I have seen a couple of places on this board and elsewhere that many cases of swine flu are afebrile. This is exceptionally alarming to me, as a school nurse! Without fever, the traditional hallmark of flu, how in the world am I to know which of these kiddos are truly sick? I see tons of sore throats and runny noses, there is no way I can send them all home or have them see their PCP (heck, most of the kids at my school don't even have a PCP!) My district is no help, it is all business as usual with them. Right now, I am going on how the kid "looks", which is completely unreliable. Maybe I will start refering them if they have at least 2 symptoms OR a fever. I just don't want an outbreak to occur because I missed a kid who was really sick. I have no idea what to do with this! Any advice?