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 新学期のインフルエンザ流行に備える大学
 アーバナシャンペーンにあるイリノイ大学はすべての学生に対してEメールを送り、大学にもどる荷造りする時に、体温計、風邪薬、1週間分の食料を忘れないようにとしている。
 しかし大学の保健センター長の現実の計画はと言うと非常に簡単であると言う。寮の部屋に居ないで実家に帰り、両親に面倒を見てもらうようにということだ。ここの学生の約80%は車で2-2.5時間以内の所に住んでいるし、両親が十分心配することを望んでいると言う。
 全国の大学が数週間先には新学期が始まり数百人が新型H1N1インフルエンザに感染するだろうという予想の下に計画を立てている。新型インフルエンザの流行で大学の授業日程はズタズタになるだろう。
 管理部門は妊娠・肥満・喘息といった学生や職員が重症化して地域の病院に押し寄せてしまうことを恐れており、何とか流行を減速させたいと考えている。
 必要なら簡易ベッドで体育館を満たし、タミフルを分配するという話もされたが、多くはより穏便な計画を立てている。
 数十の手清浄薬を設置し、寮で学生の症状に気を配り、季節性インフルエンザワクチンを注文し、ブタインフルエンザワクチンの提供計画を立案した。保健センターでは「インフルエンザ待合室」作った所もある。
 ほとんどの大学ではイリノイ大学のように学生に食料を持参するようにとは頼んでいないが、食堂が病気を広めるだろうという。
 ノース・カロライナ大学では、スープ、タイレノール、ゲイタレードのパックを用意しており、電子レンジでインスタント食事ボックスも使えると言う。
 連邦のガイドラインwww.flu.gov により、大学を閉鎖することは避けたいと願っている。
 一番の優先事項は「群れをまばらにする」ことである。感染した学生は実家に帰るように勧められるだろう。寮ではルームメイトが回復するまでは別の場所に簡易ベッドを用意することになる。
 オンライン・クラスが話題になっているが用意できている大学はほとんどない。清掃スタッフはドアノブやキーボードなどの掃除に注意する必要がある。体育系の学生はバスで遠征途中に発症した場合は厄介である。
 連邦のガイドラインでは、感染した学生は解熱後24時間以上過ぎるまでクラスに入れない。看護師は7日以上患者に近づけない。
 実家へ帰らせる計画のない大学は米国陸軍士官学校一つである。夏期訓練時に4,300人のウエストポイント士官学校生全員が検査を受けた。陽性なら隔離舎に入れただろう。ニューヨーク近くの基地だが、4月以降で6人の士官学校生と9人の兵士が感染したのみである。握手はしないように周知されている。うまく銃弾を避けたようだという。
 ソルトレーク・シティのユタ大学では、2つの事件があり役員の準備に役立った。2002年の冬季オリンピックで6週間学生寮から学生を追い出す必要があったことと、今夏、大学グラウンドを使用したキャンパーから住宅スタッフの30%に感染が広がったことである。大学としては、無料のインフルエンザワクチンを提供したいが、生徒の約90%はオプションの学生医療サービスに加入していない。
 イリノイ大では十分な接種プログラム予算があり、食堂で並んでいる学生に接種するなどで、41,000人の学生のうち12,000人までが毎年受けている。
 ノース・カロライナ大の保健センターには電子医療記録システムがあり、喘息や糖尿病の学生へは電子メールで送りたいと考えている。
 しかし、英国の大学は米国をしのぐ。英国では幼年期のワクチン接種率が低く、インフルエンザ、髄膜炎、おたふくかぜのキャンパス内流行が頻繁にあるので「新入生のインフルエンザ」と呼ばれている。今年多くの大学では、「インフルエンザ仲間計画」を始めた。お互いのIDを登録することで食事やタミフルをキャンパスの薬局で受け取れる(?)ものである。
 しかし、英国の仲間選び計画や米国の母親呼び出し計画の両方とも以前の流行時計画と異なっている。3年前の鳥インフルエンザの時は、大学全体を閉鎖するか家に帰るかだった。
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Universities Are Preparing for Back-to-the-Classroom Outbreaks of Swine Flu
http://www.nytimes.com/2009/08/23/health/23flu.html
By DONALD G. McNEIL Jr.
Published: August 22, 2009

As you pack for college, the University of Illinois at Urbana-Champaign told all its students in a recent e-mail message, don’t forget a thermometer, some over-the-counter cold remedies and a week’s worth of food.

画像A poster and hand sanitizer standing duty at the University of Illinois at Urbana-Champaign.

But the real plan in case of a major swine flu outbreak on campus, said the head of the university’s health center, is simple: Don’t try to sweat it out in your dormitory room. Go home. Let Mom and Dad take care of you.

“About 80 percent of our students live within a two-, two-and-a-half-hour drive of here,” said Dr. Robert D. Palinkas, director of the McKinley Health Center on campus.

“We’re hoping the parents will have high-enough anxiety about their kids having swine flu that they’ll come get them.”

All across the country, universities are making plans in the expectation that dozens or hundreds of their students will fall ill with the new H1N1 flu as classes start over the next few weeks.

