September 16, 2009


Dear Parent/Student:


As you may know, the H1N1 “Swine” flu virus is spreading quickly and easily from person to person in our county, the state and across the nation.  School and college age children are the groups most affected.  The average age of illness in the US is 12 years.  It is the only flu virus we have identified locally at this time.  Skagit County Public Health is working with all 7 school districts in Skagit County taking steps to prevent the spread of the H1N1 flu. 


The H1N1 flu virus does not appear to cause more severe disease than the normal seasonal flu virus.  The concern is we don’t have an H1N1 flu vaccine yet as we do for the seasonal flu.  Vaccine helps to build community-wide immunity also known as “herd” immunity. We receive the vaccine to protect ourselves as well as to protect those around us.


All parents are strongly encouraged to keep their child at home if she or he develops fever and one or more of the other flu-like symptoms listed below.  It is okay to use fever-reducing medication like acetaminophen (Tylenol and others) or ibuprofen (Advil, Motrin and others), but don’t use aspirin. All children should stay at home until they have been fever free for 24 hours without fever-reducing medicines.  Illness usually lasts 5-7 days. Flu-like symptoms include:

·        Fever (100 degrees or higher)

·        Congested chest cough

·        Sore throat

·        Runny or stuffy nose

·        Body aches

·        Headache

·        Feeling very tired or weak

·        Vomiting and/or diarrhea, in some cases


We suggest not seeing a medical provider unless symptoms progressively worsen over 3-5 days or your child has a high risk medical condition. People with underlying medical conditions like asthma, heart, diabetes, neuromuscular conditions and pregnancy, need to contact their doctor if they become ill with the following flu-like symptoms listed above. Any child who is already ill with flu-like symptoms who develops any of the following symptoms should be seen immediately by a health care provider:

·        Fast breathing or trouble breathing

·        Bluish skin color

·        Not drinking enough fluids

·        Not waking easily or not interacting appropriately

·        Being so irritable that the child does not want to be held

·        Flu-like symptoms improve, but then return with worse fever and cough


Skagit County Public Health and all Skagit County Schools emphasize the most important step toward prevention of flu outbreaks is for sick children to remain at home.  Follow these important steps to reduce the number of students who become infected with the H1N1 virus:

·        Do not send your child to school if ill with flu-like symptoms!

·        When calling your child’s school with the absence, let school staff know your child is ill with fever and at least one other flu-like symptom

·        Keep children at home until 24 hours after fever is gone

·        If your child develops flu-like symptoms at school, she or he will be sent home as soon as possible.  Have a plan to arrange for pick-up of your child if she or he becomes ill while in school.

·        Check to be sure the school has the correct emergency  phone numbers to get hold of you or a close contact, so your child does not have to remain in school all day, when ill.

·        Look for updated information about the flu such as when the vaccine will be available and new prevention information.

·        Have your children vaccinated with both seasonal and H1N1 flu vaccine as soon as available.  Seasonal flu vaccine will be available for children in Skagit County by the end of September.


Additional, but very important things you can do include:

·        Teach your child to wash hands frequently with soap and water.  Alcohol base hand cleaners should only be used when soap and water wash for 20-30 seconds is not available.

·        Teach your child not to share personal items like drinks, chap stick/lipstick, food or unwashed eating utensils.

·        Teach your child to cover coughs and sneezes with tissues or to cough/sneeze into the arm, not the hands or into the air.

·        Know the signs and symptoms of flu.


Other prevention techniques schools are implementing include making sure hand washing stations have plenty of soap and drying supplies; teachers and school staff will continue to remind students to wash hands often, how to cough and sneeze; and clean desks, door handles, tables, etc. more often.  The virus lives on surfaces approximately 2-8 hours.


Skagit County Public Health will come to your schools to vaccinate children for H1N1 as soon as enough vaccine is available.  We will vaccinate according to the highest risk tiers first as designated by the Centers for Disease Control (CDC):

Tier 1:

·        Pregnant women

·        Household contacts and caregivers of infants under 6 months. Infants can’t be vaccinated for the flu until 6 months of age.

·        Children 6 months – 4 years of age

·        Children 5-18 years of age who have chronic medical conditions, like asthma, diabetes, heart or neuromuscular diseases

·        Healthcare and emergency workers who do direct care, because infections can cause potential exposure to vulnerable populations and absenteeism in the workplace would reduce healthcare system capacity

Tier 2:      

·        All children 6 months – 18 years of age

·        Young adults 19-24 years of age

·        Persons 25-64 years of age with high risk medical conditions who can develop complications from the flu

Tier 3:   

·        All healthy people 25-64 years old  

·        65 and older population



Any decision to close schools will made jointly by Public Health and School Administration.


For more information, visit <> or <<, <>, your school’s website, or call Maryl Skjei at 336-9382 or Sandi Paciotti at 336-9397.




Peter Browning,                                                                                                Dr. Howard Leibrand

Director of Public Health                                                                                       Health Officer