Schools asked not to close if flu hits

That recommendation is expected to mirror new guidelines being released this morning in Washington by federal health authorities, according to health officials familiar with draft summaries of the US plan. Disease trackers fear that the fall and winter months could deliver an influenza double whammy, with the arrival of the typical seasonal virus accompanied by the return of the swine strain.

The guidance at both the state and federal levels is a direct response to the economic and social upheaval spawned during the spring when hundreds of schools across the nation were shuttered because of outbreaks of swine flu. In Massachusetts alone, at least 42 schools - from small private academies to Boston Latin School, the city’s biggest - canceled classes at some point during May and June as waves of coughs, fever, and aches washed over New England.

“The focus is going to be on avoiding closing schools if at all possible,’’ said Dr. Lauren Smith, medical director of the state Department of Public Health. “And that’s not only because of the educational disruption, but also because of the disruption that happens in a community when 300 or 400 or 500 kids aren’t in a school and all those families have to scramble to make plans to take care of them.’’

In recent weeks, Boston health authorities have met with business representatives to encourage them to allow parents to take paid sick days when their children fall ill. The message to businesses has been this, said Barbara Ferrer, executive director of the Boston Public Health Commission: “It’s much better for a handful of parents to be able to stay home with sick kids than to have me close a building with 1,200 kids and to now require all of those kids to stay at home.’’

And, so far, that message appears to be resonating with employers, Ferrer said. One business pledged to her that it would double employee sick days if a flu epidemic sweeps across the region.

A specialist in preparing for flu outbreaks hailed the decision to largely abandon the strategy of school closings as a means of controlling transmission of the virus. Such closings make sense only in the earliest days of an outbreak, said Dr. Paul Biddinger, medical director for emergency preparedness at Massachusetts General Hospital.

There is, for example, little evidence the school closings that stretched into June - more than a month after the first detection of the H1N1 virus that causes swine flu - significantly slowed transmission.

“Once the virus is out in the community, so are the children. They’re out in the malls, they’re in the grocery store,’’ Biddinger said.

A disease-tracking network run by Boston health authorities estimated that at least 23,000 people in the city became infected during an eight-week period, with children and young adults disproportionately bearing the burden of illness. By one measure, up to 11 percent of 5- to 17-year-olds in Boston caught the germ during those two months. Ten people in Massachusetts have died from the virus, and at least 353 nationwide.

But in many cases, the decision to close will rest with school officials. Last spring, after initially advising that classes be cancelled when a single swine flu case was confirmed, state and federal health authorities reversed course after it became clear the swine strain was widespread and no deadlier than the seasonal variety.

Some schools with only a few cases chose to close anyway - often in response to parental pressure.

This fall, health authorities plan to emphasize the importance of recognizing when a child is stricken with the hallmark symptoms of influenza, especially cough and fever, and then keeping them out of school, at home, and away from other youngsters.

In coming weeks, representatives from the Boston Public Health Commission will fan across the city to convey that sentiment. They will also stress the importance of children and parents being vaccinated against both the seasonal flu and the swine strain, which will require two vaccinations.

“The culture has to shift around what you do when you’re sick,’’ said Ferrer, a former Boston school principal. “You’ve got to stay home. You cannot either go to work or go to school when you’re sick because that’s how the flu is most easily transmitted, particularly in school buildings where children are so close together.’’

Public-health and education authorities acknowledged there could be occasions when they have no alternative but to close a school. Ferrer said her agency had no firm calculus it will use in recommending whether classes should be cancelled. But she described a scenario in which so many teachers and staff members fall ill that it becomes unsafe for a school to remain open.

A spokesman for the state Department of Elementary and Secondary Education said that agency and local school districts will work closely with public health departments in deciding if schools need to close.

Stephen Smith can be reached at stsmith@globe.com.