (>100°F) for 24 hours without fever reducing medications**

Persons who have traveled to area where novel H1N1 or seasonal flu has been confirmed and do not symptoms

0 days, monitor for illness

* If influenza severity increases, people with flu-like illness may be asked to stay home for at least 7 days, even if they have no more symptoms.

Box 1. Persons at Higher Risk for Complications of Novel H1N1 and Seasonal Influenza

o    Children younger than 5 years old. The risk for severe complications from seasonal influenza is highest among children younger than 2 years old.

o    Pregnant women

o    Adults 65 years of age and older.

o    Persons with the following conditions:

§  Chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological (including sickle cell disease), neurologic, neuromuscular, or metabolic disorders (including diabetes mellitus);

§  Immunosuppression, including that caused by medications or by HIV;

§  Persons younger than 19 years of age receiving long-term aspirin therapy and who might be at risk for experiencing Reye syndrome after influenza infection; 

§  Residents of nursing homes and other chronic-care facilities.

For more information on preventing influenza, taking care of an ill person at home, and other influenza issues, go to

·         Families and Individuals on the www.texasflu.org site.

For more information on influenza and schools, colleges and universities, and businesses, please visit the following sites, also accessible through www.texasflu.org:

·         Schools, Colleges and Universities, Congregate Settings

·         Communities and Employers

 

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