Only a couple of dozen suspected swine flu cases have been reported at St. Louis area colleges so far, but universities are on heightened alert.

St. Louis University has set up an off-campus "recovery center" where students who become sick with the H1N1 virus can be isolated from their roommates and other people in their residence halls.

Washington University plans to clean residence hall bathrooms more thoroughly and will ask sick students to wear a mask when leaving their rooms. The school has ordered 500 thermometers and is stock-piling Tamiflu. It also may have resident advisers deliver meals to sick students' rooms so they don't risk infecting other students in the cafeterias.

And Southern Illinois University Edwardsville is asking professors to be more lenient with class attendance policies and to put more class materials online so sick students can keep up with coursework.

Colleges and universities across the country are taking such actions because young people — between ages 5 and 24 — appear to be the most susceptible to swine flu and account for the largest percentage of illnesses to date.

Campuses have been planning for a heavier-than-normal flu season since the summer. They are asking students, staff and faculty who contract the flu to stay home.

The University of Missouri-Columbia had about 50 students who appear to have swine flu contact the student health center last week. The school has continued to field many calls and visits from newly infected students this week.

Washington U. didn't have any reported cases of H1N1 as of Thursday afternoon. But students who show up at the school's student health center with a cough or other flu-like symptom are immediately given a mask and taken to a special area where they are examined.

"We're being very conservative," said Dr. Alan Glass, director of the health center. "We're prepared for it. We certainly know it will come eventually."

Thus far, the swine flu is acting similar to the seasonal flu in terms of its contagiousness and severity. Most people who get it do not need treatment and do not become seriously ill. But like the seasonal flu, there have been deaths related to the swine flu. In most cases, the victims had underlying medical conditions.

Flu cases in Missouri hospitals doubled this week, state health officials said Thursday. Flu symptoms now account for about 4 percent of emergency room visits, compared with 2 percent on average. The spike is linked to the start of the school year, officials said, because young people in close contact can facilitate the spread of the virus.

A voluntary survey by the American College Health Association found about 1,640 reported swine flu cases at 165 colleges last week.

One of the challenges for college campuses is that many students come from far away — sometimes halfway around the world — to study. Students live on campus in crowded residence halls and eat at bustling cafeterias, making it difficult for them to "go home" and isolate themselves from others if they get sick.

That's why SLU is using part of a building it uses for retreats and overflow student housing as a place for students who become sick. Health personnel will staff the center 24 hours a day. A public safety official will also be on hand. One or two students have briefly stayed there so far.

Nearly all of the 24 SLU students suspected of having H1N1 have gone to their parents' homes to recover. One sick student is staying in a private room on campus, a university spokesman said.

Washington U. also has identified a number of empty residence hall rooms — including many on the same floor — for sick students if they have a roommate and need more seclusion.

MU has asked students to call the health center instead of just showing up if they are sick. Flu-stricken students could infect other students as they travel to the health center, said Christian Basi, a university spokesman. But the students with flu-like symptoms who do go there in person now have a separate waiting room so they don't expose other students to the illness.

The Columbia campus's dining services department has put together "get-well packs" with soup, crackers, clear soda, a fruit cup and granola bars that friends can pick up and take to sick students.

The school also is encouraging professors to use new technology that allows them to post their lectures online so students who fall ill can stay on top of their classes, Basi said.

Some universities are asking students to notify them so they can try to track how prevalent the illness is on campus. But MU is no longer counting the number of students who become sick, in part because many students will self-medicate or go to health clinics off-campus. Still, Basi said that staff in residence halls and professors of large lecture classes are monitoring the situation to see whether the school needs to take additional steps.

Many schools are putting up posters on campus urging students to wash their hands frequently and advising them on proper coughing etiquette — cough into a tissue, then throw the tissue away. Colleges are ordering more bottles of hand sanitizer to place in busy hallways, residence halls and computer labs. And they also are signing up to get the H1N1 vaccine when it becomes available in mid-October.

School officials are following recommendations of the federal Centers for Disease Control and Prevention, which suggests that students, faculty and staff stay home until 24 hours after the fever subsides without the use of medicine. The CDC also suggests that schools not require a doctor's note to confirm illnesses because doctor's offices may be busy and may not be testing for swine flu.

If the situation becomes more severe, the CDC recommends colleges consider taking more drastic measures such as suspending sporting events or canceling classes.

Donald McDonald, SIUE's director of emergency management and safety, said he wants college students, who do not traditionally get very sick during flu season, not to shrug off the heightened concerns this year.

"We're trying to tell them to take it more seriously and to follow safety precautions," he said. "But don't panic. It's one of those situations where we need to remain calm."

Blythe Bernhard of the Post-Dispatch contributed to this report.