At least 114 U.S. children have died of swine flu since April, the Associated Press reported October 30. Nineteen of those deaths occurred in the last week, U.S. health officials said. That's the largest one-week total so far, the U.S. Centers for Disease Control and Prevention (CDC) said. The CDC said more medicine for children will soon be available. The CDC released the drug Tamiflu from a government stockpile. There have been spot shortages of the children's dose of this medicine.
By Claire McCarthy, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
Between August 30 and October 24 of this year, 74 children died from complications of H1N1 influenza. This is the type commonly known as swine flu.
Actually, 74 isn't that many, since thousands of people have been hospitalized with the illness. Thousands more have been sick but stayed at home. Nearly all states are seeing widespread cases of influenza-like illness, more than in peak flu months in a regular year. Given all that, it's easy to ignore a number as small as 74.
But here's what's worrisome: In the whole 2006-2007 flu season, 78 children died from complications. In the 2007-2008 season, 88 died. These are totals for the entire flu season. Generally, that runs from around September to March. We're up to 74, and the season has barely started.
Researchers still don't know why, but children are particularly vulnerable to H1N1. And it's not so much babies, who we think of as being vulnerable to everything. Of the 74 that have died this fall, 75% were between 5 and 17 years old. Some of these children had medical problems that made them more likely to get very sick with influenza. But many of them were perfectly healthy before they got H1N1.
This is scary stuff. It certainly scares me as both a pediatrician and a parent. If parents haven't already done so, they need to pay attention -- and take action.
What Changes Can I Make Now?
Parents can do several things parents to help keep their children safe and well this flu season.
- Stay informed. Learn everything you can about H1N1, and learn it from reputable sources. A lot of rumor and misinformation is flying around. Make sure your information is good. The CDC's H1N1 website is a great place to start. It is constantly updated and has all sorts of useful links. You can find it at http://www.cdc.gov/H1N1flu/
- Get your child vaccinated. The vaccine against H1N1 is safe and effective. It's new, yes. But really, it's a flu shot, made the same way the flu shot is made every year. The nasal spray version is more available in some areas. It may be even more effective for children, especially the under-6 crowd (and there's no shot involved!). But distribution of H1N1 vaccine has been delayed and uneven. If your doctor's office doesn't have the vaccine available, contact your local or state department of health and ask about public flu clinics. While you're at it, see if you can get vaccinated yourself. The shot is only available for pregnant women or adults 24 to 49 years old with health problems. However, the spray is available for healthy adults.
- Wash your hands. If there was ever a time for becoming a hand-washing fanatic, it's now. Carry alcohol-based sanitizer. Use it, especially when you are out in public touching things that all sorts of people touch (such as banisters, doorknobs, and elevator buttons). Keep some by the door to your house, and in your kitchen. Get in the habit of washing as you come in and before you eat. Pack hand sanitizer in your children's backpacks. They might not use it, but it's worth a shot.
- Teach your children not to touch their eyes, mouth or nose. If you can even get them to do it less, there's less risk of bringing germs inside their bodies.
- Stay away from sick people. This year it's totally okay to ask about coughs and illness in the family before accepting (or offering) invitations.
- If you or someone in your family is sick, stay home! Please, don't send Junior to school with a fever, even if staying home from work is inconvenient. It's not good for Junior, and it's really not good for his classmates. And while you may feel like work or other commitments can't manage without you, spreading germs doesn't help anyone.
If your child gets sick, don't panic. Children who have serious health problems should be seen by their doctor at the first signs of illness, in case they need antiviral medicine. But for most children, plenty of rest, fluids and TLC usually do the trick. However, it's important to seek medical attention promptly if your child:
- Has any trouble breathing
- Is so sleepy you have trouble waking him
- Has a seizure
- Has a high fever (102 or greater) that won't come down with acetaminophen or ibuprofen
- Isn't drinking, and shows signs of dehydration. They include:
- Dry lips and mouth
- Urinating much less frequently
- Excessive sleepiness
- Has severe pain of any kind
- Gets a high fever again after seeming to improve. This could be a sign of pneumonia or other bacterial infection.
- Doesn't start to get better in three to five days
- Does anything else that worries you. It's always best to call to be safe.
What Can I Expect Looking to the Future?
Many, many people are working feverishly (excuse the pun!) to understand this virus better and figure out how to treat and prevent it. Already their efforts have led to the vaccine. I hope that in this season and seasons to come we will find even more weapons to fight this illness and keep our children, and all of us, well.
