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Treating a Child With Swine Flu

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

What can a child’s temperature tell us about whether they need to see a doctor?

“Any child less than the age of 2 [months] or 3 months should definitely always be checked out with a fever," O'Donnell says. "If a child has symptoms over age 2, they don’t necessarily need to come in. If the child has other medical problems, such as having a heart condition, a lung condition, bad asthma, even if those children just have mild symptoms, they probably should be brought in. This includes children [with a weakened immune system.]"

Paul Spearman, MD, pediatric infection disease specialist and vice chairman of research at the Emory University School of Medicine department of pediatrics, also tells WebMD,  "We use a cutoff of 100.8.

"That would be a cause for concern, along with lethargy. In an older child there is no cutoff. I usually use [a temperature of] 101, but that doesn’t mean one needs to go to an ER with that. They certainly don’t. What should be said right now is, ‘don’t panic.’ Keep up with the news."

What swine flu treatments are available for children?

"We already know this virus is susceptible to antiviral medication like Tamiflu and Relenza," Bocchini says. "Those drugs are in adequate supply. ... Early treatment with Tamiflu is remarkable. Relenza is not for young children."

When pediatricians believe a child has the flu, CDC guidelines suggest that they immediately offer Tamiflu to children under age 2 and to children of any age with chronic medical conditions such as asthma, diabetes, heart disease, or neurologic conditions.

Healthy kids 2 years old and older don't necessarily need treatment with antiviral drugs. The CDC guidelines advise doctors to use their clinical judgment to guide treatment decisions. But prompt antiviral treatment is recommended for any child with suspected flu and lower respiratory symptoms -- or for any child whose flu is getting worse instead of better. Antibiotics should be started if the doctor suspects the child also has a bacterial infection.

 Tamiflu is most effective when given within 48 hours of flu symptoms. However, hospitalized patients do better even when treated more than 48 hours after symptoms start. The CDC says its very likely that other patients benefit from treatment more than 48 hours after symptoms appear -- especially those with risk factors for severe disease.

What can you do for your children if they do get the flu?

“Children with influenza should not get any product that contains aspirin," Bocchini says. "We don’t recommend aspirin for children anymore. Make sure it’s not in any medicines they are given. Tylenol, ibuprofen compounds are fine.”

How should I care for a child with the flu?

To help guide parents, the CDC has posted tips on caring for a child with flu-like symptoms:

  • Keep the child at home. Don't let him go to school or day care for 10 days after the onset of symptoms.
  • Keep the sick child away from other people as much as possible.
  • If the child has underlying health problems, see a doctor when symptoms start.
  • If the child is otherwise healthy, call a doctor to see if an appointment is needed.
  • When holding small children who are sick, place their chin on your shoulder so that they will not cough in your face.
  • If the child has severe symptoms, has been to an area where there have been cases of swine flu, or has been directly exposed to a swine flu patient, see a doctor.
  • Wash your hands with soap and water often, or use an alcohol-based hand gel if soap is not available.
  • Keep surfaces (including toys and bedside tables) clean -- wipe them down with a household disinfectant.
  • Wash bed sheets and towels with laundry detergent in hot water. Avoid "hugging" the dirty laundry on the way to the washing machine, and wash your hands right after handling dirty laundry.

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

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Reviewed on November 17, 2009

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