Health officials are offering some basic advice for college students with flu symptoms: Avoid other people until 24 hours after a fever is gone.
At colleges across the country, planning for flu season, particularly the H1N1 virus, is well under way.
Recommended safeguards could mean students with a private dorm room should stay in their rooms and find a "flu buddy" to deliver meals and notes from class. Or it could mean students with roommates might need to move to some kind of temporary housing for sick students. And if sick students can't avoid close contact with other people, they need to wear surgical masks.
The point is for sick students to isolate themselves, Education Secretary Arne Duncan said.
"So if that student is not feeling well, they don't need to be walking around to get meals; they don't need to be walking around to pick up class notes," Duncan said Thursday during a conference call. "They can get a friend or roommate to help."
College officials are making preparations.
"We've got masks. We've got the kits to diagnose the flu. We've got Tamiflu," said Nancy Calabrese, director of student health at St. John's College in Maryland. "We've done everything we can do."
The college guidelines are aimed at keeping schools open and students learning, which is the goal of guidelines issued earlier this month for elementary, middle school and high school students. Officials also are urging schools to set up online learning tools for students who have to stay home.
Students with flu symptoms — fever, cough, sneezing, chills, aches, sometimes diarrhea or vomiting — should stay home from class, officials said. And schools should not demand a doctor's note to prove someone is sick or recovering, because doctors may be inundated, the new guidance said.
College-age students are more vulnerable to the H1N1 virus than to regular winter flu, Health and Human Services Secretary Kathleen Sebelius said. And they don't always see doctors or get regular vaccinations, said Sebelius, who noted she has personal experience with her 28- and 25-year-old sons.
"They need to be encouraged to not only take care of themselves, but to isolate themselves when they are sick," Sebelius said.
The new guidelines recognize that college planning will vary greatly according to the size and location of the school, the number of students living on campus and the severity of an outbreak.
Amherst College in Massachusetts is keeping two residential halls empty for isolating infected students from Amherst as well as other colleges in the area. Nearby Mount Holyoke will send infected students home by private car if they live within 250 miles, but those from farther away may be assigned to isolated campus quarters.
St. John's in Maryland has a campus gymnasium available for isolating students if needed. And at Carnegie-Mellon University in Pittsburgh, officials are reserving an unused sorority house in case it's needed for infected students.
Some colleges have concluded it would be too difficult to isolate entire groups of sick students. Florida's Eckerd College, where 80 percent of students live on campus, will focus instead on sick students' roommates, offering to move those in high-risk groups to other dorm rooms or possibly hotels.
Larger schools may focus on getting students to isolate themselves; the University of Michigan is asking students to stay in their rooms or apartments, and Penn State says sick students will be able to have boxed meals delivered to their rooms.
Hamilton College in New York also plans to deliver food crates and "flu kits" with items like tissues and thermometers to moderately ill students in their rooms, though it plans to move more seriously ill students to isolated housing.
Officials said colleges would be reluctant to impose some kind of quarantine.
Instead, they will rely on students to do the right thing, said Anita Barkin of Carnegie-Mellon University, an official of the American College Health Association.
"We're telling students we want you to be a good public health citizen here," Barkin said. "We're telling them you need to either go home, or go to the home of a relative or go to isolation housing."