Fighting Through
The Centers for Disease Control and Prevention (CDC) reported last week that since April, there have been 95 confirmed pediatric H1N1 deaths, including 46 since Aug. 30. High schools in the St. Louis area report an average absentee rate of six to eight percent and highs around 20 percent. But for the most part, their sports teams are taking the strategy of canceling practices and promoting junior varsity players for games, rather than canceling those, too. Most schools are taking the flu as it comes and hoping it doesn't have too significant an effect on the season.

"We have had a great deal of discussion on how we would proceed with state tournaments regarding H1N1 closings, whether it be one school, 10 schools or 100 schools," Matt Troha, Assistant Executive Director of the Illinois High School Association told the St. Louis Post-Dispatch. "At this time, though, we have not made any formal decisions."

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Calling it Off
Other high schools and colleges across the country are not as shy about eliminating a contest. The Wisconsin Interscholastic Athletic Association created a rule at the beginning of the year stating that if a high school closes due to illness, it must forfeit all athletic events during that time. As fall playoffs approach, some administrators are worried.

"I can see it both ways," Edgar (Wis.) High School Athletic Director Jim Steinke told WAOW. "You can't push back the playoffs and keep saying this school is closed, we'll wait. This school is closed, we'll wait. Pretty soon you'll be playing football in December."

In Maine, some college teams are postponing games against their rivals without hesitation, as well as taking many other precautions.

"It's a very big priority for us," Al Bean, University of Southern Maine Athletic Director, told the Portland Press Herald. "It's been pretty well documented that this may be a pretty serious health concern for an awful lot of people. We have to be concerned for their health. We don't want to overreact. We want to play the games. But we certainly take it seriously."

The Wyoming High School Activities Association discussed adopting its rule originally designed for weather or travel difficulties that states an event will be canceled if 25 percent or more of the participants are unable to attend.

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Taking a Break
Another problem for student-athletes with the swine flu is that new research suggests exercising with the flu, especially strenuously for a prolonged period, could delay recovery.

"The best information we have says complete bed rest is best," David Nieman, Director of the human performance lab at Appalachian State University told the Los Angeles Times. "We know that heavy exertion causes a transient downturn in immune function that can last from a few hours to a day. During this downturn, if you have a virus, it will multiply at a higher rate and make you sick."

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Keeping Clean
Teams that decide to compete during the flu season are taking precautions. One high school in Buffalo is transferring from water bottles to cups.

Earlier in the season, the NCAA suggested volleyball players forgo the traditional post-match handshake.

Medical experts seem to think that measure is largely ineffective, but high schools in New York took a similar approach.

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Prevention
Keeping the swine flu out of schools really comes down practical advice similar to avoiding many illnesses. The CDC released advice for High Schools.

The advice includes:
* Staying home when sick
* Separating ill students from staff
* Practicing hand and respiratory hygiene
* Early treatment of high-risk students and staff
* Considering selective school dismissal

The CDC also released college-specific advice.

The advice includes:
* Facilitating self-isolation of students and staff who display flu symptoms
* Discouraging attendance of campus events for ill people
* Considering special populations such as students studying abroad and disabled students
* Increase social distances and consider suspending classes

Kyle Garratt is an Assistant Editor at Athletic Management.