Frequently Asked Questions (Updated October 30, 2009)

UPDATED: November 30, 2009 2:47:30 PM EST

H1N1 Flu Preparedness

University officials have been closely monitoring developments with the H1N1 flu affecting the campus community since the flu began to spread in spring 2009.

As H1N1 continues circulating worldwide, health officials expect cases to increase in the United States – particularly since flu transmission typically accelerates during the fall and winter. This increases the likelihood that University students, faculty and staff could be exposed to someone with H1N1, either on or off campus, and contract the illness.

Frequently Asked Questions

General Questions:

Have any cases of H1N1 Influenza been identified at UNC-Chapel Hill and how are they being reported?

The University recorded its first confirmed case (confirmed by specific laboratory testing) on May 29, 2009. As H1N1 has spread, specific testing is no longer recommended for people with flu-like symptoms unless they are hospitalized. The numbers of confirmed or probable cases are no longer being reported at the state or national levels. Accordingly, the University has no way to know the total number of cases of H1N1 affecting students, faculty and staff.

Public health authorities currently track the number of cases of Influenza-like Illnesses (ILI) through statistics compiled from designated clinics each week. Campus Health Services long has participated in this surveillance program for North Carolina to help monitor seasonal influenza cases. ILI is defined as the presence of fever greater than 100 degrees Fahrenheit with cough, congestion or sore throat in the absence of a known cause.

The numbers reported by Campus Health Services reflect only a snapshot of surveillance data and are a useful marker for measuring the extent of ILI in the University student community, which consists of more than 28,000 undergraduate, graduate and professional students.

Every Tuesday, Campus Health Services reports summary statistics about cases of ILI seen in its clinic during the previous week. This information is posted on the H1N1 section of the Alert Carolina Web site (see http://www.piersystem.com/go/doc/1395/322436/). As of August 31, Campus Health Services saw a marked increase in the number of patients with flu-like symptoms. The number peaked in early to mid-September and has dropped significantly since then.

These numbers are reported to the State Health Department, UNC General Administration and the American College Health Association. Information about H1N1 affecting Orange County is included on the Orange County Department of Public Health Web site, http://www.co.orange.nc.us/health/, and information about H1N1 statewide is included on the N.C. Department of Health and Human Services Web site, http://www.flu.ncdhhs.gov/epi/gcdc/flu.html. The American College Health Association’s reports are posted at http://www.acha.org/ILI_Surveillance.cfm.

Will H1N1 flu continue to spread?

The state’s health department reports that H1N1 is currently the predominant strain of flu circulating across North Carolina. As of late October, 46 states, including North Carolina, had reported widespread flu activity, according to the Centers for Disease Control and Prevention (CDC). Nearly all the flu viruses identified so far are H1N1 influenza A viruses. Visits to doctors for flu-like illnesses have increased across the United States during the fall and overall are higher than the typical pattern this time of year.

How can I keep from getting sick?

The virus is spread by coughing and sneezing. Although H1N1 flu has proven to be relatively mild and overall has been responsive to anti-viral medications, the CDC recommends that everyone take the following actions to stay healthy:

Cover your nose and mouth with a tissue or your sleeve when you cough or sneeze. Throw the tissue in the trash after you use it.
Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand sanitizers can be used if soap and water are not available.
Avoid touching your eyes, nose or mouth. Germs spread this way.
Avoid close contact with sick people.
Get flu shots for both seasonal flu and H1N1 when the vaccine is available.
Keep high-touch areas (computers, doorknobs, bathroom faucets, etc.) clean. The virus does not live on environmental surfaces for extended periods and is easily killed by normal household disinfectants like Lysol or Clorox wipes. The University’s Housekeeping staff has been instructed about proper cleaning procedures.

When will a flu vaccine for H1N1 be ready?

The vaccine is being distributed to health departments and some hospitals and doctors’ offices across the nation. The University and UNC Health Care have requested a sufficient quantity to vaccinate our students, faculty and staff as well as hospitalized patients.

On October 28, the University received an allocation of the H1N1 vaccine for faculty, staff and students who are health-care workers with direct patient contact, or who are pregnant. The University has followed recommendations from the Centers for Disease Control and Prevention (CDC) to vaccinate people in these groups as soon as possible.

As additional doses of the vaccine arrive, the University will send the campus community details about how and when people can be vaccinated. Updates about distribution of the H1N1 vaccine also will be posted on Alert Carolina, http://alertcarolina.unc.edu/go/site/1395.

