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'Flu rituals' added to the church season

[Episcopal News Service] Episcopalians can expect new rituals in the order of service this flu season in an attempt to mitigate the spread of the seasonal and H1N1 viruses (AKA "swine flu").

At St. George's Episcopal Church in Germantown, Tennessee, a simple bow or nod has replaced the passing of the peace's handshakes and hugs. At Grace Cathedral in Topeka, Kansas, vodka-moistened gauze is used to wipe the communion chalice rather than cloth. Stanford University's Memorial Church has temporarily suspended use of the communal cup in favor of intinction, or dipping the bread in the wine.

"Though a common practice by most, during Holy Communion congregants are asked to dip the bread in the chalice and refrain from drinking from the cup," said the Rev. Joanne Sanders, Memorial Church's Episcopal associate dean and liturgical officer.

In early 2009, the H1N1 virus caused the first global outbreak of influenza in 40 years, infecting more than 300,000 people in 191 countries, and killing 3,917, according to the most recent data issued by the World Health Organization (WHO). Twenty-six U.S. states have reported widespread influenza activity, according to FluView, the Center for Disease Control (CDC) and Prevention's weekly flu report.

Influenza, or the flu, is a contagious respiratory illness caused by influenza viruses. It spreads from person to person and can cause mild to severe illness, and in some cases, can lead to death. In the United States, flu season typically begins in the fall and continues into early spring. In addition to the regular seasonal flu, the H1N1 flu virus also is circulating, according to, a federal government information site operated by the U.S. Department of Health and Human Services (HSS).

Flu symptoms include fever, cough, sore throat, and may be accompanied by headache, tiredness, runny or stuffy nose, chills, body aches, diarrhea and vomiting. Like seasonal flu, novel influenza A (H1N1) infection in humans can vary from mild to severe, the site said.

"Once you are actually experiencing the symptoms, the virus is well established and being shed," said Stephen Stray, assistant professor of microbiology at the University of Mississippi Medical Center in Jackson, Mississippi, and a member of Executive Council's Committee on Science, Technology and Faith. "It can be up to two days between when you first have the contact with the virus and get the first symptoms."

Stray emphasized "sneezing etiquette" -- sneezing into a tissue or sleeve.

"We know the virus is transmitted very well when people sneeze or cough; as soon as hits a surface it begins to degrade, surface transfer is less important," he said.

The CDC recommends vaccination as the best means for preventing flu viruses, both seasonal and H1N1. Seasonal influenza vaccines are widely available now. Vaccines against the pandemic H1N1 influenza virus are expected to be available by mid-October and will be administered as separate vaccinations, according to the CDC website.

The Episcopal Church of St. Paul in Chatham, New Jersey, will offer season flu shots at its Wellness Clinic on October 3 and 4, and has tentative plans to offer the H1N1 vaccination October 24 and 25, pending availability of the vaccine.

"This is something that we have done for the last four years," said the Rev. Elizabeth Kaeton, rector. "We get about 120 to 150 people, and it's open to the community. We had one person say, 'I know I could go to city hall (to get it), but it's so much more fun to get it at St. Paul's.'"

Four registered nurses and one licensed practical nurse staff St. Paul's Wellness Center, which offers health screening and consultation services year-round.

For the time being, however, Kaeton said, the Eucharist will remain unchanged, but the nurses will wipe down the pews and other common surfaces with a disinfectant, and purse-size bottles of hand sanitizer will be made available.

"We are asking people to use common sense … and stay home if they feel sick," she said. "We're not going to take any more precautions until the pandemic becomes a local epidemic."

If that happens, Kaeton said, St. Paul's will follow the CDC guidelines.

In Tennessee, St. George's sent a letter to its parishioners September 2 outlining its flu season practices. In addition to bowing and/or nodding during the passing of the peace, the communal cup will not be used during the Eucharist, and in addition to soap and water, clergy will wash their hands with hand sanitizer.

Eileen Fields, St. George's parish administrator, said so far parishioners have embraced the changes.

According to its website, St. George's will also offer flu shots to its members and the community October 1.

The Episcopal School of Texas in San Antonio, Texas, closed the school for two days (four total, including the weekend) in February when 20 percent of its 405 students (48 of whom board at the school) contracted the seasonal flu, allowing the students to rest and recover and the janitorial staff to sanitize the campus said Cindy Schneid, the school's director of public relations.

Within minute of the school's closing, local media sent a news helicopter and crew to the school, she said.

"The media was so interested in this story," she said. "The real story was we were just mirroring what was happening in the community."

There were no confirmed H1N1 cases at the school last year, Schneid said.

In anticipation of this flu season, the school is working with the San Antonio Department of Health, participating in conference calls to discuss the local situation and to work on prevention strategies, and communicating that information to parents, she said.

At Grace Cathedral in Topeka, it was discovered that vodka-moistened gauze was more effective in cleaning the chalice than cloth, said Kent Wingerson, the cathedral's verger.

The combination was first used to rid the chalice of lipstick, he said, but added disinfection and the fact that the chalice bearers can get more use out of the combination has made the vodka-moistened gauze more effective.

Anyone administering bread for Eucharist will also be required to use a hand sanitizer and parishioners choosing intinction will not be allowed to dip the bread themselves, Wingerson said.

"We are also making it clear that to receive the bread alone is sufficient," he said.

Episcopal churches, schools and affiliates offer many services to many different people: daycare centers, preschools, worship and fellowship centers, after school programs, food pantries and homeless shelters.

In its H1N1 guide for community and faith-based organizations, the U.S. Department of Health and Human Services (HHS) recommends publishing flu facts and tips for staying healthy in newsletters and establishing a "buddy system" to ensure that the most vulnerable and hard-to-reach members have the services and information they need. HHS also offers guidelines for working with homeless populations.

Episcopal Relief & Development has also prepared an H1N1 resource guide.

-- Lynette Wilson is staff writer, Episcopal Life Media.

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