After closing schools and making headlines this spring, Novel H1N1 A (swine flu) is back in the news and stirring up parental anxieties anew. Of course, H1NI really didn’t go anywhere over the long, hot Texas summer; it quietly continued to infect kids in summer camps and at home. Most cases were not life threatening, with symptoms similar to that of seasonal flu.

But now that we’re starting flu season, what can we expect? Will H1N1 rebound this fall like the 1918 flu epidemic causing severe illness in many people, or will it be just another pesky bug that keeps us home this year?

“For the most part, it (H1N1) has been mild,” says Galit Holzmann-Pazgal, MD, assistant professor of pediatrics at The University of Texas Medical School at Houston, adding that there is no evidence that the virus has mutated into a different, more dangerous strain at this time.

That doesn’t mean H1N1 should be taken lightly, Pazgal says. The virus has caused severe illness and deaths nationwide; much like the seasonal flu does every year. More than 1 million Americans have been infected with H1N1 and nearly 600 have died from it, according to the Centers for Disease Control’s estimates. Severe illness is more common in persons with underlying medical conditions.

So far this fall, outbreaks of H1N1 have been worst in southeastern states, although cases are picking up in Texas. The volume of patients coming into the emergency room with flu-like symptoms has increased since school has started, says Pazgal, she also is medical director of infection control at Children’s Memorial Hermann Hospital.

Parents can ease their anxieties by arming themselves with facts about H1N1 and using the following commonsense tips to get through this stressful flu season.

*Wash your hands after you touch…and Twitter

Washing your hands is the single-most important step to prevent the spread of H1N1. The virus is spread by droplets from coughs and sneezes as well as touching hands and objects contaminated with these droplets. H1N1 can survive on surfaces for two to eight hours. After contracting H1N1, you can be contagious up to 24 hours before becoming ill, and up to seven days after your symptoms first appear.

Younger kids spread the virus easily because their personal hygiene leaves something to be desired. But, your ultra-connected tweens and teens also can spread the virus when they handle each other’s phones, computer keyboards, iPods and video games. Encourage your kids to use hand sanitizer and sanitizing wipes after each use.

“Every kid should be armed with their own bottle of Purell and know when to use it,” says Houston mom and businesswoman Gail Gerber Stalarow, who had H1N1 this summer together with her sons, ages 14 and 11.

*Know the symptoms

Fatigue and fever were the main symptoms in her family, she says. Other symptoms of H1N1 include body aches, runny or stuffy nose, cough, sore throat and fever, headache, chills, diarrhea and vomiting. “We had such light cases,” she says. “My younger son never had a fever higher than 102.5 and my older son truly had fever only one day and felt better a few days later.”

*Know when it is an emergency

Unfortunately, not all youngsters are as lucky, and may become severely ill from H1N1. Call your doctor if your child has symptoms including rapid breathing, not drinking enough, fussiness or if symptoms improve and then return with fever and worsened cough. Take your child to the emergency room immediately if he has trouble breathing, bluish or gray skin color, has severe or persistent vomiting, is not easily aroused from sleep or is not interacting with others.

*With mild cases, call your doctor first

If your child just feels lousy, and doesn’t have a high fever or trouble breathing, call your pediatrician instead of heading to the hospital. If it is a mild illness in which there is no evidence of respiratory distress, I would definitely avoid the emergency room, because your wait time is probably long, and you don’t need emergency care,” says Pazgal.

Ask to talk to your doctor or his office staff first before you make an appointment. Depending on your child’s health history, your doctor may want to prescribe treatment over the phone to avoid spreading the virus to others.

*If it looks like the flu, treat it like the flu

If you do go in, your doctor may give your child the rapid influenza diagnostic flu test that can determine whether your child has the flu and the general strain of the flu, but not whether it is H1N1. The Texas Department of Health is “sub-typing” for H1N1 only in seriously ill patients admitted to the hospital. False negative tests are common with the rapid flu test (both Stalarow and her younger son tested negative, but a retest revealed her son had the flu virus) so a negative test doesn’t definitively rule out an infection with influenza virus.

Your doctor may decide to start treatment if your child has an underlying condition that places her at high risk. If the office is full of flu cases, your child’s buddies all have the flu and your child has symptoms—it is likely that she has the flu.

If your child has the symptoms and is in an at-risk group, your doctor may choose to treat her with oseltamivir (Tamiflu) or zanamivir (Relenza), antivirals that shorten the duration and severity of the illness for H1N1 virus.

The CDC currently recommends treatment of H1N1 only for persons who are hospitalized with the flu or who have an underlying medical condition that places them at high risk. Others not in these categories do not usually need treatment.

Otherwise, drinking lots of fluids and resting at home are the recommended treatment. If your child develops a secondary infection, your doctor may prescribe antibiotics to counteract opportunistic bacteria.

*Keep the kids home

He’ll be heartsick of course, but your sick child should stay home for at least 24 hours after his fever is gone (without the use of a fever-reducing medicine) except to get medical care or for other necessities, according to the CDC. That’s the amount of time most school districts require students to stay home for any illness, and quite a difference from the seven days that was previously recommended during the spring outbreak.

Try to keep your child away from others as much as possible. Encourage her to cover her mouth and nose with a tissue when coughing or sneezing, throw away used tissue in the waste basket, and to clean her hands every time she coughs or sneezes.

“We washed our hands more than ever,” says Stalarow of her family’s attempts to stem the spread of germs after they got sick. “My kids were really considerate. They didn’t open the refrigerator with their hands, they wiped off surfaces they touched and used Purell. Now, even though we aren’t sick anymore, we are still being proactive in terms of hygiene.”

*Start the vaccinations

Federal officials expect release of the H1N1 vaccine in October. The vaccine may require a second shot given three weeks after the first. It may take another two weeks before the vaccine fully protects the body against the flu. Recent studies showed that one shot may protect against H1N1, stretching the supply of the vaccine.

Until the H1N1 shot is ready, Pazgal advises families to go ahead and get the “regular” flu shot, which protects against the seasonal flu and is already available. That way, your children won’t get the flu twice in one season. The seasonal flu can be more dangerous than H1N1. Annually, an estimated 36,000 people die from flu-related complications and more than 200,000 people are hospitalized from flu-related causes. Of those hospitalized, 20,000 are children younger than 5 years.

If your child had H1N1 over the spring or summer, she will have some immunity to the virus. However, if you aren’t sure that your child had H1N1 (she wasn’t tested or had a false negative), the CDC recommends vaccinating anyone between 6 months and 24 years of age. Other at-risk groups that should get the vaccine include pregnant women, people who live with or care for children younger than 6 months of age, health care and emergency medical services personnel, and people ages of 25 through 64 years of age who are at higher risk for 2009 H1N1 because of chronic health disorders or compromised immune systems.

Live your lives
“It is understandable that parents may have a sense of panic about H1N1, but we need to remain as calm as we can.” Pazgal says.

Source:  University of Texas Health Science Center at Houston