H1N1 - Swine Flu

Definition 

Swine Flu is a viral infection of the nose, throat, windpipe, and bronchi. The main symptoms are a cough, sore throat, runny nose and fever.  If you don’t have a fever, you don’t have Swine Flu. Usually there’s more muscle pain, headache, fever and chills than seen with the common cold.

Cause 

Flu is caused by the H1N1 virus.  It started in March 2009 and by June had spread to most of the world (a pandemic). After exposure (close contact), 20% of people come down with symptoms in 4 to 6 days. 

Diagnosis: How to know that your child has Swine Flu 

If Swine Flu is widespread in your community and your child has flu symptoms with a fever, then he or she probably has Swine Flu. You don’t need to get any special tests. You don’t need to call or see your child’s doctor, unless your child is HIGH-RISK (see 7) or develops a possible complication of the flu (see the “Call your child’s doctor” section).  

How to Treat Swine Flu 

The treatment of Swine Flu depends on your child's main symptoms. It’s no different from treating symptoms of the common cold. So far the rate of complications is no higher than with regular Seasonal Flu. Bed rest is not necessary. Antibiotics are not helpful. 

Give acetaminophen (Tylenol) or ibuprofen (Advil) for fever over 102°F (39°C) or for any pain. Children and adolescents who have influenza should never take aspirin. 

For children over age 6, give cough drops. If your child is over 1 year of age, give honey (1/2 to 1 teaspoon as needed). Never give honey to babies. If honey is not available, you can use corn syrup. Drugstore cough medicines are not as helpful as honey. Also, they are not approved for children under 4 years old (FDA). 

Tylenol or ibuprofen is very helpful for throat pain. Children over 6 years old can suck on hard candy. Children over 1 year old can sip warm chicken broth or other warm liquids.  

Saline (or warm-water) nose drops followed by suction (or nose blowing) will open most blocked noses. Use these “nasal washes” whenever your child can't breathe through the nose. You can buy saline spray without a prescription. Saline nose drops can also be made by adding 1/2 teaspoon (2 ml) of table salt to 1 cup (8 oz or 240 ml) of warm water. Use 2 or 3 drops at a time. 

Encourage your child to drink adequate fluids to prevent dehydration. 

The  CDC recommends antiviral medicines be prescribed for all HIGH-RISK children (see 7) who come down with Swine Flu symptoms OR live with someone who has Swine Flu. Most LOW-RISK children with Swine Flu do not need antiviral medicine unless they develop serious symptoms (such as pneumonia). Antiviral medicines must be started within 48 hours of the start of flu symptoms to have an effect. They usually reduce the time your child is sick by 1 or 2 days. They improve the symptoms but do not eliminate them. If you have other questions about antiviral medicine, talk with your healthcare provider. 

The following children are at higher risk for complications from Swine Flu:  lung disease (such as asthma), heart disease (such as a congenital heart disease), weak immune system (such as cancer), diabetes, sickle cell disease, kidney disease, diseases requiring long-term aspirin therapy, other chronic diseases, pregnant teens, or young children less than 2 years old. 

The fever lasts 2 to 3 days, the runny or stuffy nose 1 to 2 weeks, and the cough 2 to 3 weeks. Complications are uncommon.

Prevention of Swine Flu 

Swine Flu shots: When the Swine Flu vaccine becomes available, get it according to CDC guidelines.  The highest priorities are pregnant women and caregivers for babies.

Preventing Spread to Others: The virus is spread by sneezing, coughing, and hand contact. Cover the nose and mouth with a tissue when coughing or sneezing. Wash the hands frequently. Stay home when sick. Your child may return to child care or school after the fever is gone for at least 24 hours. (CDC)

 Call your child's doctor Now (night or day) if:

Your child looks or acts very sick

Breathing becomes difficult or fast or causes retractions (sucking in between the ribs)

Dehydration occurs (no urine in 12 hours, dry mouth, no tears)

Call your child's doctor during the day if:

Your think your child needs to be seen

Your child is in the HIGH RISK group and has flu symptoms

Earache or sinus pain occurs

Fever lasts more than 3 days

Cough lasts more than 3 weeks

Your child becomes worse

 Author: Barton D. Schmitt MD, Denver, CO. Copyright 2009. Revised 9-3-2009