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Dear Students,

As we all return to campus this weekend, our world is facing the uncertainty of a novel strain of influenza A- the H1N1 or swine-origin flu. This new strain is spreading quickly around the world and has reached every state of the union and almost every county in North Carolina, including Watauga County and our ASU campus.

While there is uncertainty and understandable fear, we are learning much about the virus and are making preparations for its inevitable presence on campus this fall. When asked to write this update, I decided to wait until the deadline for submission due to the evolving nature of this pandemic.

When faced with uncertainty, my approach is to identify what we know about the situation, what we don't know, and then what we can do based on current knowledge. The Center for Disease Control and Prevention (CDC) and the North Carolina Department of Health and Human Services (NCDHHS) are monitoring the virus and making recommendations for all of us. We are abiding by their advice. I highly recommend their web sites to you:

• http://cdc.gov
• http://ncdhhs.gov

What we know so far (8-20-09):

1. The H1N1 virus is highly contagious to children and young adults. Most illnesses have been relatively mild (for flu), following the pattern of seasonal flu.
2. The virus causes most severe disease in people with underlying, chronic medical conditions, particularly respiratory illness and pregnancy.
3. The practices of hand washing and coughing into one's sleeve are currently the best means of prevention of spread of disease. Also, the CDC currently recommends isolation until fever has been gone for 24 hours.
4. There is no available specific test for H1N1 other than viral culture through the state lab. Because ASU is a sentinel site for influenza surveillance, the Student Health Service is allowed to send three samples for viral culture to the state lab weekly. We are the only surveillance site in the county.
5. Presumptive diagnosis (in the absence of a specific test) is made by the symptoms of fever and cough, often accompanied by body aches, sore throat, and diarrhea.
6. The virus is sensitive to the neuraminidase inhibitors (Tamiflu, Relenza). If started within 48 hours of the onset of illness, these medications may shorten the course and lessen the severity of the illness.
7. A vaccine for H1N1 will be available through our public health system sometime between mid-October and mid-November. This vaccine will require two doses one month apart.

What we don't know:

1. We don't know if the virus will become more virulent, i.e. cause more severe disease, as time passes.
2. We don't know how quickly or severely this virus will spread through the University. Just as camps have been disrupted this summer, classes and programs may be disrupted as students, faculty, and staff become ill. The University is preparing for this possibility.
3. We don't know if the vaccine will be made available to universities. The details of distribution and administration are being worked out by the NCDHHS.

What you can do:

1. Monitor current activity and recommendations of the CDC. Public health experts are getting information to all of us, and we are following their advice to the best of our ability.
2. Equip yourself with knowledge about the pandemic, a thermometer, and a droplet (surgical) mask. Such supplies as canned soup, crackers, clear liquids, and acetaminophen or ibuprofen would also be helpful.
3. If fever and cough develop, isolate yourself from others and seek medical evaluation if your condition worsens.
4. By all means, if you have an underlying medical condition which increases the risk for complications of H1N1, such as asthma, seek prompt evaluation if symptoms develop.
5. Be prepared to be flexible and creative in a time of uncertainty. Work together with us as we face the coming weeks and months.
6. Visit http://emergency.appstate.edu regularly as updates become available.

Dr. Pat Geiger
Director, Student Health Service

This page last updated August 26, 2009.