Swine Flu (aka H1N1): Part 1 - Our Perspective

With the media and government putting us all on the edge of our seats worrying about a possible pandemic of swine flu, it's important to have basic factual information and a realistic perspective about what is happening as questions and fears grow with every news report. While we know this blog entry is going to be a bit lengthy, we decided this was not the time to edit. We are choosing to fully explain the situation in a very straightforward manner, with as much information we have at this point, and answer some of the most common concerns we've addressed in our pediatric practices.

Simply speaking, Swine Flu (H1N1) is just a new, unexpected strain of influenza A. We are all familiar with the concept of new strains of flu -- it's why we need to revaccinate every year to keep up with changes in the makeup of of flu viruses. But since Swine Flu only comes around once or twice a century, most humans have no acquired or natural immunity. Swine Flu strains are typically not included in flu vaccines, and thus more people may be susceptible to illness in a pandemic situation (though this is not at this point classified as a 'pandemic').

The good news is that, unlike many strains of influenza that are not responsive to therapy, this Swine Flu strain, H1N1, is TREATABLE with Tamiflu or Relenza. In the last year our practice alone has treated 390 cases of documented influenza. Some, but not all, patients received Tamiflu, but many were treated conservatively with rest, fluids, supportive care and staying out of work, school or daycare until symptoms resolved. We had no children hospitalized due to the flu, and had good outcomes, even with just supportive care as treatment.

Because the US Government has stockpiled Tamiflu, should H1N1 become a problem in our communities, we anticipate ample supplies to treat this strain of the flu.

We continue to remind families that the best way to stay healthy and avoid flu risk is to:

• Avoid those who are ill and thrive with those who are well
• STAY HOME IF SICK and don't return to work, school or daycare until well and fever free for at least 24 hours
• WASH HANDS, WASH HANDS, WASH HANDS when coming in from school, outside or work and before putting anything in your mouth
• If you are coughing, cough into your sleeve or tissue. Wash hands frequently throughout the day
• Don't share food or drinks with others. Secretion exchange is a common route of infection.
• Don't ask for trouble by traveling to high risk areas
• Call your pediatrician if your child has true flu symptoms so that they can diagnose and treat early (with 24-36 hours of onset of fever). True flu symptoms include fever (usually over 101-103), chills, headache, sore throat, runny eyes, cough and bodyaches. Influenza A symptoms tend to hit a bit harder, so symptom recognition is usually obvious.

When new strains of flu emerge, such as H1N1, it takes 4-6 months to develop an appropriate vaccine to cover that strain. Already efforts are in place to develop a vaccine agains H1N1, in addition to other new strains of influenza that have attacked worldwide.

We must remember that the total number of confirmed cases of Swine Flu in the US (109 as of the morning of 4/30/09) really amounts to a handful, and that, with the support of our medical and public health communities, we are equipped to handle this situation. We must also keep in mind that flu claims the lives of 36,000 Americans yearly (most often in the elderly and very young) and infects millions of Americans every winter -- and the great majority survive and thrive. It is still too early to tell how severe this now prolonges flu season will be, but remember that summer is coming and the flu virus tends to wane with warm weather. We anticipate a short outbreak with the help of Mother Nature. So hang in there -- and continue to be calm and sensible!

Stay tuned for Part 2: a Q&A with Tara Mandy, publisher of StrollerTraffic.com. Tara has been fielding a ton of questions from concerned parents, so she came to us for answers. We'll share them with you in our next blog posting...

AAP Considering Update: Rear-Facing Carseats Until Age 2

In case you haven't heard, the American Academy of Pediatrics is considering changing their carseat policy in 2010 to recommend REAR-FACING carseats for ALL children up to the age of TWO YEARS. Not official at this point (though that implication is making the rounds...even to our offices!).
Even if little feet touch the seat, injury rates and severity have been shown to decrease dramatically with kids in the rear-facing position. In fact, according to research, toddlers between the ages of 12 and 23 months who ride rear-facing in a car seat are more than FIVE times safer than toddlers in that same age group who ride forward-facing in a car seat.
We're thinking it's a great idea to turn your tots back to rear-facing -- for their health and safety. Your sanity may suffer a little bit, but safety comes first!

We want to know what you think. How do you feel about this potential recommendation? Will you turn your kids back to the rear-facing position?