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Although the H1N1 virus isn’t the dangerous swine flu initially feared, Guilford County health and school officials have met to plan for what they expect will be back-to-school outbreaks of the illness.

“It is not gone,” said Connie Jones, a communicable disease nurse for the Guilford County Health Department, noting recent outbreaks of H1N1 among football players at Duke and Elon, and at year-round schools in Alamance County. “It’s just a snapshot of what we’re going to see when our schools go back.”

The Centers for Disease Control and Prevention has ordered trials of H1N1 vaccines to be carried out across the country, but public health educators say the earliest these could be available as flu shots will be October.

So with the first day of school one week from today, principals and school nurses are being asked to use low-tech prevention. For example:

* A letter home will remind parents how to best protect children from the flu.

* Teachers will be on the lookout for students running a fever, and schools will have designated sick areas for students to wait until they are picked up, so they don’t expose others.

With reports of H1N1-related deaths in Mexico, and two initial deaths in Guilford County in June in which the flu was a contributing factor, the threat H1N1 posed when it arrived  last spring may have appeared more lethal than it was.

But now that local health officials have gotten a closer look at H1N1 — an airborne respiratory flu that typically sidelines the patient for a week — the actual threat is more clear.

What is clear, health educators note, is that H1N1 preys on a younger to middle-years population than the standard flu, which attacks the very young and elderly. And it remains widespread enough in the region to have shut down an entire school in Alamance County earlier this month.

Said Haley Miller, a Guilford County Schools spokeswoman: “We do understand that it’s a milder form than was originally suspected. If there’s an unusual amount of it in one school, we want to know why that is.”

Yet, because the flu has become so widespread, there is no reliable estimate for how many cases of H1N1 have occurred locally. According to Jones, the state Health Department and the CDC ordered that only patients sick enough to be hospitalized be tested for H1N1, so that labs would not be overwhelmed.

Consequently, there were only 40 lab confirmed cases of H1N1 recorded in Guilford County since the outbreak began. But as the CDC concluded  nationwide, Jones said, there were many more cases than those that were tested in labs.

“We are telling physicians when they call, if the patient has a fever greater than 100, a cough, sore throat, they more than likely have H1N1,” Jones said. “That’s pretty much the only flu we’re seeing.”

In the first 48 hours of the symptoms, the prescription medicine Tamiflu is still the only remedy available to inhibit the flu. Should a successful vaccine be developed, public health educators foresee a two-shot series taken in the arm 21 days apart.

The health department and the schools are planning to use schools as centers to distribute the vaccinations for children. The shots also could be made available through employers, doctors offices and drugstores.

This year’s seasonal flu shot supply is expected to arrive in early September, Jones said, and the state is encouraging health departments to have consumers get their regular flu shots before the H1N1 shot comes on line.

Contact Lorraine Ahearn at 373-7334 or lorraine.ahearn@news-record.com