Swine Flu (H1N1/09)

Contact your Pediatrician to find out if taking Tamiflu (antiviral medicine) as a preventive measure would be appropriate. Tell them when and how she was exposed to the virus. Tamiflu can be given to children over one year old.

Contact your doctor to ask if you and other members of the household should also take precautionary antiviral medicine, especially if you have any family at high risk of complications from A-H1N1/09 "Swine Flu" [see related questions below]. Or if you should wait until/if she develops symptoms.

Monitor her closely for symptoms [see related question below], checking temperature regularly. Give plenty of fluids. Do not give aspirin as a fever reducer, use Acetaminophen (Tylenol) or other non-aspirin fever reducer.

According to the Centers for Disease Control and Prevention (CDC), "in children emergency warning signs that need urgent medical attention include:

* Fast breathing or trouble breathing

* Bluish skin color

* Not drinking enough fluids

* Not waking up or not interacting

* Being so irritable that the child does not want to be held

* Flu-like symptoms improve but then return with fever and worse cough

* Fever with a rash "

Take all precautions and inform all family members how to avoid catching the flu [see related question]. When you must be in close contact, especially if she is coughing and sneezing frequently, consider wearing an approved face mask (N95).

If she develops symptoms, high risk family members may need to go somewhere else while she is ill to avoid exposure. They should not provide her care and should try to stay in areas where she is not frequenting.

Use a disinfectant that includes influenza viruses on its label of pathogens on which it is effective. Follow label directions and use this disinfectant regularly around the house on things she touches and things the rest of the family frequently touch, such as table tops, door knobs, chairs, toys, etc. Teach them proper hand washing, and monitor that everyone is abiding by the guidelines with proper hygiene.

Protect yourself and other members of the family, if you must be in close contact such as during bathing, snuggling, or feeding, where she may cough or sneeze on you, you might want to wear a surgical mask (N95). Wash her hands often as well as yours and other members of the family.

Be familiar with all the potential symptoms, if she does develop symptoms, watch for signs of conditions that require immediate or emergency attention [see related questions below]. Monitor her temperature regularly. Do not give aspirin for fever, use another fever reducer, such as Acetaminophen (Tylenol). Provide plenty of liquids.

There are no statistics from either the Illinois Department of Public Health (IDPH) or from the McHenry County health statistics web page about the number of cases specific to that county. The IDPH site does have a map that shows McHenry County among the counties that have had have cases of swine flu confirmed, and it is shown among the counties that did not have associated deaths.

The total cumulative count of confirmed cases in Illinois is 405 as of August 28, 2009 with 17 deaths state wide.

Flu vaccination with a "dead"/inactivated vaccine is contraindicated in children younger than six months old due to their immature immune systems. People caring for these infants should receive an injection with the "dead" virus to vaccinate them and prevent their exposing the baby to the virus if they are infected.

The nasal mist vaccines that contain attenuated (weakened) live viruses are contraindicated in children under 2 years old.

See the related question below about others who should not receive a flu vaccination.

There are many different types of flu and the seasonal flu shot only prevents three of the most likely to be circulating flu viruses. So if you happened to get exposed to a type of flu that wasn't in the vaccination, then you could get sick from it.

Another reason might be that you caught the flu before you got the flu shot and so there was not time for the shot to work before you got sick.

Another reason might be that you got the shot and then were exposed to the flu before your immune system could give you immunity from the vaccination. It takes around two weeks after getting the vaccination for an adult to have full immunity from it. For children under 10, a series of two vaccinations are needed given approximately a month apart, then it takes another few weeks before the body has developed the full immunity, so exposure during any of those time frames before full immunity can cause illness in those children.

