Many parents are looking for answers about the 2009-2010 flu season. What makes this flu season different is the emergence of the “swine flu” or H1N1 subtype of Influenza A. Because H1N1 is a novel strain of the flu, our population does not have herd immunity against the disease, resulting in widespread infection.
Influenza spreads primarily by person-to-person contact through the coughing or sneezing of infected people. The contagious period starts one day prior to the onset of symptoms and continues until the fever resolves. On average, a person with the flu is contagious for one week.
The most important aspect of infection control is prevention. Some simple measures include washing your hands, covering your mouth when you cough or sneeze, and staying home from work or school when you are ill.
Vaccines are the most effective public health tool for the prevention of influenza. This year there are two separate immunizations against the flu. Seasonal flu vaccine protects against several strains of Influenza A and B, but it does not provide protection against the H1N1 virus. The H1N1 vaccine is formulated like the traditional flu vaccine but only provides immunity to the H1N1 strain of Influenza A. Both types of flu vaccine are available in FluMist (nasal) or injectable form.
The seasonal flu vaccine is recommended for children age 6 months to 18 years of age, pregnant women, household contacts of children under 6 months of age, healthcare workers, anyone with certain medical conditions, and adults over age 50.
The H1N1 vaccine is recommended for persons ages 6 months to 24 years of age, pregnant women, healthcare workers, household contacts of children below the age of 6 months, adults over age 65, and other adults who have certain medical conditions. The first time that a child below the age of 9 years receives a flu vaccine, he or she will need to receive two doses of the vaccine given 1 month apart. The studies on the H1N1 vaccine show that the children below the age of 9 years also required 2 doses of the H1N1 vaccine in order to obtain an adequate immune response.
Symptoms of influenza include fever, chills, headache, sore throat, cough, runny nose, vomiting, and diarrhea. The fever associated with the flu can be as high as 102-105F and can last between 2-5 days. Because influenza is a virus, antibiotics are not used for treatment.
There are antiviral medications that are available for treatment of influenza; however, antiviral medications are not “miracle drugs” and are not recommended as part of the treatment in an otherwise healthy person. The use of antiviral medications is only recommended in certain “high risk” patients, which include very young children, persons with chronic medical problems such as asthma, adults over age 65 years, and pregnant women. In fact, lastest epidemiological studies of patients who have been hospitalized due to H1N1 have shown that the use of antiviral medications did not change the patients’ outcomes. Therefore, the majority of patients who are diagnosed with the flu will be given the advice to take Tylenol or Motrin for fever, stay well-hydrated, and rest.
Despite all of this reassurance, there is still the fact that influenza does cause severe illness in some cases that can lead to hospitalization or even death. For this reason, parents should be aware of “red flag” warning signs that would indicate the need to seek medical treatment. These signs include rapid breathing or difficulty breathing, fever for longer than 3 days, irritability, lethargy, rash, dizziness or confusion, dehydration, or vomiting. It is also concerning when a new fever or worsening cough develops after the initial flu-like symptoms have resolved.
In summary, the emphasis for this year’s flu season is on prevention. For more information, visit cdc.gov or consult with your healthcare provider.Have a question for Dr. Patt? Ask it in the comment field and she'll try to answer it in a future column.