How will the H1N1 flu vaccine be distributed at UNC?

The vaccine will be distributed through H1N1 flu vaccine clinics, just as the University distributed the seasonal flu vaccine. People will be able to make an appointment on the Environment, Health and Safety (EHS) Web site, http://ehs.unc.edu. The clinics will be by appointment only; unfortunately, people who walk in cannot be accommodated

The University is following recommendations from the Centers for Disease Control and Prevention (CDC) to vaccinate health-care workers with direct patient contact and pregnant women as soon as possible, so people in these groups will be able to receive the vaccine first.

As the University receives additional shipments of the vaccine, it will be available for other students and employees, and the University will notify the University community when additional H1N1 vaccine clinics are available.

Employees who are in high-risk groups should contact their personal physicians and follow their advice. The CDC Web site, http://www.cdc.gov/h1n1flu/sick.htm, has information about people who are considered high risk.

Students, postdoctoral fellows, spouses or other people who are eligible to receive services at Campus Health Services and are pregnant or are caregivers for infants younger than 6 months old can schedule an appointment to receive the vaccine by calling Campus Health Services at 966-2281.

Will there be a charge for getting the H1N1 vaccine?

There will be no out-of-pocket expense for students or employees who have the following insurance coverage: the State Health Plan, Blue Cross Blue Shield; Partners; Aetna; Humana Gold; SummaCare; Advantra Freedom; or Medicare Part B. However, you must bring your current insurance card and a photo ID to the clinic.

If you are not insured with any of these companies, you can still get a flu vaccine (shot or nasal spray), but you will have to pay an administrative fee of $12 (cash or check). The fee is paid to an outside health-care agency for the nurses and other staff providing the vaccination service, not to the University.

Will the seasonal flu vaccine protect me from H1N1?

No, H1N1 is a novel flu, a new flu virus of swine origin. H1N1 and seasonal flu require separate vaccines.

The seasonal flu vaccine became available for the University community this fall, as it has in the past, and the Department of Environment, Health and Safety held flu clinics in September and October for employees. In addition, Campus Health Services held its seasonal flu clinics for students during October. People who were not able to get their seasonal flu shots can log on to flucliniclocator.org for available flu clinic locations.

In addition, the University will advise faculty, staff and students when the vaccine for H1N1 becomes available.

When should I seek medical attention?

Generally, people with the flu (the H1N1 flu as well as seasonal flu) can manage recovery at home with little or no medical attention. However, certain people are at higher risk of serious flu-related complications.

Risk groups
People with certain chronic medical conditions should consult with their health-care providers (or Campus Health Services for students) with the onset of flu-like symptoms or following recent close contact with someone who has the flu. These conditions include:

Asthma;
Diabetes and other metabolic disorders;
Immune-suppression from medications (cancer drugs, oral steroids), HIV or other diseases;
Chronic diseases of the heart (not high blood pressure), neuromuscular, lung, liver or kidney; and
Extreme obesity (body mass index > 40).

In addition, the following people are at higher risk and should consult with their health-care providers (or Campus Health Services for students) with the onset of flu-like symptoms or following recent close contact with someone who has the flu:

Pregnant women;
Adults age 65 and older;
Children younger than age 5; and
People younger than age 19 who are on chronic aspirin therapy.

More serious symptoms: a warning sign
People who have the flu and develop any of the following symptoms should call their health-care providers (Campus Health Services for students) without delay for medical advice or attention:

Difficulty breathing or shortness of breath;
Pain or pressure in the chest or abdomen:
Sudden dizziness;
Confusion or change in level of consciousness;
Severe or persistent vomiting;
Severe sore throat, accompanied by swollen glands in your neck:
Flu-like symptoms improve but then return with fever and worse cough;
Unidentified rash; or
Fever over 101 degrees lasting for more than three days despite drugs that lower temperature (such as aspirin, Tylenol or Advil).

In general
People with a flu-like illness (fever plus cough or sore throat) should:

Not go to work or attend classes (stay home or in their dorm rooms);
Stay home (or in their dorm rooms) until 24 hours after their fever resolves without the use of fever-reducing medicines like Tylenol or Advil (except to seek medical care);
Avoid contact with others to the extent possible;
Take fever-reducing medications (such as Tylenol or Advil); and
Drink plenty of fluids.

What should I do if I think I have a high-risk condition?

