Fort Worth Texas locks down their entire school system as confirmed swine flu cases leap. School dismissal and childcare closures are an important part of a comprehensive, layered mitigation approach aimed at reducing disease transmission and associated morbidity and mortality during the 2009 H1N1 virus outbreak in the US. Schools plays a critical role in protecting the health of their students, staff, and the community from contagious diseases such as H1N1 influenza. Children are very susceptible to getting this new virus and schools may serve as amplification point for spread of this new virus in a community. The reason for closing schools during this H1N1 outbreak is to try to reduce the spread of the virus. However, little information is available on what the effectiveness of a school closure might be in preventing further community spread of this new virus. In addition, the risk of severe illness from this virus is not yet clear. CDC recommends that affected communities with laboratory-confirmed cases of influenza A (H1N1) virus infection consider activating school dismissal and childcare closure interventions according to the guidelines below. Affected communities may include a US State or proximate epidemiological region (eg, a metropolitan area that spans more than one States boundary). These guidelines address a flexible and scalable approach that States and local jurisdictions can use based on the situation in their communities (eg number of cases, severity of illness, affected groups). Recommend Scalable and Incremental School Dismissal and Childcare Facility Closure in Affected Communities: 1. Decisions to dismiss students and close childcare facilities and subsequent implementation of those measures should be made based on the extent and severity of illness; 2. That local authorities decide whether or not to dismiss schools or close childcare facilities; and; 3. That authority for decision-making may reside in multiple sectors of State and local government; these entities must be well coordinated. Interim Recommendations * Sick people (students, faculty and staff) should stay home unless they need to seek medical care and stay away from schools regardless of whether schools and childcare facilities are operating normally or have dismissed students or closed, respectively. * Dismissal of students in a school and closure of childcare facilities should be considered in schools with one or more laboratory-confirmed or non-subtypable influenza A case among students, faculty or staff in order to decrease the spread of illness in the community. * Dismissal of students from schools and closure of childcare facilities should be considered for a school district or part of a school district (eg, a feeder school network or a geographic area) if more than 1 school in that district has confirmed or non-subtypable influenza A cases among their students, faculty or staff. This would include preemptive dismissing students from schools in that district, including schools without current laboratory-confirmed cases. * Neighboring school districts to those that dismiss students should also consider pre-emptively dismissing students from schools without current laboratory-confirmed cases. Issues to consider include geographic proximity and extent of mixing of student populations across district lines. * If a school dismisses students or a childcare facility closes, school or childcare related gatherings should also be canceled. Parents and students should be encouraged to avoid congregating in large numbers outside of the school setting. If a school dismisses students or a childcare facility closes, schools and childcare facilities should dismiss students for a minimum of 14 days. Schools, in consultation with local and State public health officials, should evaluate daily the need for possible extension of the dismissal/closure based on local influenza surveillance information, and the occurrence of new infections and severity of illness in the community from this virus. This length of time is recommended because children are likely to be infectious for about 7 10 days after the onset of illness If students are dismissed from schools, they should be encouraged not to re-congregate outside of school or elsewhere. If childcare facilities close and there is a need for childcare, families could plan to work together with two to three other families to supervise and provide care (using the same caregivers each day) for a small and consistent group of infants and young children while their parents are at work (studies suggest that childcare group size of five or fewer children may be associated with fewer respiratory infections). ENTIRE REPORT AT: www.cdc.gov