Dr. Tom Nary is the director of health services at Boston College.

AUDIE CORNISH, HOST:

As college students return to class from winter break, campuses around the country are bracing for outbreaks of the flu. It's already been a bad flu season, as we've been reporting. And now, there is special concern in Boston, where the mayor has already declared a health emergency and the student population is large.

NPR's Tovia Smith has that story.

TOVIA SMITH, BYLINE: Healthy 20-year-olds are hardly the type you'd consider most vulnerable to the flu in normal circumstances.

(SOUNDBITE OF CROWD)

SMITH: But living 40 to a bathroom, for example, is not quite normal circumstances.

DEREK HOUSEKNECH: Like, when you are in a dorm, it's just kind of...

(LAUGHTER)

HOUSEKNECH: It's pretty gross to think about.

LINDSEY CELLER: I actually think it's a germ-fest - disgusting.

SMITH: Students like Boston College freshman Lindsey Cellar, senior Derek Houseknech, and senior Mike Judd, say things can get even worse, after-hours.

MIKE JUDD: Yeah. Oh, yeah. People are grimy. I mean like, if you're at a party, like playing beer pong and stuff, people are going to be sharing cups. Plus, people are making out and passing germs left and right, all over the place.

SMITH: It all becomes a perfect storm for a flu outbreak when you also consider that young people are among the least likely to worry about getting the flu or getting the flu shot.

UNIDENTIFIED WOMAN #1: I didn't get it.

SMITH: Better things to do?

UNIDENTIFIED WOMAN #1: Yeah, not a priority.

SMITH: Well, I just have never got the flu before, so why am I going to get it this year? You know? I mean what's the worst? You get the flu and it goes away in like two days, right?

DR. TOM NARY: There's a "what, me worry?"

SMITH: BC's director of health services, Dr. Tom Nary, says colleges learned a lot from the H1N1 pandemic a few years ago about what they need to do. For example, moving sick students out of dorms and urging everyone to get the vaccine. BC emailed students over the break, imploring them not to leave home without it. Shots are also free on campus now, but so far...

NARY: It just hasn't been as busy or overwhelming as we might have expected.

UNIDENTIFIED WOMAN #2: OK. All right, so how about the left arm?

KARINA DORENTES: Perfect.

UNIDENTIFIED WOMAN #2: Just relax.

SMITH: Senior Karina Dorentes says her mom made her promise to get a shot after they couldn't find one at home in Maryland.

UNIDENTIFIED WOMAN #2: Ready 1, 2, 3, a little pinch. All set.

SMITH: Dorentes says she learned her lesson last semester.

DORENTES: I was actually really sick. I got the fever and I was living off of Advil, studying up until like three or four or five in the morning. It was just terrible and that's why I was - I really need to get this.

SMITH: Boston College is also wiping down doorknobs and banisters. Posters remind students to cough into their sleeves with all-too-vivid photos of what bursts out with a cough. No one aspires to totally prevent the flu. Rather, as the chief of medicine Howard Heller, across town at MIT, puts it, it's all about minimizing the severity.

HOWARD HELLER: We set our goals realistically. So, you know, if we go through a flu season and nobody has been hospitalized, that's great.

SMITH: MIT gave out a record 9,000 flu shots before winter break, through a kind of MASH unit set up in the student center.

HELLER: It is a military-style operation that was a dozen or more nurses and doctors just nonstop for hours giving thousands in two days.

SMITH: On campuses, it may turn out that this year's early onset of the flu helps more than it hurts. Colleges have had weeks to prepare while students were away and may have missed the worst of it.

Craig Roberts is an epidemiologist at the University of Wisconsin, Madison and with the American College Health Association.

CRAIG ROBERTS: Certainly on college campuses we're preparing for another wave, in the sense that people are returning to their schools infectious. But it's also possible that all these students got sick over break and they're better now.

(SOUNDBITE OF COUGHING)

SMITH: Back at BC, a student using a public computer in the library coughs, not into her sleeve.

BC seniors Mike Judd and Mike McCarter say students are not always the most responsible. And when feeling under the weather, they may be reluctant to skip a class or a party.

JUDD: People are so afraid to miss a Friday night that they don't realize that they might be passing it along to 30 other people at the same party.

MIKE MCCARTER: We have to take advantage of all our weekends. You know?

SMITH: Thank you for sharing. I'm not shaking your hands.

MCCARTER: All right, you're welcome.

JUDD: Yeah.

SMITH: I'm not shaking your hands.

(LAUGHTER)

SMITH: Tovia Smith, NPR News, Boston.

MCCARTER: I just sneezed anyway.

(SOUNDBITE OF MUSIC)

ROBERT SIEGEL, HOST:

This is NPR News. Transcript provided by NPR, Copyright NPR.