Wheaton Flu Survey

1. Thank you for taking the Wheaton Flu Survey

The goal of this short questionnaire is to help regularly estimate the level of flu-like illness on campus. Your participation is voluntary. All responses are confidential and will only be used to assess the general prevelance of flu among Wheaton students, faculty and staff.

* 1. You are a Wheaton?

* 2. How do you identify yourself?

Female

Male

Other

Other (please specify)

* 3. What symptoms are you experiencing? (check all that apply)

Feel feverish (i.e., feel very warm, appear flushed, and/or sweating a lot)

Fever of 100 degrees or more (temperature measured with a thermometer)

Cough

Sore throat

Runny nose

Headache

Body aches

Chills

Vomiting

Diarrhea

Other (please specify)

* 4. How many days have you been experiences these symptoms?

number of days

* 5. As a result of your flu-like symptoms have you experienced any of the following in the last week? (check all that apply)

Missed class

Missed work

Missed athletic activities

Missed meetings

Missed social gatherings (i.e., parties, travel, or other social event)

Other (please specify)

* 6. In response to your flu-like symptoms have you taken any of the following actions in the last week? (check all that apply)

Increased hand-washing or use of sanitizers (i.e., Purell)

Left campus to recover at home

Stayed away from others to avoid making them sick

Monitored your fever by taking your temperature with a thermometer

Used fever reducing medication as directed. (i.e., Tylenol, Motrin, Ibuprofen, or similar over-the-counter medications)

Rested

Drank plenty of fluids

Covered your cough or sneeze

Contacted a medical professional (i.e., Norton Medical Center/college health center, doctor, nurse, other health care person)

Other action (please specify)

* 7. Of the people you know on campus, how many do you believe have a flu-like illness?

Number of people

* 8. Share your thoughts. Is there something about your illness or the illness of others that Health Services or others should know about? Is there anything else that you, your friends, your co-workers, or college representatives could do to help members of the Wheaton community prevent or care for flu-like illness?

* Note: If you have a temperature of 100 degrees or more and a cough, sore throat, or any other symptoms listed above it is likely that you have a flu-like illness. Experts recommend that those with flu-like illness stay home, rest, manage symptoms with over-the-counter medications (such as Tylenol or Motrin) according to the package instructions. You should remain home until you are fever-free for at least 24 hours without the use of fever reducing medicine. If symptoms worsen or persist contact your doctor. For more information on flu care copy and paste the CDC link or the Wheaton Flu Advisory link below into your web browser.

CDC Advisory web-page:
http://www.cdc.gov/h1n1flu/guidance_homecare.htm

Wheaton Flu Advisory web-page:
http://www.wheatoncollege.edu/health/flu/