You suspect your child may have the Swine Flu and what to do next.

Admittedly this is not as easy to determine as you may think with modern medical technology. Rapid testing for a variety of infections including influenza have made tremendous strides in early identification and treatment of many diseases but consider the following quote from the CDC relative to the current capability of the test we now use for detecting influenza published the first week of August:


"Sensitivity (the ability of a test to be positive if the person truly has the disease) was low(40%--69%) among all specimens tested (on people that were proven to have H1N1 by another generally unavailable test that detects the DNA from the virus) and declined substantially as virus levels decreased (levels of virus in the specimen varied depending on how long the person had been ill and the method used to collect the specimen). These findings indicate that, although a positive RIDT (Rapid Test) result can be used in making treatment decisions, a negative result does not rule out infection with novel influenza A (H1N1) virus. Patients with illnesses compatible with novel influenza A (H1N1) virus infection but with negative RIDT results should be treated empirically based on the level of clinical suspicion, underlying medical conditions, severity of illness, and risk for complications."


In other words, if you have the Swine Flu, there is a 31-60% chance that your rapid flu test will be NEGATIVE. The diagnosis then must be made on a clinician's findings.


The symptoms of novel H1N1 flu virus in people are similar to the symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people who have been infected with novel H1N1 flu virus also have reported diarrhea and vomiting. Your child may have one, a combination of, or all of these symptoms. Therefore, it is safe to say that depending on how your child presents, this infection can look the same as the variety of viral illnesses that you or your child has experienced in the past.


At this point, any child with significant fever and respiratory symptoms can not be told with 100% certainty even with a negative flu test that they do NOT have the Swine Flu and should be kept home until no fever for 24 hours. When we say kept home, we mean HOME! Be careful not to expose anyone, particularly if that person is high risk.



Let's stay focused on the high risk groups of children less then 5, older children with chronic illnesses, especially asthma (that includes children in the past that have been diagnosed with Reactive Airway Disease and have been on a nebulizer or inhalers in the past) in that asthma flares with H1N1 predominate hospitalizations and those that may be battling the skin infections from Resistant Staph. Also, don't forget our expectant Mom's that are also at high risk. Children that fall into these categories need to be assessed or if your child has or will expose a child or Mom in one of these high risk groups. The antivirals can be used not only for treatment to reduce the duration of symptoms and POSSIBLY reduce complications, these same drugs can be used as a preventative medication to prevent disease in a high risk child or Mom that has been exposed.



Non-high risk affected individuals can be treated symptomatically and return to school or childcare once without fever for 24 hours. Be attuned of signs of complications even in this group. Persistent fever beyond a fourth 24 hour period, recurrence of fever after gone for a full 24 hours, shortness of breath or difficulty breathing, chest pain, wheezing, persistent vomitting or signs of dehydraton should prompt timely medical evalluation.


Let's also not lose focus on our primary objective and that is prevention until the vaccine becomes available.


Vaccine clinic dates should be posted on this blog site within the week for Pediatric Associates of
Anderson.


We are hoping that it works out that the vaccine can be administered in the schools. Let's hope this all goes smoothly and maybe we can talk them into doing this on a yearly basis for seasonal flu as well. This is the first year that we have the formal recommendation from the CDC that all children 6 months to 18 years be vaccinated with seasonal flu vaccine on a yearly basis. This recommendation was formalized prior to the Swine Flu becoming a threat. Vaccinating all children has huge potential from a Public Health standpoint. Just look at how the Swine Flu has been spread across the US. The primary infected people this summer were youth that gathered at summer camps and conferences spread it amongst themselves and took it home with them. This is to place no blame but only to support the theory that when flu appears in a community it is initially spread through the schools, then home to younger siblings, parents then who take it to work, church and their parents and grandparents. Every year we see clusters occurring in certain schools throughout the county as the disease makes its' initial appearance. Prevention of the initial spread of the disease within the schools will have a huge impact on the health in our community.