WICHITA ? When Kathy Hubka?s phone rings at the beginning of a school year, it?s usually someone with questions about head lice.
But this year, callers have a more urgent concern?the H1N1 flu virus. They want to know what the Wichita school district is doing to prepare for a possible resurgence of the virus this fall.
It?s a reasonable question given that school-aged children so far appear to be more vulnerable to the H1N1 virus than seniors, who usually succumb more readily to flu than young people.
Hubka, the district?s coordinator of health services, has been busy developing plans. She said they include the daily disinfecting of doorknobs and water fountains, the possible use of ?sick rooms? to isolate ill students from their well classmates, and sending school nurses into classrooms to remind students about the protections of basic hygiene.
?Our prevention methods are pretty much the same, whether it?s preventing seasonal flu, H1N1, the common cold, or strep throat,? Hubka said. ?Cover your cough, cover your sneeze, wash your hands. Stay home if you?re sick. H1N1 could be a little more intense, with its contagion factor, but we?re hoping to model (our response) after those same things.?
School officials across the state have been working on plans to deal with the H1N1 virus since April when it was first verified in Kansas. But with classes starting this month and new projections about the severity of the disease, education and public health officials are shifting their planning into high gear. Their goal is to contain any outbreak so that schools can remain open as long as possible.
In Kansas City, Kan., officials are taking advantage of the back-to-school enrollment period to start communicating with parents about the importance of good hygiene and keeping sick children home.
?In most years, we might think about doing that sometime in the winter, for the seasonal flu,? said David Smith, a spokesman for the school district. ?This year, we will do that at the beginning of the year. It?s just an odd time to be talking about the flu, although the experts tell us that we need to be prepared.?
The Salina school district for many years has done disease surveillance for the Saline County Health Department, said Nancy Kiltz, director of administrative and student support services.
But this year it is preparing to step up its reporting, if necessary.
To make sure the right information is gathered, secretaries and others who take calls about sick children have been given lists of questions to ask.
?Normally we might ask a couple questions,? Kiltz said. ?But now we?re making sure that everyone who?s taking these phone calls is really digging in there to find out the children?s symptoms so we can get a clear picture of the county?s health.?
Diedre Serene, a part-time school nurse in Hillsboro, said elementary and middle schools students with temperature of 99 degrees or higher will be sent home.
?If they?re coughing a lot, we?ll get them to their doctor,? she said.
Parents, she said, will be asked to keep ill children at home until their temperatures return to normal.
?We?re just getting started,? Serene said, But we?ll be encouraging kids to wash their hands, and we?ll be putting sanitizers in the schools, though they?re not in the budget so I don?t know where the money?s going to come from. We?ll find it.?
The state universities also have plans to accommodate students stricken with H1N1.
Todd Cohen, a spokesman for the University of Kansas, said a task force has been formed to monitor and react to any outbreak.
?We?ve already started sending messages to faculty, and there will be more as students and staff return to campus,? he said. ?We want to be sure everyone?s aware of what it is and what the terminology means.?
Students living in university housing who fall ill will likely be isolated in their rooms for up to a week, Cohen said. He said arrangements could be made to move their healthy roommates to other quarters, and deliver meals to infected students so they wouldn?t have to visit dining halls.
Parents also will be notified about the school?s response. If students are very sick, they may have to go home until they have recovered, Cohen said.
College students will likely be near the front of the line for the first rounds of the H1N1 vaccine, Cohen said. But he said even if vaccinations begin in September or October, students wouldn?t be fully immunized against the virus for most of the fall semester.
?But that?s only going to be part of it,? he said. ?The biggest part is getting people to be aware of their symptoms and the available treatments, and washing their hands so they don?t spread the disease.?
Why all the worry
Like other pandemic viruses, H1N1 doesn?t play by the ?usual rules,? State Health Officer Jason Eberhart-Phillips told the Kansas State School Board last week.
It?s impossible, he said, to know what will happen next.
?I can?t tell you what month the seasonal flu will hit, but I know it will come every winter,? he said. ?The intensity varies a little bit, but I know exactly what populations are at the highest risk. All of those rules are out the window with pandemic strains.
?(The virus) is a newcomer and it?s just getting used to us as hosts,? he said. ?It?s making some adjustments as it goes. These conditions could change and we could have a different situation very quickly.?
The Centers for Disease Control and Prevention have estimated that about 10,000 Kansans already have been infected with the virus. So far, most cases have been relatively mild with few hospitalizations and only one death.
But because schools house about one-fifth of the state?s population when in session, Eberhart-Phillips said it?s particularly important for districts to have plans to contain the disease as much as possible.
?It seems likely that this will be a factor in our lives whether we like it or not in the coming school year,? he said.
Over the next two years, Eberhart-Phillips has said, up to 40 percent of the state?s population could become infected with the H1N1 flu.
The Kansas Department of Health and Environment and local health departments have started discussing the possibility of hosting mass immunization clinics in schools when the H1N1 vaccine is released later this year.
The vaccine will likely be provided in two courses administered three weeks apart.
Eberhart-Phillips told state school board members that such clinics, if held during school hours, would reach the most children and would pose little disruption to their studies.
All vaccinations would be given by registered health professionals and no child would receive a shot without written consent from their parents.
Board members appeared generally receptive to the idea.
?I think most of us in this room remember going to the gym for our sugar cube? that contained the polio vaccine in the 1960s, said board member Sally Cauble, a Republican from Liberal. ?I don?t see this as much different.?
Walt Chappell, a Wichita Democrat, said given the possibility that thousands of children could be absent from school for extended periods, he wants the state to make contingency plans for delaying a statewide headcount of students and rescheduling assessment tests. The count, scheduled for Sept. 20, determines school funding.
Education Commissioner Alexa Posny said staff members would continue to watch the situation and make adjustments as necessary.
?I think the goal is to prepare for the worst and hope for the best,? Eberhart-Phillips said.
Serene, the school nurse in Hillsboro, praised KDHE?s response to the virus.
?They?ve done a great job of keeping us informed,? she said. ?They send me updates on my phone, I get e-mails from them all the time, and the Web site they?ve set up is awesome.?
Sarah Green is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. She can be reached at firstname.lastname@example.org. Staff writer Dave Ranney contributed to this report.