Day care centers urged to be vigilant against flu

WASHINGTON — Will you start seeing thermometers at day care centers? The government is urging the nation's 360,000 child care providers to be vigilant about sending home children who may have the flu — and the main symptom to check for is a fever.
The Centers for Disease Control and Prevention issued guidelines Friday for day care programs that echo the advice for schools: Kids need vaccine — against both regular flu and the new swine flu — and they should stay home when they're sick. Don't return until 24 hours after a fever naturally subsides.
"If your child comes down with the flu, we hope you plan to keep them home and not share this with their playmates," Health and Human Services Secretary Kathleen Sebelius said.
The guidelines urge day care providers to do a quick health check every day, looking for children with flu-like symptoms or other signs that they might be getting ill, such as not playing normally. Centers should separate the sick child from others until he or she can be taken home.
But it can be very hard to tell if a child is sneezing because of flu, the common cold or even allergies.
"There are many, many different kinds of respiratory illnesses that children get, and we don't want to be sending children home unnecessarily," said Dr. Beth Bell, a CDC epidemiologist.
So checking for a fever is what Bell called a "reasonable indicator" of flu, either the regular winter strains or the swine flu that scientists call the 2009 H1N1 flu.
While not everyone with swine flu has a fever, the CDC has said such cases are rare.
Regular winter flu kills 80 to 100 U.S. youngsters every year, so children are supposed to get vaccinated against it each fall. But swine flu is putting new emphasis on flu and kids: At least 40 children have died of it since spring, accounting for about one in 13 U.S. swine flu deaths, the CDC said this week — and it spreads very easily among children.
One puzzle: While regular winter flu is most dangerous to children 4 and under, most children who have died of swine flu so far are age 5 to 17. It's possible that that's because school-age children are the group most infected so far, but scientists aren't sure.
Regardless, children of all ages are supposed to be among the first in line to get swine flu vaccine when it arrives in mid-October.
Vaccine against both types is a good idea for day care workers, too, Sebelius said. It could mean the difference between a center staying open or having to close because of absent staff. Any child care workers that care for infants, or who themselves have high-risk conditions, will be among priority groups for swine flu vaccine.
"It's the best way to keep them safe and the way to keep the children in the center safe," Sebelius said.
Meanwhile, day care centers also should stress commonsense flu-fighters: Wash hands often, and teach children to cough and sneeze into their elbow, not the hand they'll immediately stick onto a toy or a neighbor. A key way that flu spreads is for someone to touch a germy surface and then touch their nose or mouth.

Jackson tomb remains a mystery at LA-area cemetery

GLENDALE, Calif. — The massive marble and concrete Great Mausoleum at Forest Lawn Memorial Park was slightly accessible by the public before Michael Jackson was entombed somewhere in its maze of floors and hallways.
Tell the entrance guard you were there to see the "Last Supper" stained-glass window show, and you were allowed to roam a portion of the catacombs for about 10 minutes before anyone hassled you.
But those open sections are only a fraction of the sprawling building that rises many stories and plunges deep underground.
So wherein lies the King of Pop in the monolith? That may be a secret for the ages.
On Friday, a tourist family asked a guard whether the superstar's tomb was private. The guard said it was.
"Private ... forever?" one of them asked.
"Private forever." he said.
No fans, no paparazzi, and so far no one trying too hard to steal a glimpse of the vault containing Jackson's golden casket.
The exact location may forever remain unknown to all but a select few: A guest who attended the Jackson ceremony told The Associated Press the casket had not been put into the vault by the time mourners left.
The guest spoke on condition of anonymity because of the sensitivity of the day.
Under Friday's hot midday sun, a woman with a camera was denied entry to the mausoleum. Guards shooed away a radio reporter who tried to go inside then began interviewing people outside.
The funeral began Thursday night nearly two hours after its scheduled 7 p.m. time. Some 200 mourners, including 77-year-old Elizabeth Taylor and other celebrities associated with Jackson, showed up promptly, only to wait at the outdoor seating area, under a withering late-summer sun that pushed temperatures to 90 degrees even as it was going down.
The ceremony began with remarks and song after the family arrived to fill the front five rows of white folding chairs.
Mourners then followed Jackson's brothers as they carried the casket into the mausoleum. The singer's daughter, 11-year-old Paris, cried and was comforted by her aunt, LaToya.
Paris and brothers Prince Michael, 12, and Prince Michael II, 7, known as Blanket, began the service by placing a bejeweled crown on their father's casket. They were composed through most of the 90-minute ceremony, the guest said.
Once inside, Gladys Knight performed the hymn "Our Father" (The Lord's Prayer) and moved many to tears, according to the guest. When it was over, many of the 200 mourners hugged each other. Among them were Taylor, Jackson's ex-wife Lisa Marie Presley, Barry Bonds and Macaulay Culkin.
As it ended, Katherine Jackson appeared extremely weary and had to be helped to her car, according to the guest. Earlier, she had a difficult time going into the mausoleum; she was overcome and turned back, making it unclear if she went in at all, the guest said.
More than 400 media credentials were issued to reporters and film crews who were kept behind barricades. The few clusters of fans who gathered around the secure perimeter encircling the cemetery entrance struggled to see.
Glendale police said all went smoothly and there were no arrests.
Jackson will share eternity at Forest Lawn with the likes of Clark Gable, Jean Harlow and W.C. Fields, entombed alongside them in the Great Mausoleum. The level of security and secrecy about the location of Jackson's vault all but guaranteed it won't be turned into a shrine or tourist stop.
The entombment also ends months of speculation that the singer's body would be buried at Neverland Ranch, in part to make the property a Graceland-style attraction.
The King of Pop died a drug-induced death June 25 at age 50 as he was about to embark on a comeback attempt. The coroner's office has labeled the death a homicide, and Jackson's death certificate lists "injection by another" as the cause.
Dr. Conrad Murray, Jackson's personal physician, told detectives he gave the singer a series of sedatives and the powerful anesthetic propofol to help him sleep. Prosecutors are still investigating, and no charges have been filed.
Associated Press Special Correspondent Linda Deutsch and AP Writers Derrik J. Lang, Sue Manning, Sandy Cohen and Ryan Pearson contributed to this report.
Copyright © 2009 The Associated Press. All rights reserved.
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