Most people with 2009 H1N1 have had mild illness and have not needed medical care and the same is true of seasonal flu. However, the flu can be serious, especially for young children (risk is highest in children younger than 2 years) and children of any age who have certain chronic medical conditions. These conditions include asthma or other lung problems, diabetes, weakened immune systems, kidney disease, heart problems and neurological and neuromuscular disorders. Children with these conditions can have more severe illness from any flu, including from the 2009 H1N1 flu virus.

If your child is 5 years or older and otherwise healthy and gets flu-like symptoms, including a fever and/or cough, consult your doctor as needed. Make sure your child gets plenty of rest and drinks enough fluids.

If your child is younger than 5 (and especially younger than 2), or you have a  child of any age with a medical condition like asthma, diabetes, or a neurologic problem, and develops flu-like symptoms, ask a doctor if your child should be examined. This is because younger children (especially children younger than 2), and children who have chronic medical conditions, may be at higher risk of serious complications from flu infection, including 2009 H1N1 flu. Talk to your doctor early if you are worried about your child’s illness.

Call the doctor or take your child to a doctor right away if your child seems very sick with any of these symptoms:

• 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.
• Has other conditions (like heart or lung disease, diabetes, or asthma) and develops flu symptoms, including a fever and/or cough.

Remember that the flu spreads through sneezes and coughs of someone with the flu, or if you touch an object with the flu viruses on it and then touch your mouth or eyes. Using good hygiene can help you and your child to stay healthy.

If you would like further information about protecting your child from H1N1, please click here to view the CDC’s Seasonal and 2009 H1N1 Flu: A Guide for Parents.

Related Links

• Children’s Regional Hospital at Cooper
• H1N1 Influenza Immunization Schedules and Information
• Seasonal and 2009 H1N1 Flu: A Guide for Parents
  

The H1N1 vaccine is already, or will soon be, available and it will continue to be available throughout the influenza season, into December, January, and beyond. This is because the timing and duration of flu activity can vary.

If you or members of your family are in the following target groups, you should be vaccinated against H1N1:

• Pregnant women because they are at higher risk of complications and can potentially provide protection to infants who cannot be vaccinated.
• Household contacts and caregivers for children younger than 6 months of age because younger infants are at higher risk of influenza-related complications and cannot be vaccinated. Vaccination of those in close contact with infants less than 6 months old might help protect infants by “cocooning” them from the virus.
• Healthcare and emergency medical services personnel because infections among healthcare workers have been reported and this can be a potential source of infection for vulnerable patients.
• All people from 6 months through 24 years of age
  • Children from 6 months through 18 years of age because we have seen many cases of novel H1N1 influenza in children and they are in close contact with each other in school and day care settings, which increases the likelihood of disease spread.
  • Young adults 19 through 24 years of age because we have seen many cases of novel H1N1 influenza in these healthy young adults and they often live, work, and study in close proximity, and they are a frequently mobile population.
• Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza. Current studies indicate that the risk for infection among persons age 65 or older is less than the risk for younger age groups. However, once vaccine demand among younger age groups has been met, programs and providers should offer vaccination to people 65 or older.

Cooper University Hospital will be vaccinating our employees following the recommendations of the CDC. Clinics for other high-risk groups are being planned. Our web site will continue to have updated information about vaccination clinics.

The most readily available clinics are being offered by county health departments. You can find dates, locations and times on your county’s web site or by calling their office. Or you can call the New Jersey H1N1 Hotline, Monday through Friday, 9 a.m. to 5 p.m., at 1-866-321-9571, for locations close to you. The vaccine is free of charge.

For more information about H1N1, including our Frequently Asked Questions (FAQ), be sure to visit the H1N1 Influenza Resources page on cooperhealth.org.

According to the Centers for Disease Control and Prevention (CDC), the H1N1 flu has hit pregnant women especially hard. About 700 cases have been confirmed in pregnant women since late April, about 100 pregnant women have required admission to intensive care units, and 28 pregnant women have died from the H1N1 flu, the CDC reported earlier this month.

“Because pregnant women who get influenza have a greater chance for serious complications, it is important they receive both the 2009 H1N1 flu shot and the seasonal flu shot.  Receiving these vaccines is the best way pregnant women can protect themselves – and their newborns – against the flu,” said Rosalie Pepe, M.D., infectious disease specialist at Cooper University Hospital.

Research has found that women who get a flu shot during pregnancy get sick with the flu less often than pregnant women who do not get a flu shot. The same holds true for their newborns. Babies born to mothers who get a flu shot during pregnancy get sick with the flu less often than babies born to mothers who did not get a flu shot during pregnancy.

A woman can receive both the seasonal flu shot and the H1N1 flu shot at any time during pregnancy. But, pregnant women should get the vaccines by injection – a “flu shot” – not by nasal spray. The nasal spray vaccine is not approved for pregnant women.

The injectable vaccine is made with inactivated flu virus. It is given with a needle, usually in the arm. The nasal spray vaccine is made with live, weakened flu virus and should be used only in healthy people ages 2 to 49 years old, and women who are not pregnant.

Following delivery, new mothers can safely get either the injectable or nasal spray vaccine, even if they are breastfeeding. In fact, vaccinated mothers who are nursing can pass on vaccine antibodies to their infants and reduce their babies’ chances of getting sick with the flu. This is especially important for infants less than 6 months old, who have no other way of receiving vaccine antibodies because they are too young to be vaccinated.

Dr. Pepe reminds pregnant women to get both a seasonal flu shot and a H1N1 flu shot as early as possible.

