University and college students who come down with influenza this autumn should either go home to their parents or hunker down in dorm rooms to avoid spreading it, the U.S. government advised on Thursday.

Officials also said colleges and universities should waive requirements for doctor's notes for both students and staff who become ill this year, to encourage people who become infected to stay home.

The goal is to keep sick people away from others so the virus does not spread, the U.S. Centers for Disease Control and Prevention said.

Students can establish a 'flu buddy scheme' in which students pair up to care for each other if one or the other becomes ill. Additionally, staff can make daily contact by e-mail, text messaging, phone calls or other methods with each student who is in self-isolation, the advisory reads.

If close contact with others cannot be avoided, the ill student should be asked to wear a surgical mask during the period of contact. There is also advice on regular cleaning.

The guidance, published here, is the latest in a series of government advisories being released ahead of an expected worsening of the H1N1 swine flu pandemic as weather in the northern hemisphere cools and students return to school.

Based on the severity of 2009 H1N1 flu-related illness thus far, this guidance also recommends that students, faculty, and staff with flu-like illness remain home until 24 hours after resolution of fever without the use of fever-reducing medications, the advisory reads.

Although the severity of flu outbreaks during the fall and winter of 2009-10 is unpredictable, more communities may be affected than were affected in spring/summer 2009, reflecting wider transmission and possibly greater impact, the advisory reads.

The U.S. government has also asked businesses to be flexible about sick leave and to help educate workers about vaccines and hygiene, and it has recommended that elementary and high schools only close if many students and teachers get sick.

UNSTOPPABLE VIRUS

The new H1N1 strain, which emerged in March, has been declared a pandemic and the World Health Organization has said it is impossible to stop its spread. WHO predicts a third of the population will eventually become infected.

But health experts say it is worth trying to control the virus somewhat with common-sense measures. These include encouraging people who are infected to avoid spreading it by staying home when they are sick, by keeping hands clean and by avoiding coughing on other people or onto surfaces.

Drug makers such as Sanofi and GlaxoSmithKline are racing to make vaccines but a shortage is expected for the first few months.

Governments are also stockpiling antiviral drugs such as Roche AG's Tamiflu but doctors recommend using these only for people at high risk of complications -- pregnant women and those with chronic conditions such as asthma, diabetes and heart disease.

The new H1N1 flu causes symptoms similar to seasonal flu -- sudden onset of fever, extreme tiredness and muscle aches, coughing and sore throat. It may also cause stomach upset and diarrhea. In about a third of the cases there is no fever.

Like seasonal flu, H1N1 can be spread before a patient feels ill and after he or she feels better.

Based on the severity of 2009 H1N1 flu-related illness thus far, this guidance also recommends that students, faculty, and staff with flu-like illness remain home until 24 hours after resolution of fever without the use of fever-reducing medications, the advisory reads.

Medicine