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H1N1 Information for Families | H1N1 Flu Q&A | ER and Children with Flu Symptoms | H1N1 Flu (Swine Flu) Information
With flu season now underway, parents' concerns about H1N1 flu and the possible impact it may have on their children's health continue to rise. In this article, pediatric infectious disease expert Dr. Ina Stephens addresses some of the common questions surrounding H1N1 flu in an attempt to separate fact from fiction for concerned parents throughout the region.
What is the difference between H1N1 and the regular flu?
H1N1 is a form of regular flu. Influenza (the virus that causes the flu) mutates on a regular basis every year, and the H1N1 virus just mutated a bit more than usual. We call a minor mutation in the influenza virus a "drift" and the more major mutation, a "shift."
The H1N1 flu is no more severe than seasonal flu. About 95% of the people who get seasonal flu or H1N1 will develop a fever, in addition to a sore throat, congestion, runny nose, and cough. People can also develop muscle aches, which are a very common symptom of both seasonal flu and H1N1.
The biggest difference between H1N1 and the seasonal flu is that we're seeing a few more people (about one-third of those diagnosed) experiencing gastrointestinal side effects, including vomiting and diarrhea.
Why do children appear to be most susceptible to the H1N1 flu?
The younger population is more susceptible to the H1N1 virus because their immune systems do not recognize this virus. This virus has been around before, but most people who are younger than 50 have never been exposed to it. They have not had the chance to build an immunity against it, and that's why it has the potential to infect them.
Even though the seasonal flu virus changes and you need a flu vaccine every year, most individuals have some immunity against seasonal influenza, and a little protection is better than none. Most people, especially those younger than 50, have almost no immunity to the H1N1 virus at all.
Should my child get vaccinated?
Absolutely, I believe that children should get vaccinated. It's the only protection we have against this virus, and the vaccine is highly effective. We know that the H1N1 vaccine is a perfect match to the virus that is currently going around, and, after being vaccinated, most individuals develop a very robust immune response and are protected against this virus. It is absolutely a good thing to get vaccinated.
What forms of vaccination are available?
The two forms of vaccination that are available include the shot and the nasal spray. Both are very good vaccines.
You would not want to give FluMist to someone who is potentially immunocompromised, and, because it has not been studied in children under two years of age, those children have to receive the inactivated vaccine shot. The inactivated vaccine is approved for all children older than 6 months of age.
Children can get both the seasonal flu and H1N1 vaccine at the same time. These vaccines, if administered together, have to be given in separate sites on the child's body and cannot be combined into the same syringe. If the child does not receive both immunizations on the same day, and receives the live-attenuated nasal mist formulation, he or she will have to wait a period of 28 days before receiving the other vaccine to allow the body to develop an immune response to the first vaccine.
Are these vaccines safe for children?
The H1N1 virus is an influenza virus, and the way the H1N1 vaccine was made was identical to the way we have made seasonal flu vaccine for years and years.
We know that the seasonal flu vaccine is a very safe vaccine. There have been millions of individuals who have received this vaccine, including children. It's very safe. The H1N1 vaccine has been formulated in the exact same way, and in the vaccine trials that we have performed it has shown to be a very safe vaccine.
So, you might ask, "Why test the vaccine if it's just another seasonal flu vaccine?" The reason is that we wanted to test it to make sure that the dose was appropriate, the number of doses was appropriate, and that it would provide adequate immunity against the virus. We were not concerned that it was going to be unsafe.
How can my children avoid getting sick?
The vaccine is the number one way of preventing the flu. If you cannot get vaccinated for whatever reason, either the vaccine is not available or your child is ineligible to receive it, there are other preventative measures you can take.
First, vaccinate everyone around the child -- parents, siblings, family members, and other caregivers. Also, use precautionary measures such as washing your hands, not coughing in anybody's face, covering your face when you sneeze, and keeping a "social distance" of roughly three feet when conversing with other people if you believe you may be sick.
When should I treat my child at home? When should I go to the emergency room or consult a physician?
There are some warning signs to look for that will help you figure out whether you should take your child to the doctor. A child who develops any of these symptoms should be seen by a health care provider immediately:
On the other hand, a child who has a runny nose and congestion, has a little bit of a fever and muscle aches, you may give them Tylenol to bring the fever down (you can also use ibuprofen) and then see how they feel. Make sure that your child eating and drinking, at least drinking to stay hydrated, and if he or she is able to do that, you can stay home and continue to observe.
How do I know if my child has the common cold, seasonal flu, or H1N1?
The number one way to find out whether your child has the common cold, seasonal flu, or H1N1 flu is to get tested. The test is a nasal wash, like a swab, and it is the most accurate way of determining whether you have the flu or another common cold virus.
The other way you might figure it out is if you know what's going around. Because there are other viruses going around that share the same symptoms as the flu, you have to know what's going on in your community. If you know that the flu is going around your child's classroom, and your child starts coming down with flu-like symptoms, you can pretty much bet that's what he or she has.
What are some treatments for H1N1?
There are some antiviral treatments for H1N1. Tamiflu and Relenza are the two treatments that seem to work best against H1N1.
However, the recommendation is to give these antiviral treatments within the first 48 hours of getting sick. So, if your child has been sick for a week with the flu, these treatments are not going to work, and therefore should not be prescribed.
In addition, the Center for Disease Control (CDC) does not recommend that everyone be prescribed antiviral medication. Tamiflu and Relenza are recommended only for those individuals who may have a very difficult time with the flu -- individuals who may be immunocompromised as a result of age or other underlying health problems.
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