Swine Flu and You

Here we are entering the most virulent flu season anticipated in nearly a century, and one of my daughter's classmates just ran up to me in the carpool line to gleefully announce that my darling little girl had licked his hand.

When I asked her about it, she said the boy had kept putting his hand in her face and she wanted him to stop, so she did what any kid would do. She licked him. Besides, my daughter explained, "I didn't lick it that much."

Really, it's amazing that children don't all have Bubonic plague by the time they finish preschool - so how can parents defy CDC projections of widespread swine flu (officially known as the Novel H1N1 virus) this season? Following is advice gleaned from the Centers for Disease Control, the American Academy of Pediatrics, and Baystate Medical Center Children's Hospital in Springfield:

Get Vaccinated

The first doses of H1N1 vaccine were expected in mid-October, and first in line to receive these should have been pregnant women, people who live with or care for children younger than 6 months of age, health care and emergency medical services personnel with direct patient contact, children 6 months through 4 years of age, and children 5 through 18 years of age who have chronic medical conditions.

Next, the CDC recommends swine flu vaccination for all people under age 65, especially young people under age 25 and those with chronic medical conditions. People over the age of 64 are considered less susceptible to H1N1, but should receive the vaccine once higher-risk populations have been inoculated.

Unfortunately, the seasonal flu vaccine is still necessary as a separate shot.

For those suspicious of H1N1 vaccination, experts tend to agree that the risks of getting swine flu - especially for pregnant women, healthy young people, and those with underlying medical conditions - outweigh the possibility of complications from the vaccine itself. Because the H1N1 vaccine is formulated in much the same way as seasonal flu shots, the CDC expects it to share the same, positive safety profile of seasonal flu shots.

Be Clean

Maybe you don't need to carry your alcohol based hand sanitizer on a holster, but keeping a bottle in the car, one in your bag, and one in your child's back pack isn't entirely paranoid, either. Swine flu is transmitted as droplets in the air, and the virus left by, say, the spray of somebody's sneeze can live where it lands for up to eight hours. That said, be sure that your kids wash their hands often and avoid touching their eyes, nose, and mouth as much as possible. Also, this is the season to gently encourage nail-biters and thumb-suckers (and hand-lickers!) to kick the habit.

Be Courteous We're all parents here, so we know that dirty dilemma that surfaces when little Johnny says his throat is scratchy on the same day that we have a really, really important meeting at work. The standard response at my house is, "Go to school and see how you feel. If it gets worse, tell the nurse and I'll come get you." The kids get to school and, half the time, they forget they ever thought they were sick.

But with swine flu, it's that other half of the time that matters.

According to Dr. Jackson Williams, Director of Pediatric Hospital Medicine at Baystate Medical Center, "H1N1 doesn't seem to be any worse than the typical flu, but many more people can be potentially infected. From everything I've read, I do think H1N1 is going to be a significant event for us this fall and winter."

Because swine flu tends to be at its most dangerous in pregnant women and children under 4, think of your child's classmates and their families before sending a "maybe it's nothing" kid to school - especially before the vaccine is widely available.

Be Calm

If your child comes home feeling achy and feverish; if he has a runny nose and sore throat; if she is tired with a headache or (sometimes) diarrhea and vomiting, don't panic.

"For the vast majority of children who get this H1N1 virus," said Dr. Williams, "it's going to be like the regular flu. It really is going to be one of those situations where it's chicken soup, ibuprofen or acetaminophen, and keeping the children well hydrated."

The American Academy of Pediatrics does remind parents not to give children aspirin products or over-the-counter cold medicines, and there's certainly no shame in calling your child's pediatrician for some reassuring advice.

Also, there are prescription anti-viral drugs, such as Tamiflu, which could help. But Dr. Williams cautioned, "It doesn't stop the virus in its tracks; in a lot of ways, the virus has to run its course. The other thing to know about Tamiflu is that if you don't start within the first day or two, then it's not really effective in slowing down the illness."

Be Concerned

If you are pregnant, if your child is under 4 years of age, or if you or your child has a chronic health condition such as asthma or diabetes, call your doctor at the first sign of flu-like symptoms. Parents should also call their doctor if their child: • has difficulty breathing • isn't drinking or urinating much • appears bluish or gray • doesn't wake or interact normally • develops a rash • becomes irritable even after the fever breaks • becomes ill again after the symptoms seem to have subsided

Beyond that, listen to your instincts. Parents are the best judge of their child's needs.

Be Prepared

Sit down with your partner and work out the answers to these sticky questions: Who will stay home if the kids get sick? What childcare arrangements can you make if school or day care is temporarily closed due to a swine flu outbreak? Who can fill in if the primary caregiver in your household is ill?

Next, hit your local superstore and load up on everybody's favorite brand of ibuprofen or acetaminophen, tissues, and other fever comforts. Grab (or make) a week's worth of frozen dinners in case the family chef takes ill, and consider filling an emergency "sick box" with books, crafts, and DVDs to pull out just as your little patient hits breaking point.

Then, on two separate index cards write the numbers for your own doctor, your pediatrician, your school nurse, the numbers for where everyone in your family can be reached during the day, and the phone numbers of the three people most likely to help you in a pinch. Keep one card in the house and the other in your car.

Finally, call your mom. It's time you thanked her for all those times she held the fort when you were sick.

Andrea Bugbee is a freelance reporter and family essayist living in Southwick, Massachusetts, where her two daughters endlessly inspire article ideas.

NOTE: Information in this article was correct at the time baystateparent went to press. However, readers are encouraged to visit mass.gov/dpf/swineflu or cdc. gov/flu for updates as swine flu studies are ongoing.