“This is a virus that disproportionately affects folks in our demographic,” said Dr. Anita L. Barkin, director of student health services at Carnegie Mellon University in Pittsburgh and chairwoman of the American College Health Association’s pandemic planning committee.

The new flu infects young people more often than it does older ones; people born before 1957 have an added advantage, because a similar H1N1 flu that was circulating then provides some immunity. The rapid ricochet of the new flu can create high absenteeism, disrupting college calendars.

Also, administrators worry that any surge in serious cases among students and staff members who are pregnant, obese or have asthma or other conditions that seem to make this flu worse could overwhelm local hospitals, so they are eager to slow down transmission.

While there has been talk of filling gymnasiums with cots and handing out Tamiflu on demand, most are making more modest plans.

Many have positioned dozens of hand sanitizers, made dormitory resident assistants aware of the symptoms, ordered seasonal flu shots and drafted plans to offer swine flu shots if they are approved.

Some are creating separate “flu waiting rooms” in their health centers so students with sprained ankles will not have to sit next to sneezers. Very few are asking students to arrive with extra food, as the University of Illinois did, but most say their dining halls will deliver to the sick.

“We have to-go packs with soup, Tylenol and Gatorade,” said Dr. Mary Covington, director of student health at the University of North Carolina, Chapel Hill, “and we could do boxes with meals-ready-to-eat that could be put in a microwave.”

By following guidelines on www.flu.gov, most universities hope to avoid shutting down.

The first priority will be, as one administrator put it, “to thin out the herd.” Sick students will be encouraged to go home, visit other relatives, even impose on kindly family friends.

Because most dormitories are full, some universities will offer healthy students cots so they can sleep elsewhere while their roommates recover.

Instructors may be asked to ease up.

“We have faculty who usually say, ‘I don’t care if you’re half-dead, I expect you to be in class,’ ” Dr. Palinkas said. “We’re asking them to bend the rules a little.”

And though talk of online classes is common, few universities are fully ready. Computer science professors are a lot readier than social science professors are, one administrator grumbled privately.

Stephanie Hanenberg, director of student health at the University of Colorado, Colorado Springs, said she had discussed flu-fighting with every campus department.

The cleaning staff, Ms. Hanenberg said, will concentrate on “doorknobs and railings in classrooms and housing, keyboards in the computer labs and restrooms everywhere.” The athletic department, she said, will figure out how to isolate players who fall ill on the road.

“They should not be put back on the bus,” she said. “You don’t want to take out the whole team.”

Colorado’s nursing students, she said, are likely to have the biggest problems making up classes. While federal guidelines suggest that ill students stay out of class until 24 hours after their last fever, nurses must stay away from patients for that long or for seven days, whichever is longer.

One university with no plan to ship students home is the United States Military Academy.

All 4,300 West Point cadets got medical exams when they arrived for summer training, said Col. Michael A. Deaton, commander of the base hospital. Anyone with symptoms or recent contact with a flu patient would have been given a nasal swab flu test, and a positive result would have put the cadet in quarantine barracks.

“Because they’re military, we can tell them what to do,” Colonel Deaton said. “It’s less like herding cats than it is on the average college campus.”

But no one arrived with symptoms. Despite the base’s proximity to New York’s outbreak, only six cadets and nine other West Point soldiers have had the flu since it emerged in April.

Students were told to take precautions “and no one was shaking hands here for a while ― everyone was either tapping or bumping elbows,” Colonel Deaton said.

“I really think that’s how we dodged a bullet,” he continued.

At the University of Utah in Salt Lake City, two previous events helped prepare officials, said Marty Shaub, the university’s director of environmental health and safety.

The first was the 2002 Winter Olympics, for which students had to vacate dormitories for up to six weeks and officials had to deal with assorted disruptions. Then, this summer, a flu outbreak among campers who use university grounds spread to the housing staff, which had 30 percent absenteeism.

“So we’ve been down the road where you define what is absolutely mission-critical and what can be interrupted,” Ms. Shaub said.

Although she would like to offer free flu shots, she said, almost 90 percent of the university’s students do not join the optional student health service.

Dr. Palinkas, of the University of Illinois, by contrast, said he had an annual flu-shot program so well financed that he not only offered dining-hall vaccinations, but also had students cajoling others in food lines to get a shot; up to 12,000 of the 41,000 students do each year.

“If you just have a nurse standing next to a poster, you have a much lower acceptance rate,” he said.

And Dr. Covington said her health center at the University of North Carolina had such good electronic medical records that she hoped to send e-mail messages to each student with asthma or diabetes to suggest a shot.

But on the flu front, British universities seem to have American ones beat.

In Britain, where childhood vaccination rates are lower, campus outbreaks of flu, meningitis and mumps are so common that they are collectively referred to as “fresher’s flu.”

This year, many universities started “flu-buddy schemes.” Students officially register to use each others’ ID to pick up an extra meal or Tamiflu from the campus pharmacy.

But both the British pick-a-buddy tactic and the American call-Mom plan are different from what was discussed in previous pandemic planning, Dr. Covington said.

“Three years ago, we were talking about bird flu,” she said. “Then, the talk was at what point do you just close the whole university and go home?”

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新学期のインフルエンザ流行に備える大学/米国 新型インフルエンザ 医師の一分/BIGLOBEウェブリブログ
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