High-risk conditions for flu complications and serious symptoms are described in the question above.

Anyone who has these medical conditions should consult with their health-care provider (or Campus Health Services for students) with the onset of flu-like symptoms or following recent close contact with someone who has the flu.

Anyone who has the flu and develops any of the serious symptoms listed should call their health-care provider (Campus Health Services for students) without delay for medical advice or attention.

How are patients seeking help from the University's health clinics, including Campus Health Services, the Employee Occupational Health Clinic and UNC Hospitals, being evaluated and treated?

Based on clinical guidance provided by the CDC, all UNC health-care physicians and nurses are following a standard protocol for H1N1 treatment and specific recommendations for using antiviral medication.
Click here to see those guidelines.

How will the University keep people informed about H1N1 developments?

Updated information will be posted on the Environment, Health and Safety Web site and the Alert Carolina Web site. People should check these sites any time they have a question.

In addition, the University will continue to communicate directly to faculty, staff and students by campus e-mail and could use other methods of communication including voice mail (for campus land lines), the University Access Channel (Chapel Hill Time Warner Cable Channel 4) and other campus television channels, or text messages.

To communicate with parents of undergraduates, the Office of New Student and Carolina Parent Programs in the Division of Student Affairs maintains a parents e-mail listserv. Sign up for the listserv [hyperlink to http://parents.unc.edu/listservs.php].

How has the University prepared for a situation like this?

The University's pandemic flu planning began in 2006. University officials continue to update and refine the plans as new information about the H1N1 flu becomes available from local, state and national health organizations.

University officials are working closely with medical practitioners and infectious disease faculty at UNC Hospitals and Campus Health Services, the N.C. Division of Public Health and Orange County Health Department, and the University’s emergency, public health and safety experts.

Will the University close because of cases involving H1N1 flu on campus?

At this time, there is no need to close the University or change any current operations. However, the University will be prepared to cancel classes or close if the spread of H1N1 reaches Level 3 in the University’s Pandemic Influenza Emergency Plan. A Level 3 status would involve recommendations or input from the local public health department or state officials. The University currently is at Level 1.

Student-related Questions

What should I keep on hand during flu season?

It’s good to have the following supplies on hand: digital thermometer, bottled water and sports drinks, soups or microwaveable meals (if you have a microwave), non-perishable lunch packs and peanut butter, fruit and/or applesauce, crackers, Advil or Tylenol, tissues, disinfectant wipes and hand sanitizer.

What should I do if I develop flu-like symptoms?

Use the resources on the Campus Health Services Web site (http://campushealth.unc.edu) to find information about symptoms (which include fever, cough, sore throat, body aches, nausea, vomiting and diarrhea) and what action to take.

Based on guidelines from the CDC, the University developed recommendations for when students should stay home from school or work. These are posted on Alert Carolina under Messages to the Campus Community (http://alertcarolina.unc.edu/go/doc/1395/313028/).

In general, you should avoid school, work and socializing. The CDC suggests self-isolation - returning home if possible or remaining in your room until 24 hours after your fever resolves without the use of fever-reducing medicines like Tylenol or Advil. Self-isolation also means limiting contact with others and not visiting the dining hall. Contact your instructors to notify them you are not feeling well and receive instructions about getting classroom material and making up any coursework. You can also communicate to the faculty through your academic advisers, the Dean of Students (966-4042) or your parents.

If you have a medical condition that predisposes you to a higher risk of complications for seasonal flu and H1N1, consult with Campus Health Services, 966-2281, or your personal health-care provider. These conditions include pregnancy, asthma, diabetes, certain chronic lung, heart, and kidney conditions and any medical condition that leads to a suppressed immune system.

If I develop flu-like symptoms, are the people I live with at risk?

It is important to note that you are contagious about 24 hours before you become ill.

If you have a private room, remain in your room as much as possible, cover your mouth and nose when you cough and sneeze, or wear a surgical mask in shared spaces.

If you share a bedroom with another person, such as in a residence hall or fraternity or sorority, your best option is to go home or stay at the home of a friend or family member. Be sure to travel by private car rather than public transportation.

If you are ill and continue to live with your roommate(s) in the same space, be sure to maintain a distance of 3-6 feet, properly dispose of any tissues you use, wash your hands frequently with soap and water or an alcohol-based hand sanitizer, and disinfect surfaces touched in the same room or in shared spaces like bathrooms. Avoid shared bathrooms if possible, and clean them frequently with sanitizing wipes such as Lysol or Clorox. If you cannot avoid close contact, you should wear a surgical mask during self-isolation (usually 3-5 days).

