August 7 (Bloomberg) -- Swine flu outbreaks shouldn�t close U.S. schools this fall unless so many students or teachers get sick that it interferes with teaching or puts the students at risk, U.S. health officials said.

The pandemic flu, also known as H1N1, can no longer be contained by closing schools, and the disruptions caused by closures outweigh the public health benefits, according to guidelines posted today on the Health and Human Services Department�s Web site. The guidelines, based on lessons learned earlier this year, cover the nation�s 55 million students and 7 million staff members at 130,000 public and private schools.

Health officials around the world are completing plans to deal with widespread outbreaks in the Northern Hemisphere beginning in September. That�s when cooler temperatures and the return to schools may fuel the biggest flu epidemic in decades. Students who are sick should stay home from school for 24 hours after their fever subsides, according to the recommendations.

�We know now that closing schools is not the best option in most cases,� said Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, on a conference call. �If flu come backs in the fall as it was in the spring, the key messages would be to stay home when you�re sick, to wash your hands, and to cover your cough and your sneeze.�

The initial spread of swine flu in April kept almost half a million students out of class by May, the U.S. Education Department said at the time. The original recommendation to shut schools was made before the virus had spread widely in the U.S. with symptoms usually no more severe than the seasonal flu.

New York Cases

Frieden dealt with H1N1 influenza as health commissioner of New York, where he said as many as 800,000 people were infected and 50 schools were closed earlier this year. Decisions to close schools should be made by local health officials and school administrations, Frieden said today.

�Perhaps we would have closed fewer if we had known what we know now,� Frieden said. Clinics may be set up in some schools to help provide the vaccine, he said.

�The best way to prevent the spread of the flu is vaccination, and our scientists are working hard to have a vaccine ready for consumption by mid-October,� Health Secretary Kathleen Sebelius said today at a press conference in Washington.

The swine flu vaccine will probably require two shots, administered three weeks apart, in order to be effective, according to today�s report. The body won�t be protected for two weeks after the second shot, suggesting that the first vaccines won�t offer protection until the last week of November at the earliest.

Preemptive Closures

Schools may consider closing if the flu is spreading widely in the community �shortly before� vaccine immunity is available, according to the guidelines issued today.

If the virus mutates and becomes more severe, the guidelines may shift to advise healthy children to stay home if their family members are sick and to prevent intermingling of classrooms within a school, according to the U.S. Health and Human Services flu Web site. Additional school closures may also be considered. When schools close, they should remain shuttered for five to seven days.

�This has been a virus that�s been smoldering, particularly among children at the many summer camp outbreaks,� said William Schaffner, an influenza expert at Vanderbilt University School of Medicine in Nashville, Tennessee, in a telephone interview. �School closings were a sensible precaution early on to try to contain H1N1 -- we�re beyond that now.�

To contact the reporters on this story: Catherine Larkin in Washington at [email protected] or Tom Randall in New York at [email protected].

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