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When to stay home from school: Is it a cold, allergies or swine flu?

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In the face of a possible wave of H1N1 flu cases this fall, public health and education officials are encouraging parents and teachers to help stem the potential spread by keeping or sending students with flu-like symptoms home.

But should vigilance surrounding the pandemic virus mean having kids hunker down at the first mere sign of the sniffles? Not necessarily, says Saskatchewan's deputy chief medical health officer.

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Dr. Saqib Shahab says since September is a common time for dust allergies, individuals may experience a lot of sneezing, coughing and sore throat but no fever.

Generally, sneezes and a runny nose with clear discharge are more likely signs of an allergy, which isn't infectious or contagious, or a non-influenza infection. Once you start getting a fever, that's definitely a red flag, Shahab says.

"If your child has a definite fever, probably stay at home for the day or two that the fever takes to resolve," he said from Regina. "It may be another influenza virus, it may be another respiratory virus. But especially once we see more H1N1 activity ... that's when really your child should not go to school if he has fever, sore throat or cough."

Shahab said it may be difficult for some to make the distinction between symptoms. But for this year, he advises parents to play it safe.

"Generally in other years, if a child generally feels OK, even if he has a slight fever, the child may end up going to school," he said. "What we're requesting is that for this particular year, this fall, erring on the side of caution."

"Parents whose children have allergies, they can usually just tell it's just a recurrence of an allergy - lots of sneezing and runny nose and the itchiness of the eyes," he added.

"We're hoping that parents can make that distinction and keep the child home, especially when it's sore throat, fever and cough, because these three are the most reliable indicators of H1N1."

"Right now, the disease activity is low, but once we start seeing higher levels of disease activity, then with these three symptoms, we're more likely to have pandemic H1N1 than something else."

With two sons living with chronic asthma, Michelle Redway-Morris won't hesitate to keep her kids home for a day or two if needed to allow time for their medications to work.

But the six-and 15-year-old boys, who also have seasonal allergies, will typically still head to classes if they have a runny nose or the sniffles. However, when those symptoms are coupled with an elevated temperature, the mother of four said she would keep them home.

It was how she handled illness before she learned of the H1N1 flu virus, and she hasn't changed her approach because of it.

"You know how to deal with flus, you know what the symptoms are," she said. "(Just) because it's named H1N1, I don't have the fear of doing anything differently."

The Public Health Agency of Canada recommends students and staff who fall ill with flu-like illness stay home until they're symptom-free. If students become sick while at school, it's advised they be isolated until they can be sent home. Schools and child-care programs are also advised to report staff and student illness above normal expected absenteeism levels to local public health officials.

Nova Scotia's chief public health officer, Dr. Robert Strang, said that's no different than what's done every year. On a given day, if there are 10 per cent or more of the students absent, public health is notified to investigate, he said.

"Is there a bunch of kids away because there's a hockey tournament going, or a number of kids reporting similar symptoms signalling there is an outbreak in the school and that we may have to do something more?"' Strang said from Halifax.

He said encouraging individuals with flu-like symptoms to stay home to limit the spread of virus has been a long-held philosophy merely being reinforced with the emergence of H1N1.

"Those would be the same messages we give for seasonal flu; I think we're just emphasizing it more for H1N1," he said. "Ideally, if people had those symptoms they'd stay home."

Calgary Board of Education spokesman Ted Flitton said since health authorities have said the vast majority of cases present themselves no differently than or similarly to seasonal flu, they haven't been told there's a need to take any different precautions. Flitton said staff members are always watching for signs of any sort of illness in classrooms.

"We have your standard procedures for taking care of a child who is ill: getting him or her out of the classroom, calling home and getting that child sent home and taken care of so that they're not passing the illness along to others," he said. "We sought guidance ... on whether we needed to change our procedures when H1N1 came and reared its head and health authorities said, 'No, continue on with the same practice."'

At the annual meeting of the Elementary Teachers' Federation of Ontario last month, there was a discussion of H1N1 and a Q&A sheet on the flu virus was distributed.

"There wasn't a sense of panic on behalf of our members or 'I'm not going to school because of this, I'm not reporting to school because of this.' Not at all," said president Sam Hammond. "It was more 'Help us clarify what H1N1 is ... and how it spreads and what we can do to protect ourselves."'

Hammond said they will monitor what is happening in school boards to ensure the safety of their members as well as students.

"It's something we as a union have and will need to monitor and certainly will act accordingly in a timely way to make sure our members are protected if this develops into something we all don't want to see."

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