LETTER FROM DUTCHESS COUNTY DEPARTMENT OF HEALTH

June 8, 2009

Dear Parents, Faculty, and Staff:

We are writing to provide you with an update on the H1N1 Influenza (swine flu) cases
in our community, as well as to provide you with a few guidance recommendations to
help alleviate concerns you may have as the end of the academic year approaches.
To date, we know that there are 18 laboratory-confirmed cases of H1N1 in Dutchess
County. All 50 States and the District of Columbia and Puerto Rico have reported
cases of swine flu as of June 3, 2009. The vast majority of Americans who have had
H1N1 have experienced mild to moderate symptoms similar to ordinary seasonal
influenza and have recovered at home.

School closure policies:

• The New York State Department of Health (NYSDOH) stopped identifying
school districts a few weeks ago when the Centers for Disease Control and
Prevention (CDC) changed the guidance on school closure to no longer
recommend closure for individual cases.

• It is now generally advised to close schools only when there is a magnitude of
faculty or student absenteeism that interferes with the school’s ability to
function.

• For the protection of patient confidentiality, NYSDOH only states whether the
individual is an adult or a child. The Dutchess County Department of Health’s
(DCDOH) response to the outbreak of H1N1 is consistent with the NYSDOH
and the CDC guidance.

Reducing the spread:

• The CDC recommends the primary means to reduce the spread of influenza in
schools and child care facilities is to focus on early identification of ill students
and staff, staying home when ill, and using good cough and hand washing
etiquette.

• The DCDOH continues to recommend that individuals with mild to moderate
flu-like illness recover at home and avoid hospital emergency departments.

• Students, faculty or staff with influenza-like illness (fever greater than 100° F
AND a cough or sore throat) should stay home, except to seek medical care.

• The NYSDOH and CDC’s guidance states they are to stay home for seven (7)
days after symptom onset or until they are symptom free for 24 hours,
whichever is longer.

• A Doctor’s note DOES NOT override the NYSDOH and CDC
recommendations of when to return to school.

• Antiviral medicines (such as Tamiflu) can help reduce the risk of severe illness
and complications if taken within the first two days of symptoms.

Page 2 of 2
Testing for H1N1:

• A diagnosis of flu-like illness does not always require medical testing. DCDOH will work
with your health care provider to determine the necessity of testing on a case by case
basis.

Attending school final exams:

• No children currently with a fever greater than 100°F will be admitted to any school
settings/functions.

• Recovering children who no longer have a fever greater than 100°F AND do not have a
sore throat or cough, but are still within the seven day isolation period, are
recommended to be placed in a separate setting in order to accommodate necessary
year-end testing requirements.

• We are encouraging parents not to let children who are sick and/or recovering take the
school bus. Please make arrangements for alternative transportation.

Graduation ceremonies:
• Those with underlying medical problems (such as asthma, chronic lung disease or
immuno-compromised conditions) with flu-like illness should contact their health care
provider as they are familiar with their medical history.

• Persons at increased risk for serious health problems should consult with their personal
health care provider who are familiar with their medical conditions, for isolation
procedures and prevention as indicated.

• Immuno-compromised persons, pregnant women, and those with significant health
problems should consider not attending graduation ceremonies.

• Suspending public gathering is not recommended at this time. Further information on
guidance for public gatherings can be found at the following link:
http://cdc.gov/h1n1flu/guidance/public_gatherings.htm.

The school districts and the Dutchess County Department of Health continue to work closely
together to ensure the health and safety of our children and staff.

If you would like more information about the H1N1 flu, we recommend visiting the following
websites: www.dutchessny.gov or www.cdc.gov/h1n1flu. You can also call 1800-CDC-INFO.

Sincerely,
John C. Pennoyer, Ph.D                            Michael C. Caldwell, MD MPH
District Superintendent                             Dutchess County Commissioner of Health