updated 10/20/2004 6:24:09 PM ET 2004-10-20T22:24:09

For millions of students and school workers who will miss flu shots this year, the advice is elementary: Wash your hands and stay home if you are sick.

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Only children with chronic medical problems or who take aspirin daily for health reasons should get a flu shot during the current shortage, federal officials say.

Healthy adults are encouraged to skip the shots to extend the U.S. vaccine, which has been almost cut in half because of contamination at the British plant where it was made.

The Centers for Disease Control and Prevention is reminding schools that good hygiene can help keep them from turning into germ factories.

Try singing 'Happy Birthday'
At Luther Jones Elementary in Corpus Christi, Texas, a school annually hit hard by the flu, the 650 students have been told to wash their hands with soap for 10 seconds — about the time it takes them to sing “Happy Birthday,” they were told.

Weekly influenza estimates“You can watch some of them timing themselves while standing in the bathroom, singing 'Happy Birthday to me,'" said principal Galen Hoffstadt. “It’s working.”

In Philadelphia, the district is working with city and state health officials to present a calm, focused message to parents about preventing the flu, said Nancy Erskine, who oversees the school system’s 300 nurses. Part of that message, she said, is encouraging parents not to send ill children to school, a point endorsed by federal health officials.

Schools have ways to help students catch up on missed work, from homework hot lines to e-mail from teachers, said Llelwyn Grant, a CDC spokesman and father of two children.

“There are parents who are concerned about their kids staying on course,” he said. “But I would not allow those concerns to put your child at risk or others at risk” for the flu.

Staying home not always easy
Yet staying home is not always easy to manage.

Parents missed almost one day of work for every three days of school missed by a child with the flu, according to a 2002 study published by the American Medical Association.

An estimated 48 million children are attending public schools this year, and they often are in settings that make them vulnerable to infection, said Julia Graham Lear, director of The Center for Health and Health Care in Schools at George Washington University.

“Have you been in a school cafeteria recently?” she said. “Just imagine all those kids and all their germy little hands on the cafeteria tables. Maybe they’re at a school where there are three sittings of lunch, and you know the school staff may not have time to disinfect the tables in between. That’s what makes the school setting unusual.”

Depending on the severity of the season, the public health system may have to mobilize school workers as “a front-line defense in reducing the spread of flu,” she said.

About 20 percent of the U.S. population attends or works in schools, according to the CDC, citing Education Department figures. The CDC also says research shows students miss fewer days of school when they practice good hygiene.

The CDC had no estimate of the school-age children who typically receive flu shots. Typically, it is a family’s doctor, not the school, providing the flu vaccine to children. But school nurses are increasingly relied upon to keep kids healthy and in class.

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