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The spread of the H1N1 influenza virus is a rapidly evolving situation filled with uncertainty. A national public health emergency has been declared and flu experts are on high alert in watching this outbreak for potential changes. So far the vast majority of cases have been relatively mild and self-limited. Sometimes the public gets confused by what seem to be mixed messages coming from the media and reputable healthcare professionals. Therefore public health’s goal is to provide the most current information as it is available and to stop the spread of the H1N1 flu virus. Public health relies on the most up to date guidance and information from the CDC and actively gets that information to the public through the media for as long as there continues to be a public health risk. In response to the situation, the CDC continues to issue daily updates on its website at http://www.cdc.gov/h1n1flu/recommendations.htm The CDC has added 50 new staff to the information line at 1-800-CDC-INFO to handle the influx of calls. Additionally, District 4 Public Health has established a flu information hotline 1-888-899-9788 or 770-830-2828 due to the confirmed case in Lagrange on 4/30/09. Supplies from CDC’s Division of the Strategic National Stockpile (SNS) are being sent to all 50 states and U.S. territories to help them respond to the outbreak. In addition, the Federal Government and manufacturers have begun the process of developing a vaccine against this new virus. While there is no vaccine against the virus yet, there are antiviral medications, Tamiflu and Relenza , that are effective in treating the virus when someone is infected. Although antiviral medications have a role in treatment and prevention, these drugs cannot be used without certain risks, and the indications for their use are fairly specific. Therefore, the medications are not prescribed unless a patient has been screened by a qualified medical professional and has a confirmed positive laboratory test for the H1N1 flu virus. Confirmation of positive tests must be done by the CDC at this time. The onset of the H1N1 virus is usually within 7 days after exposure. A child may be infectious for up to 10 days after illness onset with influenza while adults are generally infectious for 5-7 days. It is important for people living in affected areas to take steps to prevent spreading the virus to others. People who are ill should stay at home and limit contact with others, except to seek medical care. Healthy residents living in affected areas should take everyday preventive actions. The most important preventative measures are basic hand-washing and covering coughs or sneezes with a tissue or the crook of the elbow and universal precautions in healthcare settings. People who live in these areas who develop an illness with fever and respiratory symptoms, such as cough and runny nose, and possibly other symptoms, such as body aches, nausea, or vomiting or diarrhea, should contact their health care provider. Their health care provider will determine whether influenza testing is needed. School and Child Care On May 1, 2009, the CDC issued guidance on school and child care closures. The CDC guidance is available at http://www.cdc.gov/h1n1flu/k12_dismissal.htm and recommends a flexible and scalable approach that States and local jurisdictions can use based on the situation in their communities (e.g. number of cases, severity of illness, affected groups) when the H1N1 swine flu virus is confirmed in a school, school district, or community. School systems in Georgia are collaborating with local public health officials and are following policies that are consistent with the CDC guidelines. The CDC recommends scalable and incremental school dismissal and childcare facility closure in affected communities with laboratory-confirmed cases of influenza A (H1N1) virus infection. The CDC further recommends that school districts work closely and directly with their local and State public health officials to make sound decisions and implement strategies in a coordinated manner keeping in mind: 1. Decisions to dismiss students and close childcare facilities and subsequent implementation of those measures should be made based on the extent and severity of illness; 2. That local authorities decide whether or not to dismiss schools or close childcare facilities; and; 3. That authority for decision-making may reside in multiple sectors of State and local government; these entities must be well coordinated. If a school dismisses students or a childcare facility closes, schools and childcare facilities should dismiss students for a minimum of 14 days. Schools, in consultation with local and State public health officials, should evaluate daily the need for possible extension of the dismissal/closure based on local influenza surveillance information, and the occurrence of new infections and severity of illness in the community from this virus. This length of time is recommended because children are likely to be infectious for about 7 – 10 days after the onset of illness . School and child care closures can have a tremendous impact on a community’s workforce and on businesses in a community. Decisions by local officials to take these actions are taken seriously and weighed against the risk posed to the health and safety of the whole community. Businesses are encouraged to develop plans in preparation for a pandemic flu emergency that would require parents to stay home for several days to care for their children when schools and child care facilities are closed. Travel CDC has NOT recommended that people avoid domestic travel. If you are planning travel to affected areas recommendations from the CDC will help you reduce your risk of infection and stay healthy. These recommendations can be found on the website at www.cdc.gov/travel/contentSwineFluUS.aspx Nonessential travel to Mexico is not recommended. The most important message to remember is What You Can Do to Stay Healthy • Stay informed. The CDC website at http://www.cdc.gov/h1n1flu/ will be updated regularly as information becomes available. • Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people. • Take everyday actions to stay healthy. o Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it. o Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective. o Avoid touching your eyes, nose or mouth. Germs spread that way. o Stay home if you get sick. CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them. • Follow public health advice regarding school closures, avoiding crowds and other social distancing measures. • Develop a family emergency plan as a precaution. This should include storing a supply of food, medicines, facemasks, alcohol-based hand rubs and other essential items