Office of the Vice President for Global Communications

Thursday, October 1, 2009

Chief health officer updates campus community on flu’s impact

U-M students and staff may be the “leaders and the best,” but they are not immune from the H1N1 strain of the flu virus that is making people sick.

During the first few weeks of the academic year, hundreds of students have become sick with the flu along with a small number of staff members.

Across campus posters remind students, faculty and staff to cover their coughs and wash their hands. Hand-sanitizing stations have been added to the common areas of residence halls, classroom buildings and even the Big House.

Earlier this week we caught up with Dr. Robert Winfield, the university’s chief health officer and director of the University Health Service, for an update on how the flu is affecting the U-M campus. Here is what he had to say.

Q. How would you summarize the flu situation on campus? What are you seeing among students?

A. The beginning of the Fall Term showed a good deal of influenza activity, especially in the first three weeks. As October begins, it seems to be tapering off. We’ve been fortunate not to have any students who have been extremely ill. We’ve had a few students who have been hospitalized but the great majority of students seem to be improving in three to five days. They are missing a few days of classes and are recovering. We’ve been reassured by the fact that things have not been worse.

Q. Do you have a sense of how the flu at U-M compares to what is happening at other college campuses?

A. For the most part, we’ve been pretty typical for what has appeared at other colleges and universities in the Midwest. There have been more severe outbreaks of the flu in the Northwest and the Southeast parts of the United States.

Q. At this time of year in Michigan, with allergies, colds and the flu all circulating at the same time, how can people tell if they have the flu? What are the telltale signs?

A. The flu presents itself with a relatively imprecise set of symptoms. Those include a fever of 100.4 F (38.0 C) or higher, along with either sore throat or cough. Now during this time when we ordinarily see colds, some people are going to have a fever with a cold, but it is usually very mild. With an allergy, when you have a runny nose and itchy throat, it’s usually sneezing, itchy nose, itchy throat, itchy eyes and no fever. So if you are having a nose discharge, and lot of itching with your discomfort, try an antihistamine, which you can get over the counter. If that relieves your symptoms and you don’t have a fever, you almost certainly have an allergy and not the flu.

Q. If I suspect I have the flu, what do I need to do … or not do?

A. First of all you need to educate yourself. And one of the good places to do that is U-M’s flu Web site (www.vpcomm.umich.edu/flu/). Another good place is at the Centers for Disease Control Web site that specifically addresses the symptoms of the flu and how to manage it (www.cdc.gov/h1n1flu/).

If you think you have the flu after reviewing that information, and you are basically healthy and you are not pregnant, and don’t have an underlying health problem like asthma, diabetes, heart problems or an autoimmune disease, or other things that put you at higher risk, you can just use self care for your sore throat, your fever and stay home. You should stay isolated until the fever is gone for 24 hours without the use of fever-lowering drugs.

But if you have a high-risk condition, then we’d like you to call in and talk to us or come in and be seen so we can consider whether you ought to be on medication. The most common high-risk condition among college students is asthma. If you have asthma and get sick with a fever, sore throat and cough, then we would suggest that you come in (to UHS). Other conditions are pregnancy, diabetes, immune disorders or neurological disorders like multiple sclerosis. Those are examples of situations or diseases that would require us to treat you more aggressively.

Also, if you get very sick with the flu — a high fever, chest pain, shortness of breath — you should seek immediate medical care.

Q. You suggest that most people won’t need to see a doctor, yet the H1N1 outbreak has been declared a “pandemic” and the world’s pharmaceutical companies are rushing to produce a vaccine. That all sounds pretty serious. Help me make sense of all that.

A. Let’s start by defining pandemic. It is a novel type of infection that has spread across multiple areas of the world. In this situation we have a pandemic flu virus that is new and moderately dangerous. Because it’s new and the population across the world is more susceptible, it poses a special threat. One of the biggest worries is that in communities that are impoverished, where people don’t have enough clean water or good nutrition, there’s likely to be a higher death rate than what we see in a healthy community like the United States.

Also, the reason we’re worried about this pandemic in our society is that during the normal seasonal flu season, we have 36,000-40,000 deaths in the United States. Now, because this is a new virus and our immune systems haven’t been exposed to it before, we’re expecting two to three times as many people to get sick and two to three times as many people to get very ill or die. That’s a lot of deaths when you consider how distressed we are with airplane crashes that involve 250 deaths. So the public health community is working very hard to be sure the fewest number of people get very ill or die.

Q. Convincing U-M students that they really should miss class if they get sick must be a tough sell. What are the concerns you and the other physicians at UHS are hearing from students?

A. Students come to the University of Michigan because they have a strong work ethic and they want to get good grades so they are hesitant to miss important lectures or deadlines. However, the provost has committed to encourage professors to be more flexible than normal and, in fact, if you are having difficulty with that, where you have an important class you have to miss, you should e-mail your professor.

Q. What advice do you have for new U-M students about contacting their professors if they have to miss class?

A. The provost has indicated to all faculty to expect e-mails from their students and to be supportive, understanding and lenient (during this flu season) and I do think it’s the right thing to do. If they have trouble or are hesitant, students should contact their academic advisers by e-mail and seek help from that person.

Q. Let’s talk about vaccinations for a moment. I know you’ve been promoting the seasonal flu vaccine among students. What kind of response are you seeing?

A. We have seen a tremendous response for getting the seasonal flu vaccine. Just in September we have given thousands of vaccinations and we’re well ahead of our usual October schedule. And we have a mass flu clinic this week (Wednesday) for 500 more students who have all signed up. So we’re seeing a great deal of acceptance about getting flu vaccinations. We’re very pleased. We think it will make the community and individuals safer.

Q. What can you tell us about the H1N1 vaccine? When will you have it on campus and how will it be distributed?

A. We believe we will have the H1N1 vaccine available in later October and we’ll be doing that entirely at no cost for students when they come to our mass vaccination clinics, which will be situated all around campus. We’ll have more information on how that will work once we have better information on when we will get the vaccine.

Q. Some people are questioning the safety of the flu vaccine? Do you have an opinion on that? Would you get the vaccine?

A. There is a rumor that the H1N1 vaccine might not be safe. It’s based upon the 1976 vaccine that was created for a different type of swine flu, which had an unexpected neurologic complication in about one out of 100,000 people. Since that time, flu vaccines have no longer had that complication and have been found to be very safe. The current H1N1 vaccine is being made in the exact same way that the usual seasonal flu vaccine is now made. There are ongoing studies that have not yet found any complications. It’s my expectation this will be a very safe vaccine. I certainly am going to be getting it as soon as it’s available.

Q. I suppose the best approach to dealing with the flu is to avoid it altogether. What advice do you have for avoiding the flu, even though it seems like people all around us are getting sick?

A. We do recommend the approach of frequent hand cleansing with soap and water for 20 seconds or using hand sanitizer, and we do recommend covering your cough for the consideration of others along with staying 6 feet or more away from those who are sick, if you can.

I suspect that one of the reasons we’ve had a relatively mild spread of the H1N1 flu may be due to a lot people spending a lot of time keeping their hands clean and keeping their fingers away from their nose, eyes and mouth. So I probably think these techniques, to some degree, have been successful, although it’s hard to know for sure.

Q. What do you see in your crystal ball about the flu as we move ahead?

A. Flu season will continue through March or April and we’ll be watching to see what happens. In 1957, during that flu pandemic, the first wave of illness came in the spring, the second in the fall and the third in February and March. We may see additional waves this flu season as well.