Santa Clara County Public Health Department
May 6, 2009
Over the last week and up until last evening,
and consistent with guidance from California Department of Public
Health and the Centers for Disease Control, Santa Clara County Public
Health Department closed schools and daycares if a probable or
confirmed case of swine influenza (influenza A H1N1) was identified in
that setting. As you know, this outbreak has been evolving and with
each day we learn more about the virus, the severity of illness that it
causes, and how easily it spreads. The closures have helped to decrease
the spread of infection in the schools and have provided valuable time
for us to gather information about this new H1N1 influenza strain in
Information gathered over the last week in Santa Clara County and
elsewhere in the country show that most U.S. cases have not been severe
and are comparable in severity to seasonal influenza.
What will be the new policy and guidance?
Based on our
local information, as well as new draft guidance issued by CDC today,
we are now modifying our approach. Rather than continuing to close
individual schools and childcare centers based on the diagnosis of
influenza A H1N1 in students or staff, we will instead implement a
county-wide policy that focuses on keeping all students and staff with
symptoms of influenza out of school or childcare during their period of
illness and recuperation, when they are potentially infectious to
others. The new recommendation guidance to decrease spread of influenza
A H1N1 in Santa Clara County schools and childcare settings is as
- Each morning, all parents/caregivers should assess all ill family
members and especially all school-age children for symptoms of
influenza (fever and cough or sore throat) or other early symptoms that
might be influenza.
- Each morning, all school faculty should assess themselves for symptoms of influenza.
- Students or faculty with influenza-like-illness (fever and cough or
sore throat) should stay home and not attend school. All sick students
and faculty should stay out of school for at least 7 days, even if
their symptoms resolve sooner. Students and faculty who are still sick
at 7 days should continue to stay home from school until at least 24
hours after they have completely recovered.
- If a child or adult is ill with symptoms (even if they don’t have
all the symptoms or influenza), they should stay home at least one day
to observe how the illness develops and until completely well for 24
- Schools should screen students and staff for visible signs of possible influenza illness upon arrival to school.
- Students and staff who appear ill at arrival or become ill at school should be promptly isolated and sent home.
- Persons who are ill should stay home and not go into the community
unless they need medical care. Ill students should not attend
alternative child care or congregate in settings other than school.
- As always, situations can be individualized and school authorities
may still close a school at their discretion. Parents may use their
judgment regarding the risk and benefits of sending their children to
school during this influenza outbreak as they would during a seasonal
- Schools will not longer be routinely ordered closed by Santa Clara
County Public Health Department on the basis of a probable case of
swine influenza. As is our practice with seasonal influenza, schools
may be closed if larger numbers of students or faculty would become ill
and school functioning becomes disrupted.
What information is informing this policy change?
information from our case investigations and surveillance systems
suggests that this new strain has spread widely in our community and
will continue to be transmitted from person to person, including
children. Available information (from local, state and national
sources) suggests that the severity of illness from the new influenza A
H1N1 strain is not greater than the typical seasonal influenza that
circulates in our community every year.
What will the policy be for schools and daycares that have already closed?
and childcare centers that have been closed over the last week may
re-open, and should be especially diligent about following the guidance
We thank the school nurses and health clerks who
have diligently been reporting cases of influenza-like-illness to us.
As of today, we no longer need those reports as we will no longer be
following up on individual students with influenza like illness.
However, if you note an unusual number of absences from
influenza-like-illness and need assistance in deciding what measures to
take, you may consult the “school liaison” at Santa Clara County
Disease Prevention and Control Program at (408) 885-4214.
If you have questions about this change in
guidance or its implementation, please call (408) 794-0700 and ask to
speak with the Medical Group Supervisor.
We have tremendous respect and appreciation for the superintendents,
principals, teachers and other staff in schools and daycare who have
worked so closely with us, and the parents and students who have been
so patient with our actions. As you know, this has been a very dynamic
and rapidly evolving situation, and your cooperation and partnership
have been invaluable.