Swine Flu Prevention: Tips for Parents

WebMD talks to pediatricians for answers to common questions parents have about swine flu.

From the WebMD Archives

"How do I protect my child?" That's the No. 1 question parents have when it comes to swine flu.

To help guide parents, WebMD turned to three pediatricians for answers to common questions about swine flu. Are some children more at risk than others? Should you take your kids out of school if there are cases of swine flu in your town? What are the symptoms of swine flu in children?

Here's what they had to say.

What should parents do to protect their children from swine flu?

"Be vigilant, and watch your children closely," says Joseph Bocchini, MD, chairman of the American Academy of Pediatrics Committee on Infectious Disease. Bocchini is also chairman of the department of pediatrics at Louisiana State University. "Follow the usual recommended procedures for reducing risk of transmission of infection. That means frequent hand-washing. Avoid large crowds. Avoid direct contact with sick individuals. If sick, children should stay home. So should parents." And have your children vaccinated.

What if you’re out, at work, or at a playground?

"If you are out in public and someone has a cough, you should stay away from that individual," Bocchini says. And people should cover their mouth and nose when they cough or sneeze. Wash your hands or use alcohol based hand sanitizers frequently. Avoid touching your face with your hands.

How do you know whether to be concerned in your own area?

While the CDC and AAP web sites will track national flu trends, it's up to state and local health departments to monitor flu in your community. It's important to pay attention to local media and to your local health department's web site. If you haven't done so already, teach your children how to wash their hands thoroughly and often -- and teach them to cough and sneeze into their elbow, not onto their hands.

It's always a good idea to keep children away from sick people. And if you learn that flu has become widespread in your community, you may wish to keep your child away from crowds or crowded situations -- especially if the child is under age 5 or if a child of any age has asthma or a chronic medical condition that increases risk of severe flu disease.

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What’s the most important thing parents should do now?

"Follow the usual precautions. Start thinking about what you would do if the child’s school or day care center is shut down," Bocchini says. "Think about what arrangements you would make to be able to stay home with children. That may mean you need to stock up on supplies, food, and make arrangements for child care. Parents should start thinking about this now."

What advice do you have for parents with children in school?

"We know that right now we don’t have to close schools and stop movies and do other things to prevent infection except in those areas where cases have been reported. Based on finding of the virus in a certain areas, authorities may close day care centers and public events. But parents should not take children out of day care or school unless the public health authorities have recommended such a step," he says.

In situations like this, sometimes mass hysteria sets in and people overreact. What can be done about this?

"Just be aware of what’s going on in your area. You are always going to get some people who will become hysterical, withdraw their kids from school," Bocchini says. "But that is not necessary at this point. Follow recommendations of public health authorities. This is where leadership is very important. Leaders should let people know that this is serious, but not to overreact, and do what they should do, based on public health recommendations."

What if your child gets sick? What are symptoms of swine flu in children?

"Influenza is very different from the common cold. Classically, with influenza, children have sudden onset of significant fever with respiratory symptoms. High fever, chills. Older children will complain of headache, scratchy sore throat, and muscle aches. Children will develop a nasal congestion and cough."

Is swine flu easier to detect in young children and teens?

"Yes," says Bocchini. "An infant can’t describe his symptoms and may have more nonspecific symptoms. If they have a fever, we want to see them."

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Can my pediatrician tell me for sure whether my child has H1N1 swine flu?

Not right away. There are rapid tests that can identify type A flu in about 30 minutes. But these rapid tests can't tell H1N1 swine flu from seasonal H1N1 flu or from seasonal H3N2 flu. And the test is not very sensitive. That means a negative test does not mean a child does not have the flu. For this reason, many doctors chose not to offer the rapid test.

Lab tests can identify H1N1 swine flu, but not in time to get a definitive diagnosis in time to begin antiviral treatment. Health departments are no longer testing specimens unless they come from people with serious flu illness, although some private labs can do the tests.

Is flu more dangerous for very young children?

"Yes. Children under 2 have a higher risk of complications. Seasonal influenza is associated with a significant risk of hospitalization in children 2 and under. Children under 2 have a similar hospitalization rate similar to adults over 65," he says.

Are some children more at risk of getting very sick?

"Yes. Children who have an underlying disorder, including asthma, diabetes, another metabolic disease, children with chronic kidney disease, sickle cell disease."

What about the seasonal flu shot? Can it protect you from swine flu?

For the 2010-2011 flu season, the regular flu vaccine will contain the 2009 H1N1 flu vaccine (as well as vaccine against the older H3N2 type A and type B flu bugs). The regular seasonal flu shot protects against seasonal flu. Kids up to age 9 need two shots or sniffs of vaccine, given four weeks apart, if they've never had a flu shot before. The CDC recommends that all persons aged 6 months or older should get a flu vaccination every year.

WebMD senior writer Daniel J. DeNoon contributed to this report.

WebMD Feature Reviewed by Louise Chang, MD on 0/, 010

Sources

SOURCES:

Joseph Bocchini, MD, chairman, American Academy of Pediatrics Committee on Infectious Disease, Shreveport, La.; chairman, department of pediatrics, Louisiana State University.

Heather O’Donnell, MD, MSc, department of pediatrics, Albert Einstein College of Medicine, the Children’s Hospital at Montefiore, Bronx, N.Y.

Paul Spearman, MD, pediatric infection disease specialist, vice chairman of research, Emory University School of Medicine, department of pediatrics, Atlanta.

CDC: "Interim Guidance for Clinicians on the Prevention and Treatment of Swine-Origin Influenza Virus Infection in Young Children."

CDC: "Interim Guidance for Swine influenza A (H1N1): Taking Care of a Sick Person in Your Home."

News release: FDA.

CDC: "Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010."

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