At least one swine flu case in every school, and perhaps many more.
That's what school officials are bracing for this fall, as students return to classes next week and potentially breathe new life into the H1N1 pandemic. Health officials say school absentee rates could soar.
"At the peak, it may approach 30 percent," said Dr. Doug Holt, director of the Hillsborough County Health Department.
"We expect a surge within one to two weeks after school starts, and continuing for several months," he said at a Wednesday news conference. "And this entire pandemic could last up to 18 months."
Officials in other districts like Pinellas declined to predict how many students might call in sick as the virus makes its way through Tampa Bay classrooms. But all of the region's school districts say they're planning to coordinate a major, voluntary inoculation effort in schools once vaccines arrive in October.
"The school district at this point will have a major role in providing vaccine to students and staff," said Hillsborough superintendent MaryEllen Elia
"Already, the H1N1 virus has spread to the point where county health departments are no longer sending most blood samples for testing to confirm infection, Holt said. And it's virtually certain that some infected students will come back to school next week and infect classmates.
Closing schools under such conditions would have little effect, and it likely won't be done unless students with specific risk factors are exposed, he said.
So far, most of those who have been infected in the United States have had mild and short cases marked by fever, sore throat, achiness and, sometimes, gastrointestinal complaints, Holt said.
Still, swine flu last week claimed its fifth victim in Hillsborough County, bringing to six the number of Tampa Bay area deaths. At last count, 48 have died in Florida from the H1N1 virus, and 477 nationwide.
Those with flu symptoms should stay home and isolate themselves until 24 hours after the fever passes, he said. Pregnant women and those with asthma or chronic health problems are at greater risk and should seek antiviral treatment at the onset of symptoms.
In the meantime, school officials say they are ready with a plan to limit the spread and disruptive effect of the virus.
Hillsborough principals and teachers will be prepared to keep bedridden students on track with homework or online assignments, Elia said. Custodians will be asked to clean surfaces frequently and keep bathrooms stocked with soap and towels. Children will wash hands a lot, especially before lunch.
Parents should be on the lookout for symptoms and keep children home if they're sick, she said. And employers need to show flexibility if parents need to stay home.
"We will all benefit in the long run if you can understand parents' dilemmas," Elia said.
Pinellas school officials say they're putting together an information packet for teachers and parents, and considering rolling out hand-washing posters and videos.
In Pasco County, the district plans to track infection rates carefully and send home a note reminding parents of good hygiene practices.
The Hillsborough School Board created a flap last week when it suspended a popular incentive — fewer semester exams for students with good attendance records. Officials say the policy encouraged sick students to attend school.
Complaints about that change are still rolling in from residents who don't understand the threat posed by swine flu, said member Jennifer Faliero.
"It's not on the public's radar," she said. "Students are not taking it seriously."
Member Doretha Edgecomb said the district is walking a fine line, trying to prepare for the worst without starting a panic.
"It's like hurricane season," she said. "You make some predictions. It may happen, it may not."
Times staff writers Donna Winchester and Jeffrey S. Solochek contributed to this report. Tom Marshall can be reached at firstname.lastname@example.org or (813) 226-3400.