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Dr.  Lawrence’s latest email has a few highlights: we’re up to 137 total cases of H1N1, and we currently have 37 active cases.  He says that the caseload has remained constant for a couple of weeks, and recommends that if you feel sick that you stay in as much as possible.  Be nice to your classmates — don’t go out sick!  He also explains why they aren’t prescribing Tamiflu.

Also, the H1N1 vaccine won’t be on campus until about October 30th.

To:     The Rensselaer Community
From:   Leslie Lawrence, M.D.
Medical Director, Student Health Center
Date:   October 22, 2009
Re:     H1N1 Update

As of October 21, we have experienced 137 cases of influenza among
students on the Troy campus. Some 37 students have active cases of the
illness. Of those, nine are in isolation rooms and 28 are recuperating
at home with their families. The remaining 100 students are fully
recovered. In addition, several faculty and staff members have reported
influenza-like illnesses.

Our daily caseload has remained fairly static since October 4 with about
seven to eight new cases each day. The one important exception to this
is the noticeable increase in the number of ill students we see
immediately following each weekend.

Do not attend a sporting or social event if you feel sick. The H1N1
influenza can be easily mistaken for a severe cold by some
patients. When in doubt, do not attend an event where you could spread
any illness to others. At weekend events on or off campus, continue to
wash your hands (pack small hand sanitizers if necessary or use the
sanitizers around campus) and keep a distance between yourself and
others. I realize that can be difficult in tight places like football
bleachers or the seats of the Fieldhouse, which is why it is so
important that sick people stay home. Remember, you can contract the flu
from someone who does not yet appear ill. You can also spread it before
you feel ill.

This advice is particularly important given that this weekend is Family
Weekend on the Troy campus. There will be a huge increase in the number
of visitors and events on campus. Young siblings and other visitors at
risk of serious complications from the flu will be on and around campus
throughout the festivities. I would very much like to see everyone have
a good time with their families without a noticeable jump in the number
of flu cases come Monday and Tuesday mornings. Please, practice good
hygiene throughout the weekend and avoid events if you are sick.

The moral of the story: use extra caution during weekend events to
protect yourselves, family, and friends.

I have received several questions from students and parents multiple
times. The first is why we are not confirming each suspected case of
influenza with a test swab for either influenza A or H1N1. The Centers
for Disease Control (CDC) is currently recommending that confirmatory
testing occur only in cases where the patient needs to be
hospitalized. According to the CDC, virtually all influenza-like illness
is being caused by H1N1 at this time; there is no seasonal influenza
currently circulating. Therefore, the CDC has directed physicians to
assume that all outpatient influenza-like illness is H1N1 without any
confirmatory testing.

The second and third common questions are: why are you not regularly
using Tamiflu, and why are you isolating for seven days when the CDC
states you may return to work or classes 24 hours after you have no
fever? In response, I can report that the CDC recommends that Tamiflu be
reserved for those who are at the highest risk of getting severely ill
from flu, such as pregnant women, people with diabetes or asthma, or
disabled children. Several recent studies have shown that most patients
infected with the virus will be contagious for at least seven days, and
this is why we now recommend that patients stay home until they have
been free of symptoms for 24 hours, or for seven days after first
getting sick, whichever is longer.

The following link takes you to an article about a study that was done
at the Air Force Academy on students with H1N1, and provides the full
context for those answers:
http://news.yahoo.com/s/nm/20091020/hl_nm/us_flu_academy_1. We have
decided to take this conservative approach to isolation in order to slow
the spread of the illness here at Rensselaer. It also allows us to
monitor students longer for any potential complications.

Unfortunately, the H1N1 vaccine will arrive later than previously
expected. I am currently getting information that the first doses will
arrive on October 30. We are preparing to hold vaccination clinics
across campus the first week of November, as long as we receive the
amount we have requested. If smaller amounts arrive we will first try to
vaccinate pregnant women, anyone caring for children less than 6 months
of age, emergency and healthcare workers, and students with major
medical illnesses, per the direction of the CDC.

Students should continue to contact the Student Health Center if they
are experiencing flu-like symptoms. Faculty and staff with flu-like
symptoms should report their illness via our H1N1 Web site, stay home
from work 5-7 days, and contact their personal physicians for
treatment. The most accurate information on our current number of cases
on campus is vital to keeping the outbreak under control.

As always, your best protections against the flu include:

* Washing your hands often, especially after shaking hands with others
(hand disinfectants may be used if there is no access to soap and
water);

* Avoiding close contact with people who are sick;

* Covering your mouth and nose with a tissue when coughing or sneezing;

* Covering your mouth and nose with the inside of your elbow if you do
not have a tissue;

* Not touching your eyes, nose, or mouth, especially after contact with
others; and

* Keeping a three-foot [one-meter] distance between yourself and anyone
who is ill.

Please take care.

Leslie Lawrence, M.D.
Medical Director, Student Health Center, Rensselaer Polytechnic Institute

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