Influenzavirus A, Group v virus, Orthomyxoviridae, an RNA virus. Specifically:

• Order: Mononegavirales
• Family: Orthomyxoviridae
• Genus/Genera: Influenzavirus A
• Species/Type: Influenza A virus

See the related questions for more details.
Orthomyxovididae = influenza viruses

Symptoms of H1N1/09 (Pandemic swine flu):

Having a single one of these symptoms does not mean you have pandemic swine flu, but, you don't need to have all of these symptoms to suspect infection, either. The symptoms of swine flu in people are similar to the symptoms of regular human seasonal influenza. Watch for some combination of the following symptoms:

1. Fever of 101°F (41°C) or higher
2. Coughing
3. Headache
4. Sneezing
5. Body Aches
6. Fatigue
7. Dizziness
8. Chest pain
9. Abdominal pain
10. Shortness of breath
11. Malaise
12. Runny Nose
13. Sore throat
14. Vomiting
15. Diarrhea
16. Rigors (chills or shivers)

Caution: If you suspect that you might have a flu infection, consult a physician as soon as possible. Don't wait!

It is important for people who have chronic health conditions, women who are pregnant, and people with other high risk factors to pay special attention to warning signs. Influenza can make the symptoms, of other chronic medical conditions, worse

For Children: who may need urgent medical attention, symptoms include:

• fast breathing or trouble breathing;
• blueish or gray skin color;
• not drinking enough fluids;
• severe, persistent vomiting;
• not waking up or not interacting;
• being so irritable that the child doesn't want to be held;
• flu-like symptoms, after improving, return later with greater intensity.

These are warning signs that physicians think about all the time with respiratory infections and are good things for parents to have in mind at all times but especially with the Novel H1N1 strain.

For Adults: who may need urgent medical attention, symptoms include:

• difficulty breathing or shortness of breath;
• pain or pressure in the chest or abdomen;
• sudden dizziness, confusion;
• persistent or severe vomiting that doesn't go away;
• and flu-like symptoms that improve, but then come back again with a fever or worsening of cough.

Other underlying medical conditions* can create the potential for more severe illness, and it is for that reason that people who have these underlying conditions, or the family members who care for such people, need to remain vigilant about these warning signs emerging. For a list of the those at most risk of the swine flu and of complications due to it, see below.

It's often best to contact a health care provider for advice before going to an office or care center and waiting for an appointment. That's also a better strategy than going to an emergency room, but these warning signs can help people differentiate a cough or cold or respiratory symptoms without warning signs, from the type of signs that might lead you to want to get help from a medical provider urgently.

To prevent catching swine flu, colds or other strains of flu and viruses:

If you live with or care for someone known to have the swine flu virus, you should assume that you, too, can spread the disease. Wear a surgical face mask (model N95) while contacting and tending to someone with a virus, especially children, in case they cough or sneeze when you are close to them. Wash hands always before you touch your face, nose, eyes and mouth and before (as well as after) you touch other people's faces, mucous tissue. You should also wash your hands after you cough or sneeze and always use a tissue to cover your mouth and nose. Immediately throw the tissue away after one use. Wash your hands after touching used tissues. Cough into your elbow if you do not have a tissue. Don't use your bare hand unless you wash hands immediately after and before you touch anything or anyone.

To prevent spreading swine flu, colds or other strains of flu and viruses:

Even if you do not yet have symptoms, you can have the virus and spread it before you know you have it for one or two days after catching the flu. When you know you have been exposed, or when you know the risk is high for catching it, wash hands very frequently.

Stay home from work or errands when sick, and keep your kids home if they or others in your family have any symptoms. The schools will recommend if it is safe for your children to attend school if there are other children from the school infected. Be prepared with day care alternatives if the schools announce a closure. Flu virus can live for approximately two hours on hard surfaces, perhaps longer on moist or soft materials. Use disinfectants recommended for control of viruses on surfaces that are commonly touched, such as telephones, door knobs, light switches, TV remote controllers, chair arms, public pens and pencils (take your own), and grocery cart handles, as well as the lavatory knobs, handles, and surfaces.

Remember:

1. Wash hands very frequently and be alert to what you touch with them.
2. Cover your mouth and nose with a tissue when sneezing and or coughing.
3. Stay away from large groups of people and around 6.
4. Don't touch your eyes nose or mouth without washing hands first.
5. Stay home when sick so other people don't get it.

For additional information on preventing exposure to and distribution of the flu viruses, see the related questions below.