Your roommate also should follow these measures or temporarily move in with friends during the self-isolation period (usually 3-5 days).

How will I get food if I can’t visit the dining hall?

It’s best to keep items on hand that you might need (see the information in the first question in this section). In addition, the Community Office providing services to your residence hall will have several “flu-care” kits that include a sports drink and some dehydrated soup that can be prepared in your room (if you have a microwave).

You should establish a “flu buddy” who will help deliver food and other items you may need during the self-isolation period. The Campus Health Services Web site (http://campushealth.unc.edu) includes details about authorizing your “flu buddy” to pick up food for you at Top of Lenoir or Rams Head Dining Hall or obtaining a “flu-care kit” from Rams Market.

Can I go to class if I am well but I have a roommate with H1N1 flu?

You can go to class, but you should monitor your health every day. If you become ill notify your instructor and stay home. (See the advice above about what to do if you develop flu-like symptoms.)

What is the best way to clean my room and other areas?

The virus does not live on environmental surfaces for extended periods and is easily killed by normal household disinfectants like Lysol or Clorox wipes. To protect yourself and your roommate(s), establish regular schedules for frequent cleaning of high-touch surfaces (for example, bathrooms, doorknobs and tables).

Are there specific guidelines for students who study abroad?

It isn’t possible to anticipate the response of foreign governments, health authorities and educational institutions to the spread of H1N1 flu within their respective areas.

By virtue of residence in a foreign country as participants in a study abroad program, students may become subject to decisions taken by the foreign governments, health authorities and educational institutions in response to the spread of H1N1 flu while they are studying abroad.

Based on guidelines issued by the CDC, the University has developed recommendations for students who study abroad. These are posted on Alert Carolina under Messages to the Campus Community.

Faculty- and Staff-related Questions

What should I do if I'm worried I might have this flu?

Use the resources available on the CDC Web site (http://www.cdc.gov/h1n1flu/) and www.flu.gov.

Based on guidelines issued by the CDC, the University has developed recommendations for when faculty and staff should stay home from work. They are posted on Alert Carolina under Messages to the Campus Community (http://alertcarolina.unc.edu/go/doc/1395/310199/).

In general, you should notify your supervisor or department chair and stay home using available leave (sick leave, vacation, bonus leave or flexible furlough program). The CDC suggests self-isolation until 24 hours after your fever resolves without the use of fever-reducing medicines like Tylenol or Advil. Self-isolation also means limiting contact with others.

If you have an underlying medical condition or are pregnant, call your health-care provider for advice or care – including whether you should receive influenza antiviral drugs to prevent illness – before reporting to work. People who are at high risk of complications from H1N1 infection (for example, people with certain chronic medical conditions, children less than 5 years or adults 65 years or older and pregnant women) should consider their risk of exposure if they attend public gatherings in communities where the virus is circulating.

If I develop flu-like symptoms, are the people I work with at risk?

If you experience an acute respiratory illness with a fever greater than 100.4 degrees along with cough, nasal congestion or sore throat, you should stay away from others (self-isolate). Notify your supervisor or department chair and stay home using available leave (sick leave, vacation, bonus leave or flexible furlough program).

In general, maintain a distance of 3-6 feet, properly dispose of any tissues you use, wash your hands frequently with soap and water or an alcohol-based hand sanitizer, and disinfect surfaces touched in the same room or in shared spaces.

Can I go to work if I am well but I have a family member at home with H1N1 flu?

You can go to work as usual. You should monitor your health every day, and if you become ill notify your supervisor or department chair and stay home using available leave (sick leave, vacation, bonus leave or flexible furlough program). If you have an underlying medical condition or are pregnant, call your health-care provider for advice or care – including whether you should receive influenza antiviral drugs to prevent illness – before reporting to work.

What should I do if a student in my class is ill?

Encourage the student to go home, self-isolate, take care of himself/herself and wait 24 hours after fever is gone before returning to class. The self-isolation period is 3-5 days so most students will be able to make up the work they missed. If you can place as much course content as possible on your class Web site, including assignments and lecture outlines, it will help students who have to miss class keep up with their assignments.

Students who are out with the flu should communicate with you by e-mail. They also can communicate through their academic advisers, the Dean of Students office or their parents.

