Today at football practice we learned that one of the teenage boys that coach my boys’ fifth grade team tested positive for novel H1N1 swine flu. We heard so much about swine flu, but it puts things in a different perspective when the boy passing the football with my son less than 48 hours ago is now in isolation at the hospital.
What does this mean for him, my sons and their teammates?
The first is don’t panic! We’ve heard so much from the media but the reality is this strain of virus is typically mild and will resolve on its own. The seasonal flu still kills 30,000 people a year but most of those are elderly. Novel H1N1 swine flu has killed younger people but only 477 total deaths as of the latest account.
What is swine flu?
Now called novel H1N1, it is a respiratory illness, not a food-borne illness. It is OK to eat cooked pork. Swine flu is a strain of Influenza that is thought to spread mainly person-to-person through coughing or sneezing of infected people. In addition, people may become infected by touching something with flu viruses on it and then touching their mouth or nose.
What are the symptoms of H1N1 swine flu?
The symptoms of swine flu are similar to the symptoms of regular human seasonal influenza and include FEVER over 102 degrees, lethargy, lack of appetite, and coughing. Some people with swine flu also have reported runny nose, sore throat, nausea, vomiting and diarrhea. Fever and muscle aches differentiate it from seasonal allergies.
How long is it transmittable?
The infectious period for a confirmed case of swine influenza A (H1N1) virus infection is defined as 1 day prior to the case’s illness onset to seven days after onset.
What should I do now that my son has been exposed?
I spoke with the children’s hospital and according to the CDC they are not testing for H1N1 unless the person is sick enough to require hospitalization.
So who needs hospitalization?
The CDC recommends If you become ill and experience any of the following warning signs, seek emergency medical care. 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
In adults, emergency warning signs that need urgent medical attention include:
• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting
• Flu-like symptoms improve but then return with fever and worse cough
Talk to your doctor if you experience any symptoms or are not sure what to do.
Who needs antivirals?
We have medicine to shorten the duration and severity of the illness. They are Tamiflu (oseltamivir phosphate) and Relenza (zanamivir) and are most effective if started within 36 hours of symptoms. The CDC does not want everyone with exposure or symptoms to take them since the virus may mutate and the medication won’t be effective.
Regarding who should take the anti-virals, the CDC recommends the following:
• High-risk groups: A person who is at high-risk for complications of novel influenza (H1N1) virus infection is defined as the same for seasonal influenza at this time. As more epidemiologic and clinical data become available, these risk groups might be revised.
• Children younger than 5 years old. The risk for severe complications from seasonal influenza is highest among children younger than 2 years old.
• Adults 65 years of age and older.
• Persons with the following conditions:
o Chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological (including sickle cell disease), neurologic, neuromuscular, or metabolic disorders (including diabetes mellitus)
o Immunosuppression, including that caused by medications or by HIV
o Pregnant women
o Persons younger than 19 years of age who are receiving long-term aspirin therapy
o Residents of nursing homes and other chronic-care facilities
So what should I do with my sons? Prevention is the Key!
HYGIENE
• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
• Avoid touching your eyes, nose or mouth. Germs spread that way
• Try to avoid close contact (6 feet) with sick people.
• If you have fever of 102 call your doctor FIRST.
• Stay home from work or school and limit contact with others to keep from infecting them.
Viral droplets may also live on surfaces so I will have my children shower after each practice (Finally they will listen to me!), and wash all of their uniforms in hot water and wipe down pads, mouthpieces and other equipment with antiseptic cloths. I have to admit this is not something that I did after every practice before but a great habit to prevent MRSA and other locker room infections
What about masks?
Right now we don’t know how effective masks are or if a common mask or rebreather mask is effective. The most important people to wear masks are the people that are sick. If you are sick, STAY HOME! If you have to see the doctor or go out then wear a mask. Masks are single use items and should not be used over and over as you simply hold onto more germs like a garbage disposal.
When will the vaccine be ready?
This year’s flu shot will NOT protect you against the swine flu. They are working on a H1N1 vaccine that may or may not be combined with the seasonal flu and will likely require two doses. It is looking like it will not be ready until October.
What do I say to my kids?
My sons are very worried about their coach and other teammates as well as their own health. It is important to reassure them that most people recover from this illness on their own and give them basic facts. Children will blow things out of proportion if they are not talked to honestly.
Children will take the cue from adults so it is important to remain calm and not to blame people or groups. Parents should also monitor the amount of television that they watch. They may even have school closings and you should prepare your kids that these are precautionary steps.
Finally, it is not a bad idea to have at least two weeks of water and canned food in case we do have isolation. This is a very extreme case but recommended for any possible emergency.
Our thoughts and prayers are with the family of our coach.
Dr. Deb