H1N1

What is H1N1?

There is a lot of information out there about H1N1 flu, and a lot of misinformation. Your docs and practitioners here at Northside Pediatrics are here to let you know what is the most up to date info we’ve received from the CDC and from CHOA.

First, swine flu, at this point, is definitely here in Atlanta, and we are seeing many children with what we suspect is H1N1. For every child we’re seeing with H1N1, we’re seeing 3 or 4 with worried parents and colds or allergies, or another of the normal viruses we normally see this time of year. We are no longer testing children for swine flu, and you’ll find in the Children’s Hospital Urgent Care and ER’s that they are doing the same. The reason for not testing is two fold…first of all, unfortunately, it’s a bad test. 40% of the time, the test gives a positive result even though your child doesn’t have H1N1 (false positive result), and 30% of the time, it gives a negative result even though your child does have flu (false negative result).

Secondly, the CDC and AAP now state that the only children who should receive Tamiflu are kids who already have serious illnesses, are under the age of 2, or who have infants in the home, so testing would not change our method of treatment in most children. In fact, at this point, the experts say we need to put our doctor hats on and use our clinical judgment alone, and decide based on history, symptoms and exam whether or not the patient has the flu. Also, Tamiflu is not without side effects. 50% of children who take it either have nausea or throw up, and it has been noted to cause nightmares, insomnia and even depression in some children. This is for a drug that only decreases symptoms by 24-48 hrs and only works if it is taken in the first 48 hrs of the illness.

What are the symptoms of swine flu?

Well, most importantly, they’re the symptoms of any other influenza virus we’ve seen in the past. They are not more severe than any other version we’ve ever seen. These symptoms include fever (usually higher than 101) for 4-5 days, muscle aches, cough and congestion, fatigue and about 1/3rd of kids are having vomiting and diarrhea. Many other viruses we’re seeing now also have these exact same symptoms, such as adenovirus and enterovirus. This is why even though we might think your child has the flu, you should still get the vaccine if available later this fall. We treat these symptoms with what we treat any other febrile respiratory illness. Tylenol or Ibuprofen for fever, increased fluids, especially clear fluids like water, normal saline nasal spray for congestion, and steamy showers to also help congestion. There is also a study that says that chicken noodle soup really does help you get better from the flu!

How do we avoid H1N1?

Just like any other respiratory illness, it is spread via droplets, both from coughing and sneezing, and from coughing on surfaces which other children touch. Remind your children to use soap and water (sing “Happy Birthday” twice while washing is a good rule), and hand sanitizer, especially while at school (aka “the germ factories”). Also, avoid places that flu loves to hang out as much as possible like Chuck E Cheese, gym nurseries, church nursery and other places where there are large groups of children.

When to call?

Any time you have a baby under the age of 2 months with a temperature of 100.4, in the day or the night
If your child has a temperature above 101 for more than 4 days in a row
If your child ever has “work of breathing” which is when their ribs are pulling in with breathing, or she or he is making a grunting noise with each breath
If there are any signs or symptoms of dehydration, such as a dry inner mouth
If you’re having a difficult time arousing your child
Any time your child is excessively irritable or won’t “perk up” intermittently while taking Tylenol or Motrin

Bottom line is that yes, it’s no fun catching the flu, and you can count on being sick for at least a week with it, but by following these simple instructions, you probably won’t need to be seen or even call! If you do need us, please feel free to call.

Some good links are listed below for more information:

Children's Healthcare of Atlanta

Center For Disease and Control