*Underlying Medical Conditions or Other Factors That Create Higher Risk:

• children younger than 5 years old;
• persons aged 65 years or older;
• children and adolescents (younger than 18 years) who are receiving long-term aspirin therapy and who might be at risk for experiencing Reye syndrome after influenza virus infections;
• pregnant women;
• adults and children who have pulmonary disorders (including asthma, for example) or who have cardiovascular, hepatic, hematological, neurologic, neuromuscular, or metabolic disorders (such as diabetes);
• adults and children who have immunosuppression (including immunosuppression caused by medications like steroids and post-transplant drugs, or caused by HIV/AIDS), and;
• residents of nursing homes and other chronic-care facilities.
• people who are morbidly obese (see related question: Is obesity a risk factor for morbidity and mortality with Novel H1N1 - Swine Flu?)

Information for those in the UK, from NHS:

A doctor faced with a symptomatic patient cannot yet predict with certainty the course of their illness and whether or not they will be in the small proportion who may become more seriously ill. This is why antiviral medication is still being given to all those with swine flu in the UK, subject to their doctor's discretion. A doctor faced with a symptomatic patient cannot yet predict with certainty the course of their illness and whether or not they will be in the small proportion who may become more seriously ill. This is why antiviral medication is still being given to all those with swine flu in the UK, subject to their doctor's discretion.

More information taken from the NHS website:

It is important that as swine flu spreads, you know the symptoms of the disease so you can recognise it in yourself and others at an early stage.

Please read the information about the swine flu on the NHS website and consider your symptoms carefully before using the National Pandemic Flu Service mentioned below.

During the pandemic in 2009, most swine flu cases were mild, with symptoms similar to those of seasonal flu. Only a small number of people had more serious symptoms.

If you or members of your family end up with a fever (high temperature over 38°C/100.4°F) along with two or more of the following symptoms, you may have swine flu:

• unusual tiredness,
• headache,
• runny nose,
• sore throat,
• shortness of breath or cough,
• loss of appetite,
• aching muscles,
• diarrhoea or vomiting.

Checking For Symptoms:

It makes sense to always have a working thermometer at home, as fever is one of the main signs of this and many other infectious diseases.

The NHS website provides a National Pandemic Flu Service#. If you are concerned you may have swine flu, stay at home and check your symptoms using the online guides at the pandemic flu service.

Call your GP directly if:

• you have a serious existing illness that weakens your immune system, such as cancer,
• you are pregnant,
• you have a sick child under one year old,
• your condition suddenly gets much worse, or
• your condition is still getting worse after seven days (five days for a child).

# Note: the National Pandemic Flu Service is a new online service that will assess your symptoms and, if needed, provide an authorisation number that can be used to collect antiviral medication from a local collection point. For those who do not have internet access, the same service can be accessed by telephone on:

• Telephone: 0800 151 3100
• Minicom: 0800 151 3200

For more information available on the National Pandemic Flu Service site go to Flu Service: Q&A.

High-risk groups:

For most people, swine flu is a mild illness. Some people get better by staying in bed, drinking plenty of water and taking over-the-counter flu medication.

However, some groups of people are more at risk of serious illness if they catch swine flu, and will need to start taking antiviral medication as soon as it is confirmed that they have the flu.

It is already known that you are particularly at risk if you have:

• chronic (long-term) lung disease,
• chronic heart disease,
• chronic kidney disease,
• chronic liver disease,
• chronic neurological disease (neurological disorders include motor neurone disease, multiple sclerosis and Parkinson's disease),
• immunosuppression (whether caused by disease or treatment)and/or
• diabetes mellitus.

Also at risk are:

• patients who have had drug treatment for asthma within the past three years,
• pregnant women,
• people aged 65 and older, and
• young children under five years old.

It is vital that people in these higher-risk groups who catch swine flu get antivirals and start taking them as soon as possible, preferrably within 48 hrs of first signs.

A couple different cold-weather factors contribute to there being just too much fluid for the nose to hold (gross, I know, but true).

First, because winter air tends to be very dry, the nose has to produce a lot of extra fluid to humidify it properly on its way to the lungs. Sometimes it makes so much that it runs right out the end of the nose.

What’s more, when that warm, moisturized air gets breathed back out into cold, dry surroundings, it condenses on the cold tip of the nose, adding even more fluid.