To all Students, Faculty Members and Administrative Staff,

Guidance for the Prevention of Influenza

　(25,October,2011)

It is preferable that the group activity is suspended as early as possible (when more than two persons are absent due to influenza in the same period). However, an absence rate of 10% or 20% could be the threshold to suspend the group activity depending on cases. Please read the following information for details.

Influenza A (H1N1) affected a large number of students in 2009. The influenza A(H1N1) has been treated as seasonal influenza since April,1,2011. Both the new seasonal influenza and the existing one will be present this 2011-2012 winter season. The influenza season has arrived and it is important that people of all age groups take prevention measures to prevent severe illness complicated with influenza.

Simple hygiene practices such as gargling and hand washing, as well as adequate sleep, nutrition and rest are the principal means of preventing the transmission of disease.

In influenza infections, the importance of taking immediate action after the occurrence of infection in reducing severity and death is quite clear, when taking into account that the death rate (per population) associated with influenza in Japan is less than one twenty-fifth of that in the US, though having the same medical standards. Since the primary goal is to prevent as much human exposures to the virus as possible, it is important that everyone take precautions not only to prevent infection to themselves but to others as well.

Students, faculty and staff are asked to report to the University as indicated below upon being diagnosed with influenza.

In student group activities, if there are more than two persons confirmed of having influenza or more than ten persons showing symptoms of fever above 38℃ accompanied by acute respiratory symptoms (either a runny nose, stuffy nose, sore throat or cough) within seven days, notification must be made as indicated below. (Please refer to “Student Group Activities” below as to how the activities should be conducted.)

Please refer to the University Health Center website

Reporting Process for Students, Faculty and Staff
　in the event of Influenza Infection

Students, faculty and staff must report all confirmed cases of influenza to the University Health Center online or by fax to prevent the spread of infection. Students, faculty and staff of the following campuses must promptly report to the designated department as well.

　・Affiliated school of Keio University (student, faculty and staff)
　　　report to the relevant branch (dispensary) of the Health Center

　・Shinanomachi Campus (student, faculty and staff)
　　　follow instructions of the Faculty or the University Hospital

　・Shiba Kyoritsu Campus (student, faculty and staff)
　　　report also to the Shiba Kyoritsu Branch of the Health Center

　・Faculty of Nursing and Medical Care,
　　Graduate School of Health Management (student)
　　　report also to their supervising teacher

• Infected individual must refrain from coming to the University for class or work until at least 48 hours after the fever subsided. Please have the "Permission to attend campus after having an infectious disease" filled out by your doctor and submit to the Health Center.
• Since the infected individual can be contagious from one day before the onset of his/her symptoms, the individual should inform the people whom he/she had contact with.
• Please inquire the Office of Student Services (Academic Division) at your campus for details on classes.
• Students of the medical faculties who will be absent from clerkship activities must also report to their supervisors as well.

Student Group Activities
(Academic, Athletic League Activities, Student Circles, Seminars, Research Activities, etc.)

Prevention of Group Infection

In order to continue group activities without the risk of becoming infected, it is important that each member of the group take responsibility for their own health and that of others. It is advisable that all individuals take their body temperature (without the administration of antipyretic medications) before leaving home, let alone when they are sick. For fever over 37 degrees Celsius, the individual should take extreme precautions (e.g. wear a mask when going out, take temperatures regularly, etc.), and for fever over 37.5 degrees Celsius the individual should refrain from participating in any activities and seek medical attention. This will greatly reduce the risk of group infection.

Understanding the Progress of Group Infection and Taking Steps

It is important to know the spread of group infection at an early stage as possible when it occurs. When more than two persons are infected within the same group in the same period (the incubation period of influenza is usually 2 or 3 days), it is indicative that group infection has occurred and preventive measures must be taken. If more than ten persons are showing symptoms of fever above 38 degrees Celsius accompanied by acute respiratory symptoms (either a runny nose, stuffy nose, sore throat or cough) within seven days, it is indicative that the infection has spread within the group.

The supervisor in charge of the activity in such event must report to the Health Center, either online or by fax.

Measures to Control the Spread of Group Infection

The effective way to stop the spread of group infection is to suspend the group activity for a fixed period of time (for approximately one week from the time period when infection occurred) and to avoid contacts (including personal contacts) with other members of the group.

It is advisable to suspend the group activity as early as possible (when more than two persons are infected in the same period) to prevent the infection from spreading further and to reduce health risks. However, in circumstances where suspension of activities would have a significant social effect and cannot easily be imposed, the supervisor may choose to postpone the suspension and enforce precautionary measures such as temperature checks and other infection control. Academic activity is a matter of highest priority for students, and the reason school and class closures are decided based on absence rates (10% or 20%) is to minimize the potential effect on such academic activities. However, since delaying the suspension heightens the possibility of increasing the number of infected individuals at an accelerated rate, it is important that any sign of infection receives medical attention without delay. The Health Center provides consultations for supervisors to give careful consideration to the objectives of the activity and to take appropriate actions. Please bear in mind that the most important consideration for infection control is to reduce human health risks and take necessary steps in promoting prevention methods such as self-care practices (observations of symptoms, early intervention and treatment), in addition to adjusting group activity plans.

Basic Measures to Prevent Infection and its Spread

• Wash your hands and gargle regularly (when arriving at home or work, before eating, etc.)
• Observance of a cough etiquette
  Wear a mask if you have any one of the following symptoms: coughing, sneezing, runny nose, sore throat, fever, nausea or vomiting.　Until you wear a mask, cover your nose and mouth with a tissue when coughing/sneezing or cough/sneeze into your sleeve to avoid respiratory droplets being passed through the air (if you coughed/sneezed into your hands, wash them before touching anything).
• Get sufficient sleep and practice other good health habits to stay fit.

Alert for Severe complications

• Although over 90% of the patients affected by influenza are cured , it is a viral infection with a high risk of severity, with some deaths reported every year. Regardless of whether the individual has a pre-existing condition, be alert to any signs of influenza and any signs of worsening should receive medical attention immediately.
• Signs of increase in severity include breathing difficulties (even without fever), shortness of breath, continuing chest pain, vomiting and diarrhea, fever lasting for over three days and worsening of other symptoms.　In cases of infants, such signs also include fast breathing, paleness, inadequate fluid intake, inadequate communication and grumpiness.
• Below are the underlying diseases and conditions that are reported to have high severity risk when affected by Influenza.

　　・Chronic respiratory diseases [asthma, chronic obstructive pulmonary
　　disease (COPD), etc.]

　　・Chronic cardiac diseases [congenital cardiac disease, coronary artery
　　　disease, etc.]Smokers are often unaware of having signs of COPD or
　　　coronary artery disease.

　　・Metabolic diseases such as diabetes and obesity

　　・Kidney failures [chronic renal failure, dialysis/transplant patients, etc.]

　　・Other diseases that may compromise immune systems and those who
　　 are under such treatment.

　　・1-year-old to preschool children, persons who are over 65 year old or
　　 pregnant.

Further information on influenza

Information about the University’s policies for addressing influenza is posted on the University website as needed. Information from public health authorities can be found on the following websites.

Ministry of Health, Labour and Welfare:2010 Influenza Measures http://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou01/index.html

Ministry of Health, Labour and Welfare:Influenza A (H1N1) Measures http://www.mhlw.go.jp/english/topics/influenza_a/