News this month
Children among those most at risk for
complications from the H1N1 virus
Simple steps can
help kids ward off flu
There is no way to be completely protected from the H1N1 flu virus. But there are steps you can take to minimize the risk for you and your family. Getting the H1N1 flu shot will be the first line of defense when it becomes available in October 2009. And for children who are older than six months, and who are not allergic to eggs, getting the seasonal flu vaccine now is an important step.
As things stand now, the vast majority of children who develop flu-like symptoms will have a few miserable days, and nothing more. And those days are best spent at home, not in the ER or a doctor’s office. Most people should recover from the new H1N1 flu without needing medical care.
Those most vulnerable to H1N1 are children 12 and under, and young adults. So parents should pay attention to their symptoms closely. Parents of special-needs children should consult their pediatrician now to see what extra precautions might be needed.
There are several precautionary steps for families to take until the vaccine is available. These steps will help protect children from many respiratory viruses, not just the flu:
- Wash your child’s hands often with soap and water, especially after he or she coughs, sneezes or blows his or her nose. Alcohol-based hand rubs also work well.
- Teach your child to cover coughs into a tissue (or into his or her elbow or shoulder if a tissue is not available). Your child should learn to throw the tissue in the trash after use, and wash his or her hands.
- Keep your sick child at home until at least 24 hours after there is no longer a fever or signs of a fever (without the use of a fever-reducing medicine).
- Call the school or daycare to notify that your child has flu symptoms.
- Do not take your sick child to the mall, grocery store or any place where he or she might expose others to the flu.
- Do not give aspirin or aspirin-containing products to children 18 years of age and younger. This increases the risk of Reye syndrome.
- Children older than 6 months can take acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®) for relief of fever.
- Do not give over-the-counter cold medicines to children younger than 4 years of age.
A chronic illness (like asthma, diabetes, cystic fibrosis and others) can make your child’s flu symptoms more severe.
Call your pediatrician if your child’s flu symptoms get more severe, or if you are worried about your child’s illness. Call your doctor if your child is younger than 2 years and not drinking enough fluids.
If your child shows any of these warning signs below, seek emergency medical care:
- Fast breathing or trouble breathing
- Bluish or gray skin color
- Not waking up or not interacting
- Being so irritable that he or she does not want to be held
- Not urinating or no tears when crying
Dr. Santucci is chief of emergency medicine at Yale-New Haven Children’s Hospital and associate professor of pediatrics at Yale School of Medicine.
Fall 2009
H1N1, more commonly known as the swine flu, is a novel virus in the influenza A family. The wide range of symptoms can include fever, cough, sore throat, body ache, headache, nausea, chills and fatigue. Like seasonal flu, H1N1 may vary in severity from mild to severe. According to the U.S. Centers for Disease Control and Prevention (CDC), the H1N1 virus poses a particular risk to children, and those with high-risk medical conditions such as asthma, diabetes or neurological problems, who are at increased risk of influenza-related complications.
According to the CDC, nearly 500 Americans have died of complications from H1N1 since the virus first surfaced last spring, including at least 36 children. Of these children, about two thirds had at least one chronic high-risk neurological developmental condition, such as epilepsy, cerebral palsy or developmental delay. Additionally, bacterial infections, such as bacterial pneumonia, were contributing factors to an increased risk of death in children, including most children older than 5 who didn’t have a pre-existing high-risk medical condition. The CDC stated that this suggests that bacteria, in tandem with the H1N1 virus, can cause severe disease in children who may be otherwise healthy.
CDC officials have stressed that the death rates and complications from H1N1 in children are very similar to the rates seen in children sickened by the seasonal flu each year, with one exception: in past seasonal flu outbreaks, the children who died tended to be 5 years or younger. But since the H1N1 virus first surfaced in April, the death rates have been higher for children older than 5 years.
Since the emergence of H1N1, the federal government has been working with state and local leaders to plan for any eventuality. In June, the World Health Organization declared the outbreak to be a pandemic, but also noted that most illnesses were of moderate severity.
"Most people who have become ill with this new virus have recovered without requiring medical treatment," said a CDC official. "Illness with the new H1N1 virus has ranged from mild to severe. While most people who have been sick have recovered without needing medical treatment, hospitalizations and deaths from infection with this virus have occurred."
The CDC is recommending that all children age 6 months and older be vaccinated against the pandemic H1N1 flu virus, and that children should also be vaccinated for seasonal flu. Since children under the age of 5 are at particular risk for complications from the H1N1 virus, the CDC issued new guidelines designed to limit the spread of the virus in early childhood programs.
The CDC recommends that anyone with flu symptoms stay home and avoid going out in public as much as possible, at least until 24 hours after the fever is gone without the use of fever-reducing medications.
Two specialty programs at YNHCH — diabetes and endocrine disorders, and kidney disorders — have been recognized for their excellence in U.S. News Media Group's 2009 edition of "America's Best Children's Hospitals."
Find out more
For more information on this topic
- Yale-New Haven Children’s Hospital
- American Academy of Pediatrics
- Centers for Disease Control and Prevention
- World Health Organization
HealthLINK-Pediatrics archive