Flu-like illnesses have continued to increase on college campuses, though as of the week ending Oct. 30, the rate had slowed. According to the American College Health Association (ACHA), at the 274 colleges and universities participating in a survey, 9,128 new cases of influenza-like illnesses (ILI) were reported. This was an increase of 2 percent from the previous week. (Though 25 hospitalizations were reported, there were no deaths.) That brings the totals for the academic year to more than 65,000 cases and 123 hospitalizations from among the 3 million students at the reporting campuses. Ninety-seven percent of the schools saw new cases of ILI, a figure that was unchanged from the prior week. All of these statistics indicate to Dr. James C. Turner, ACHA president and executive director of the department of student health at the University of Virginia, that the "disease remains relatively mild."

According to ACHA, 43 percent of the 243 institutions said they had received at least some swine flu vaccine by October; 30,464 doses of the vaccine had been administered -- representing 1 percent of students.

I've received plenty of cautionary notices from San Francisco State University's administrators on the threat posed by the virus and the simple precautions students can follow: vigorously wash hands, cover nose and mouth when coughing or sneezing, and stay home when exhibiting flu-like symptoms. In keeping with the CDC's recommendations for college campuses, the school recently implemented a new policy that professors not require a doctor's note to confirm illnesses.

Recently, I caught up with Alberto Angelo, a health educator affiliated with the campus' Student Health Services. Angelo says the number of H1N1 cases at San Francisco State is not known because Student Health Services is not testing for the virus. Also, because administrators are asking all students with flu-like symptoms to stay home, there is no way to know for sure how many were or are infected.

Angelo emphasizes preventative measures as an under-utilized component to effective health care. He says owning and using a thermometer, practicing proper cough etiquette, proper and frequent hand washing and a healthy diet are the best defenses against the flu. Students are "more likely to own iPhones" than thermometers, he says. Though there is a new application for iPhone users to track infectious-disease outbreaks, "we don't send [preventative health] messages out until there's a panic," Angelo says.

For Angelo, the H1N1 threat illustrates why robust public health institutions are important. Services such as public health clinics and campus health services often serve as a safety net for those without insurance or access to regular check-ups or medical supervision.

Angelo says he was told that San Francisco State -- which has an enrollment of about 30,000 -- is expected to receive "2,000 doses or less" of the vaccine by the middle of this month. In a perfect world, the campus would have enough vaccinations for every student, faculty and staff member, but, Angelo asserts, "the college-aged population is generally the safest population." The vaccinations will be given on a first-come-first-served basis and Angelo is prepared for busy, long days when that happens.

Another large supply of vaccines is expected to ship out in January. Angelo hopes the worst is over by then, though it's too early to say. He will surely continue to promote preventative measures, though he's not kidding himself -- he's buckling down for a long and bitter flu season.