Swine flu will undoubtedly be back in the news this fall and winter as school starts up again and children are cooped up indoors breathing and coughing on one another. According to the Associated Press, Georgia Tech has reported 150 suspected cases and the University of Kansas 200 suspected cases in just the last two weeks since re-opening their campuses. If college campuses are any indication of what will be occurring in grammar and high schools across the nation, there will be a lot of concern both on the part of parents and school officials once doors open.
Luckily there will be a vaccine available. The bad news is that it will most likely not be ready for distribution until October. In addition, it seems that, at least initially, there will be significantly less doses available than anticipated. Hopefully though with a steady stream of vaccine production through the fall there will be enough available for all who would like to be vaccinated.
As the virus has been found to be more dangerous to pregnant women and children, these will be the first target populations for vaccination. Pregnant women should be vaccinated as soon as possible as they are at increased risk of complications due to their reduced lung capacity and altered immune system. Family members of children less than 6 months of age should also be vaccinated early in order to reduce the likelihood that they will bring the virus home to their unvaccinated infant. Children older than 6 months can be vaccinated and should start the two shot series as soon as it is available.
Both children and adults will need two doses of the vaccine spaced 3 weeks apart. This is in addition to the regular seasonal flu vaccine. It is thought that both the H1N1 and seasonal flu vaccine will be able to be given on the same day and that there will be thermisol-free versions of both. Parents of children over 2 years of age should discuss with their child's pediatrician if FluMist (the nasal spray version of the seasonal flu vaccine) is appropriate for their child as it could decrease the number of shots needed this flu season. A nasal spray version of the H1N1 vaccine should also be available and may make both seasonal and H1N1 vaccination relatively painless.
Vaccination is the best defense against this new flu strain; however, there will undoubtedly be numerous reports of the virus sweeping through schools within weeks of them opening their doors. This is because unlike the seasonal flu, H1N1 has remained fairly prevalent throughout the summer months.
It will be more important than usual to encourage your children to wash their hands. Since most children don't do this, try buying them an alcohol based cleanser that can be clipped to their backpack where they will see it and hopefully be more likely to use it. Start reminding them now in the week or two before school starts to wash their hands, or use a cleanser, in the hopes that they will continue the behavior when you are not around and able to prompt them. Also encourage them not to rub their eyes, nose and mouth. If they have asthma make sure it stays well controlled and if it is not well controlled call your child's doctor to talk about changing your child's treatment regimen.
Most importantly, allow your children to stay home when they are sick. This cannot be stressed enough. Children should not go to school if they are ill. Most schools will have a stricter policy this year of not allowing sick children to attend class and many schools will have a quarantine room for sick children awaiting pick-up by their parents.
Although there have been a few instances of resistant H1N1 most cases respond to anti-viral treatment. Treatment is most effective if started within the first 48 hours of symptoms. In the case of pregnant women, due to their high rate of complications and mortality, it is recommended that treatment be started as soon as H1N1 is suspected and even before confirmatory tests are completed. Symptoms of H1N1 are fever, cough, sore throat, runny nose, body aches, fatigue, chills and vomiting. The following is an excerpt from the Center for Disease Control's website:
"In children, emergency warning signs that need urgent medical attention include:
Fast breathing or trouble breathing
Bluish or gray skin color
Not drinking enough fluids
Severe or persistent vomiting
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"
Most children who contract H1N1 recover just fine but parents should not be complacent this year. There have been over a hundred pediatric deaths in the US since the start of the swine flu outbreak last September. If your child seems ill with a fever and cough, bring him to the doctor as soon as possible so that if H1N1 is suspected an antiviral can be started early.