The Minnesota Department of Health issued stricter influenza recommendations on Thursday, aimed at reducing the risk of serious illness in young children.
Health officials now recommend that parents keep children under five-years-old at home until seven days after influenza-like symptoms first appear, or 24 hours after a child's symptoms go away, whichever is longer.
School-age children can return to school 24 hours after their fever has resolved without the use of fever-reducing medicines like acetaminophen or ibuprofen, if they feel well enough.
MDH officials have also recommended that child care settings and early childhood education programs follow stricter guidelines.
At facilities where older children interact with children under five, all children should follow the recommendations for children under five, health officials said.
Health officials stressed the importance of stricter regulations for young children, as they are at higher risk of severe illness from the H1N1 virus. In Minnesota, children under five have been hospitalized with the H1N1 virus at twice the rate of children aged 5 to 12 years.
"Observing precautions for preventing the spread of influenza is often not very feasible for young children," said Dr. Ruth Lynfield, Minnesota State Epidemiologist. "For a young child, it can be difficult to control a runny nose and to cover their nose and mouth when coughing or sneezing. In addition, young children tend to put shared toys and other items in their mouths. Frequent hand washing is also a challenge.
"For these reasons, influenza and other infectious diseases are easier to spread among young children.We believe extra precautions are justified to protect the health of children in this very vulnerable age group," Lynfield said.
MDH issued the new guidelines one day after the Centers for Disease Control and Prevention said pandemic flu activity in Minnesota is now considered "widespread." The label is the highest classification in the agency's flu reporting system.