The University is asking faculty members to be flexible both about attendance policies for students who have the flu and in helping students make up missed classes, exams or assignments. The provost’s office has asked faculty members not to require students to provide written proof of illness because health authorities expect that most people will recover without having to seek medical care, and requiring written proof of illness would place additional pressures on health-care facilities including Campus Health Services.

I have the flu but have used all my sick time. What should I do?

Any employee who has symptoms associated with a communicable disease is encouraged to stay home. If you do not have sufficient sick leave available, the University may work with you to advance a reasonable amount of leave or make arrangements for you to make up the time within 24 months.

I came to work with flu-like symptoms and my supervisor has sent me home. How will this affect my leave?

If you have flu-like symptoms, your supervisor may send you home and require that you not report back to work until you are well. You will be required to use available accrued paid time off or available vacation, bonus or sick leave to cover the time absent.

My supervisor thinks I’m infected. Can my supervisor send me home and make me use my own leave?

Yes, if a supervisor has reason to believe that you may be infected (for example, showing flu-like symptoms), your supervisor can send you home. With your supervisor’s permission and if work duties allow, you could perform some work from home temporarily. Otherwise, you will have to use your available leave to make up for any time that isn’t worked.

I am pregnant and my co-worker has H1N1 (or is coughing and showing flu-like symptoms). What should I do?

Symptomatic employees, especially those who have a fever, should be instructed by their supervisors to go home, using available leave. If you are concerned about proximity to an employee who may be symptomatic, notify your supervisor. There are many social distancing practices that can be used in the workplace to help reduce exposure risks, including the use of hand sanitizers, facial masks and minimizing close or frequent contact. The University’s Communicable Disease policy outlines other examples.

You should consult with your physician about how to handle any exposure risks relative to your specific medical situation. If your physician recommends that you stay out of the workplace for the remainder of your pregnancy, the University’s Family and Medical Leave policy would apply. Discuss with your supervisor what accommodations could be made to your work schedule or work location for the duration of your pregnancy.

What happens if I’m exposed to H1N1 at work?

If an employee contracts H1N1 and becomes ill, and it is determined that the exposure was work-related, regular Workers’ Compensation rules would apply.

I am fine but my children are home because the schools are closed. Do I have to use my own leave to stay home?

Yes. If you must stay home to care for your children when schools are closed due to an H1N1 outbreak, you must use your available leave (including sick leave, even if no one in the household is sick) to cover the absence. With your supervisor’s permission and depending upon job duties, you might be able to perform some work from home rather than use leave.

Are there any situations where I don’t have to use my own leave to cover an absence that is related to H1N1?

Yes. If a public health official has placed you in quarantine, the time in quarantine is paid communicable disease leave without charge to your other available leave. However, if during the quarantine you become sick, you would need to use your own available leave.

If the University closes due to an outbreak (Condition III), the first 30 calendar days of work time will be paid communicable disease leave, provided that you would have been able to work (for example, not already scheduled for vacation or other absences).

If I run out of leave, can my supervisor advance me paid leave?

Yes. If you have become ill with H1N1 – or if you must stay home with a parent or child because a school, day care, or elder care facility is closed because of an outbreak – and you run out of leave, you can take communicable disease advanced leave, which has to be paid back within 24 months. This leave works very much like adverse weather leave.

Can we isolate students who contract H1N1 at Campus Health Services or in a residence hall?

That just isn’t feasible with the number of people expected to contract the illness. Recommendations for students to self-isolate are outlined in the student section above.

What are the University’s plans if this should become a public health emergency?

The campus will be notified if the University's Pandemic and Communicable Disease Emergency Policy (http://hr.unc.edu/Data/SPA/leave/cd/pcde) is activated.

The policy outlines personnel provisions that apply to all employees - faculty, EPA non-faculty and SPA employees - during a public health emergency that has been declared by public health officials. The policy describes the University's status in terms of five condition levels, similar to those used with the Adverse Weather Policy.

In addition, the policy includes detailed information about the designation of mandatory employees, when those employees should report to work and how they should be compensated. It also specifies when other (non-mandatory) employees should report to work, accounting for absences and emergency furlough provisions.

If the University should have to close for a public health emergency, information would be posted on the University's homepage and Alert Carolina.

Is it safe to travel?

See the University's Travel Policy (http://ehs.unc.edu/healthy/h1n1.shtml) for details. University restrictions are triggered by travel health warnings from the CDC and travel alerts from the U.S. State Department.