A summer of anticipation and worst-case-scenario planning has given way to a new academic year of inevitable illness as the H1N1 flu virus appears at colleges and universities across the nation.
As many institutions ratchet up to full capacity with students, faculty and staff returning for fall classes, campuses from Kansas to California and just about everywhere in between are beginning to report handfuls to hundreds of cases, mostly among students. Though it’s still too early to predict how widespread and severe H1N1 will be this fall and winter, administrators are taking cues from state governments and the Departments of Education and Health and Human Services in anticipating outbreaks much larger and more dangerous than those seen among students during the spring and summer.
The University of Kansas prepared for an outbreak by creating handouts to help students diagnose themselves with the virus  and to figure out how to deal with being sick while living in on-campus housing . As students have reported having flu-like symptoms, Todd Cohen, director of university relations, said the cases peaked on August 29 with 313 sick students that day.
On Monday, 224 students were sick and administrators hoped the outbreak was waning, but Tuesday's numbers showed 266 students reporting flu-like symptoms . As large as all those totals seem, Cohen emphasized that they represent just 1 percent of the university's student population of 30,000.
"The vast majority of our students are doing just fine and haven't gotten H1N1 at all," he said. Though there have been “little groups here and there” of a few students living in the same dorm or belonging to the same sorority all getting sick within a few days of each other, Cohen said the university has yet to see large clusters of students whose illnesses are tied to specific student groups or classes. He added that the small batches of sick students linked to the same sorority probably resulted from the fact that they returned to campus a week earlier than most other students to take part in rush activities.
Louisiana State University  and the University of Alabama  have also reported multiple sick students associated with the same sorority. Oklahoma State University's flagship campus in Stillwater, another large public institution also a few weeks into its fall semester, has since the start of August seen fewer than 100 confirmed cases of H1N1 among its 20,000 students. On any one day over that period, 10 to 20 students have been known to be sick.
Gary Shutt, a university spokesman, points to an aggressive communications campaign. “Students, I think, have gotten it. They know to take precautions, isolate themselves if they’re sick, stay away from sick people if they’re not.” Another factor in slowing the virus’ spread, Shutt said, is that very few cases have been reported among students who live in the close quarters of dorms. Students living off campus have had an easier time isolating themselves.
For more on H1N1, visit our
"In Focus" page  for highlights of our
coverage of the virus's impact
on higher education.
The College of Charleston saw its first eight cases of the fall semester appear in students this Monday and Tuesday. They’ve been prescribed Tamiflu, given masks and told to limit their contact with others, said Michael Robertson, director of media relations. “We’ve known about this illness for a long time, so now we’re just carrying out the plans we’ve been putting in place for months.”
One university where communications problems have been evident is the University of Colorado at Boulder. The Denver Post  reported that some faculty members have been telling those with the flu (there are 50 confirmed H1N1 cases among students so far) that they should drop their courses. The university is in fact not encouraging that action, but has been asking professors to be lenient about helping students who miss class make up work later.
Just outside Richmond, Va., John Tyler Community College has yet to learn of any H1N1 cases among its students, but Fred Taylor, vice president of finance and administration, thinks it’s likely that at least a few have been exposed to the virus.
“As of early August we were hearing that there had been more than 20,000 cases in Virginia, so we can’t help but think that some of them were probably in or around our area and that we’re going to have to deal with this virus at some point in time.” For now, John Tyler’s focus is on reminding students to wash their hands , to cover their mouths and noses when coughing or sneezing, and to stay home when sick. “If the volume or severity of cases were to get really high, we would treat [the virus] differently, but for now we’re treating it like the regular flu,” said Taylor.
Diane Asaro, director of Loyola University Chicago’s Wellness Center, said the institution has identified four students it presumes to have the virus since classes started on August 24. She said there are no patterns or connections between those students and that they were probably exposed to the virus before classes began. With just a few cases so far, Asaro said Loyola is trying to “focus on prevention.… This is a great opportunity for us to empower all our students by having them follow safety precautions that really can have a big effect on keeping our community healthy.”
Students in the university’s nursing school plan to visit residence halls to give students and advisers ideas on how to contain and cope with H1N1 . Clinical nursing and medical students will help campus health officials administer traditional flu shots later this month and H1N1 inoculations once they’re ready for delivery in mid-October or later.
Amherst College, a close-knit private institution in western Massachusetts with 1,700 undergraduates, plans to isolate ill students in three vacant dorms with a total of 75 beds, said Caroline Hanna, a spokeswoman. Most Amherst students live on campus and come from hometowns simply too far away for their parents to pick them up if they fall ill.
Amherst is a member of the Five College consortium -- which also includes Hampshire, Mount Holyoke and Smith Colleges, as well as the University of Massachusetts at Amherst -- which has been keeping tabs on preparedness programs and illnesses for the last few months. Kevin Kennedy, director of communications for the group, said “all the colleges are meeting regularly, keeping up with each other, getting all the issues on the table just in case we end up seeing a lot of sick students.”
The International Association of Emergency Managers has been doing the same thing on a much larger scale, mapping cases and safety precautions at colleges and universities since May . (The link shows a map of U.S. activity from May through August.) Dave Bujak, chair of the group’s Universities and Colleges Committee and emergency management coordinator for Florida State University, said that while the map was created to track when the virus “showed up on campuses and how it spread,” it has since evolved into a way for emergency managers and other administrators to see how dozens of other institutions have tackled cases on their own campuses or how they’ve planned for the possibility of widespread illness.
“The main thing,” Bujak said, “is that institutions want to try to monitor H1N1 and see what other people are doing to prevent and fight it -- why reinvent the wheel when others have already figured out a good way to deal with it?” Anticipating a glut of cases this fall, Bujak launched a new calendar Tuesday for September cases and idea-sharing , and plans to create more on a monthly basis as long as the virus continues to threaten colleges and universities.
Once an H1N1 vaccine is released, the map will also track its distribution. Bujak also discussed the plans in place at his institution, Florida State, where administrators are in a state of “just watching and waiting.” They’ve anticipated that at least a fifth of the student, faculty and staff population of more than 50,000 will get sick with H1N1 or the traditional flu this fall, but really don’t know how many people will get sick or how sick they’ll get. “Closeness is just the nature of colleges, so we expect that if H1N1 is going to be bad somewhere, it’s likely going to be on campuses.”