It's that time again, when universities throw open their doors to a new intake of students, then deal with the fallout when large numbers of that intake fall victim to "freshers' flu", a catch-all term for a catalogue of symptoms that trail in the wake of late nights, overindulgence, and a deep-fried diet.
It's pretty well accepted that the first term in higher education is unlikely to be the healthiest three months of your life. And this year (needless to say), freshers face a whole new threat to the student body. Swine flu has been hogging the headlines all summer, and most informed opinion has it that autumn, the start of the traditional flu season, will see a marked resurgence.
It's also possible that an upswing in swine flu cases will be sharpest on campus, where large groups of people will mingle, party hard (at least for the first few weeks of term), and adopt lifestyles that don't always tally with the latest Government pamphlet on sensible drinking or optimum nutrition. And indications are that, after young children and pregnant women, young adults are more susceptible to swine flu than most.
The reaction of universities to all this is one of calm preparedness, they say. "Universities are places where many people come and go, and also gather in large numbers, and we are experienced in handling health issues that occur," says Professor Michael Farthing, incoming chairman of Universities UK's health and social care policy committee. "We are working closely with local authorities, NHS organisations and the Health Protection Agency to ensure that each institution is able to respond appropriately."
James Forshaw, a member of the welfare team at Liverpool John Moores University, agrees that, for both institutions and their potential students, there's no cause for alarm. "There's no panic and it's business as usual," he says. "The best advice we can give students is to encourage them to register with a GP when they get here and before they catch any kind of illness. We'd be saying that anyway, but the message is reinforced by swine flu."
Though there are no plans in place to restrict campus life, many universities are preparing for a worst-case scenario, with potentially thousands of new cases in September and October. That could mean flu-buddying schemes, an expansion of online lectures that students can watch or hear at home, and even the temporary closure of departments. A spokeswoman for the University of East Anglia says that quarantine procedures for infected students were already in place.
Reassuringly, however, universities may be uniquely well placed to deal with a swine flu outbreak. "We have been through every scenario that we can envisage, and planned for them all," says Dr Susan Robson, a consultant occupational health physician at Manchester University.
"And of course we've had a meningitis contingency plan for years. We've had flu pandemic plans since the first suggestions of avian flu five or six years ago. We've always been in a position where we recognise that outbreaks can happen among a large student population, and we've always planned for them."
Ann Musk, a team manager for the student welfare service at Newcastle University, agrees. "Universities have had to deal with mumps and meningitis, and plan for bird flu. We think about things like this all the time. At Newcastle, we're already planning to highlight the importance of looking after your flatmate. We'll encourage domestics in halls to keep an eye out for people who may be unwell. It's all the things we'd be doing anyway, but with added emphasis."
Universities already invest a great deal of time and energy into trying to educate new students in the importance of a healthy(ish) lifestyle.
In Newcastle, minibuses full of freshers are taken on tours that include the locations of cheaper out-of-town supermarkets and local sports centres. All universities organise welfare talks and run campaigns, often in conjunction with the students' union, on subjects like healthy eating, sensible drinking or safe sex. With the arrival of swine flu, many of these activities will be stepped up, in recognition that the most basic health advice – washing your hands after coughing or sneezing, eating healthily and so on – is the best defence against the catalogue of recurring minor ailments that make up freshers' flu, and the risk of swine flu.
In the vast majority of cases, swine flu requires nothing more than paracetemol, plenty of fluids and a few days in bed, especially for robust young adults without underlying health problems. "Any students worrying about coming to university who do have an underlying health issue should know they will get the vaccine as soon as it's available," says Robson. "And eventually the vaccine will be available to all students."
Why do so many freshers get ill?
'It's quite common in the first term to get recurrent minor illnesses'
First-year students fall ill in large numbers because they gather together in large groups, overindulge, fail to eat a nutritious diet and don't get enough sleep. Mix in a bit of stress and anxiety, and you have the perfect recipe for a bout of freshers' flu.
But freshers' flu is not, actually, flu. "It really isn't like flu at all," says Dr Deborah Smith, a GP at Leeds Student Medical Practice. "It's quite common in the first term at university to get recurrent minor illnesses, and that usually means colds and upper respiratory tract infections. When young people are mixing for the first time with others from around the country and around the world, there can be a lot of minor viral illnesses going around."
Stress can exacerbate physical symptoms. "By the end of freshers' week, many of the new intake will be physically quite worn out," says Smith. "On top of that, they've had the stress of having to live away from family for the first time, maybe living in a big city for the first time, and fitting in with a new peer group. It all adds to the mix of things that can cause illness."
Dr Susan Robson, a consultant occupational health physician at Manchester University, thinks freshers may be under more pressure to overindulge. "New students are going to push the boundaries. But I do think the drinking culture is different today, and other excesses are more freely available," she says.
But she adds most new students learn to find the right balance quite quickly, while Smith thinks freshers' week can actually be quite useful. "It's a kind of cut-off point. You do a lot of socialising, then it finishes and most students know then they also have to get down to some work."
How to stay healthy: a freshers' guide
'Have the odd alcohol-free day'
Before you go
Think prevention: go to your GP before leaving for college to check that your mumps and meningitis jabs are up to date. There’s no harm in having a booster.
Do the boring things
Freshers’ week is a whirlwind of social events, and all the better for it. But if you try and eat some fruit and veg, get some decent sleep and have the odd alcohol-free day, you’ll have some energy left at the end.
Stress can be a major factor in freshers’ flu, but you’ll feel much more relaxed if you get organised early. By which we mean, go to some of those introductory talks on welfare, register with a GP, plan a budget, and read that pre-arrival bumf. Some of it is really quite useful.
It’s true in every walk of life that the poorer you are, the less healthy you tend to be. So make a budget early, and stick to it. Don’t blow a term’s worth of living allowance on a weeklong binge.
For the sake of yourself and the rest of the course, if you do come down with something curtail your fresher activity for a day or two and keep yourself to yourself. Unless it’s just a hangover, of course.