“You will need both shots this year to fully protect yourself and your baby against the flu. Both shots are absolutely safe and recommended for pregnant women and nursing mothers,” she said.

Additional H1N1 Flu Resources from Cooper University Hospital

• H1N1 Influenza and Seasonal Flu Information and Resources – Cooperhealth.org
  Visit our H1N1 resource page for information to help you and your family prepare for this year’s flu season. We will be updating this page as new information becomes available.
• Health eTalk Web Chat: Your Questions about H1N1 Pandemic Flu – Cooperhealth.org/etalk
  Join Rosalie Pepe, M.D., of Cooper University Hospital’s Division of Infectious Diseases, as she answers your questions live on Cooperhealth.org.  No question is too big or too small, as she’ll help you sort through the rumors and debunk the myths.

With the nation’s focus on the development of a vaccine for the H1N1 pandemic flu expected to be available later in October, health officials are concerned that families might choose to wait to get vaccinated against the seasonal flu.

Each year, as many as 60 million Americans get the flu, and the resulting complications cause more than 200,000 hospitalizations annually, according to the CDC.

Also, children between the ages of 2 and 17 reportedly are twice as likely as adults to get seasonal flu and frequently require medical care.

While protection against the H1N1 influenza virus might be just around the corner and foremost on our minds, safeguards against seasonal flu viruses still are necessary and are available now.

“We may be thinking about the need for an H1N1 vaccination, but we can’t forget the importance of getting vaccinated first for the seasonal flu,” said Anat R. Feingold, M.D., Head of Cooper’s Division of Pediatric Infectious Diseases.

An expert in pediatric infectious disease, Dr. Feingold took part in last month’s “Don’t Play With the Flu” national health-awareness campaign  led by MedImmune, the biologics business for Astra Zeneca PLC, in partnership with Women’s Professional Soccer and the American Youth Soccer Organization. The high-profile campaign kicked off in New York City with a one-of-a-kind soccer clinic led by soccer legends Mia Hamm and Brandi Chastain.

“It is very important to increase seasonal flu vaccination rates for eligible children and families,” Dr. Feingold said. “Along with all the things that parents know are important for helping keep their kids healthy, like washing hands and getting enough sleep, influenza vaccination should be at the top of the list. It’s a smart defense to help protect our kids – and ourselves – from seasonal flu,” she said.

See your healthcare provider to get the flu vaccine, or seek out other locations where the vaccine is being offered.

This year’s seasonal flu vaccine protects against three, new influenza virus strains that research indicates will cause the most illness during the 2009-2010 flu season. They are:

• A/Brisbane/59/2007(H1N1)-like virus.
• A/Brisbane/10/2007 (H3N2)-like virus.
• B/Brisbane 60/2008-like antigens.

According to the CDC, the vaccine can protect you from getting sick from these three viruses, or it can make your illness milder if you get a related but different influenza virus strain.

In general, anyone who wants to reduce the chance of getting seasonal flu can get vaccinated. However, it is recommended by the CDC and the Advisory Committee on Immunization Practices that certain people should get vaccinated each year. Most of these people are recommended for vaccination because they are at high risk of having serious flu complications or they live with or care for people at high risk for serious complications.

People recommended for seasonal influenza vaccination during the 2009-2010 season are:

• Children aged 6 months up to their 19th birthday.
• Pregnant women.
• People 50 years of age and older.
• People of any age with certain chronic medical conditions.
• People who live in nursing homes and other long-term care facilities.
• People who live with or care for those at high risk for complications from flu, including healthcare workers; household contacts of persons at high risk for complications from the flu; and household contacts and out-of-home caregivers of children less than 6 months of age. (Children less than 6 months of age are too young to be vaccinated.)

“Whenever there is stressful news pervading the airwaves, children can be very vulnerable to the resulting effects,” says Dr. Richard Selznick, child psychologist at The Children’s Regional Hospital at Cooper and Director of the Cooper Learning Center. “I saw this after 9/11. There were many anxious children coming into my office at the time who seemed fundamentally shaken by the events.  With the current concerns regarding Swine Flu, the first place to look is your own anxiety.”

Dr. Selznick notes that while you can’t control all of your emotions, it is important to not overwhelm children with your own fears and concerns.  As a general rule, look for the opportunity to answer questions in fairly straight forward terms.  Do not provide too many statistics, or medical terminology, in your explanation.  Try and talk in terms of “likelihoods” and do not use the word “never,” as in “it can never happen in your school.”  Above all, do not have the child continually exposed to TV or radio news, which is designed to get people’s attention.

Some things that parents can observe when their children may be encountering internal stress is:

• Disturbed sleep patterns.
• Differences in their appetite
• Drawings that may depict a scary situation

“Many times we can see our child’s frustrations come out when they are sitting down drawing pictures. If you see something that may be out of sorts in their pictures, ask them about it and ask them to describe the scene. This may be a great opportunity to calm their fears,” says Dr. Selznick.

Bedtime is also a time when children have a tendency to “open-up” to their parents. When sitting down to read your evening books with them, you are in a comfortable environment for them.  This provides an opportunity to talk openly with your child about anything that they may have heard about Swine Flu that you can clear up for them.

The most important thing a parent can do for their child during this elevated time of concern is make sure they are teaching their children proper hygiene. Talk to your children about always washing their hands and covering their coughs and sneezes with a tissue.

Remember, children look to adults for guidance on how to react to stressful events. If parents seem overly worried, children may panic. Parents should reassure their children that health and school officials are working hard to ensure that people throughout the country stay healthy.