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Swine Flu: A Guide for Parents

With the kids back to school, how worried should you be about the upcoming flu season, especially in the year of H1N1, also known as swine flu? You may have heard -- and been frightened by -- the "plausible scenario" from the President's Council of Advisors on Science and Technology (PCAST) that 30 to 50 percent of the population could contract this flu, with up to 90,000 deaths possible. Already, experts estimate more than 1 million people in the United States have contracted the virus.

It's easy to freak amid the scary-sounding stats, but take a deep breath. Many experts think the worst case scenario outlined by PCAST is unlikely, and that swine flu is still pretty much acting like seasonal flu. "The southern hemisphere is completing their flu season, and the virus hasn't mutated to become more virulent and it's still susceptible to the drugs we have to treat it," says Neil Fishman, M.D., director of the department of healthcare epidemiology and infection control at the University of Pennsylvania Health System in Philadelphia.

There's a good chance more people will get infected, but the percentages of mortality should remain the same as in previous years," says Dr. Fishman. About 36,000 people die each year due to the regular flu. But the most encouraging news so far: An effective vaccine is on the way.

What's more, you're probably already doing everything you need to do to protect your family. "Parents should be aware of what public health officials are saying, and then just be extra vigilant about the precautions they'd normally take to prevent the spread of germs," says Joseph Bocchini, M.D., chair of the American Academy of Pediatrics committee on infectious diseases and pediatrics chair of the Louisiana State University Health Sciences Center in Shreveport. Number one on the list: washing hands more frequently. Read on for all information you need to know now.

• All About the Vaccine
• Signs & Symptoms
• How to Talk to Your Kids about It
• Easing Symptoms & Treatment
• Prevention 101
• How to Get Your Kids to Wash Up
• Is It Allergies, a Cold or the Flu?
Swine Flu and Halloween

All About the Vaccine

The vaccine is expected to be available in mid-October. Encouraging early clinical trials indicate that the shot offers effective protection from H1N1, and that one dose might be all it takes for adults and kids ages 9 to 18. Kids under 9 may require a booster, says Anthony S. Fauci, M.D., Director of the National Institute of Allergy and Infectious Diseases at the National Institute of Health, which is conducting clinical trials for the vaccine. "Whether kids need the second dose will depend on their prior vaccination record and the results of clinical trials in kids, expected in about a month," says Dr. Fauci. Immunity kicks in 8 to 10 days after the shot.

Parents who are worried about the vaccine being rushed to the market -- and thus not properly tested, risking unforeseen side effects later -- can rest assured, says Dr. Fauci: "The process is exactly the same as that of the seasonal flu vaccine. No corners have been cut."

According to the Centers for Disease Control and Prevention, some groups are higher-risk than others, and should receive the vaccine first: health care and emergency workers, pregnant women (for more on the specific risks to moms-to-be, see Swine Flu and Pregnancy), everyone aged 6 months to 24 years, along with adults up to age 64 with medical problems that put them at risk for flu complications. "To protect babies younger than 6 months old, parents and caregivers should get the shot themselves to create a cocoon effect," says Dr. Fauci. "Also, separate child from anyone who has flu symptoms." Although the regular flu shot won't protect you against H1N1, it's still a good idea to get one.

Signs & Symptoms

Indicators of swine flu are not unlike those for regular old run-of-the-mill flu. What makes this virus different from typical flu is that more serious complications, like pneumonia, might occur more often. Also, says Dr. Bocchini, this is a new strain of flu, and only people who have already contracted swine flu would be expected to be immune. Your job is to know how to spot the signs. If you or your child is experiencing any of the following, call your doctor.

• fever (above 100.4 for babies 3 months and under and 101.1 for everyone else), plus 
• cough 
• sore throat 
• intense body aches
• headache 
• chills 
• fatigue

Some people have reported diarrhea and vomiting, too.

Pregnant women are at extra risk for complications even with regular flu, according to Dr. Bocchini, and small children have a higher rate of hospitalization. Both expectant women and moms of kids under 2 should be extra careful about taking action quickly.

When to Head to the ER

If your child demonstrates any of the following symptoms, it's time to seek emergency care:

• Fast or troubled breathing
• Bluish skin color
• Refusal to drink fluids
• Difficulty waking up and/or 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
• Fever with a rash, especially one that does not blanch

In adults, the following symptoms deserve an ER trip as well:

• Difficulty breathing or shortness of breath
• Pain or pressure in the chest
• Abdominal pain
• Sudden dizziness
• Confusion
• Severe or persistent vomiting

How to Talk to Your Kids About It

While school closings are largely being dismissed as an effective way to curb the spread of the virus, in some cases they may still happen. If your kids are worried about the flu, it's important to project an image of calm (even if you're internally flipping out) and make them feel safe. You'll want to explain to kids that germs can make us sick, and that's why it's important to wash your hands. You can say, "Soap and water rinse away the little buggers so they can't make us feel bad." Small kids should be soothed with a simple explanation that there are different kinds of flu, and we should just keep up with washing up. Older kids, who may be scared but hide it, can be given a few more details but should still be reassured that their parents and our health officials are on top of it.

Easing Symptoms & Treatment

If you come down with the flu, swine or otherwise, there are a few things you can do to keep yourself comfortable.

• If you or your child feel at all flu-ish, skip work and school. Stay home until you feel 100% better.
• Try to stay in a separate area of the house to limit the risk of passing the virus.
• Rest up -- consider it your free pass to catch up on your DVR list.
• Push clear fluids, like water and soup.
• Ease body aches with acetaminophen, ibuprofen, or naproxen. If your child is under 2, check with your doctor before giving them medication.
• Using a humidifier can ease a stuffy nose. Saline drops followed by suctioning with a nasal syringe can bring additional relief to small children.
• There is treatment for swine flu. Antiviral medications like Tamiflu and Relenza can lessen your symptoms make you feel better faster and prevent swine flu-related complications if taken early on. Consult your doctor about a prescription, especially if you're pregnant or have a small child.

Prevention 101

You probably already know all about how to prevent the spread of germs, but in an outbreak like this, it can't hurt to be a little more vigilant. Here's a rundown of easy things you can do, starting today.

At home:
• This one's a no-brainer but bears repeating: wash your hands frequently, and make sure your kids do the same. It's a good idea to get into the habit of doing it as soon as you walk in the door, before meals and food prep, post-potty and after touching pets. Some experts question the effectiveness of hand-washing in preventing swine flu, which is primarily transmitted by inhaling particles in the air. But it certainly can't hurt, especially for kids, known to wipe their nose with their hand and put anything and everything in their mouth. And it can prevent you from getting other nasty bugs.
• Take a moment to clean germ hot spots, like tables, doorknobs, desks and kitchen counters, with a disinfectant. Look for products that contain bleach or alcohol.
• Keep your family's immune system strong with regular sleep, and lots of fruits and veggies. If you know anyone who's been sick, stay away for now.

Out and about:
• Try to keep up the frequent hand-washing, especially after trips to the playground.
• If you don't have a sink handy, use an alcohol-based sanitizer gel or wipe. Look for ones that contain at least 60% alcohol.
• Try to avoid crowded areas. Consider wearing a mask if you're in a public place where lots of germs are being transmitted, like doctor's offices or public transportation.
• Wash your hands or use sanitizer after handling money.
• Use your own pen when signing credit card slips.

• Cover your mouth with your elbow when you cough or sneeze, and remind your kiddos to do the same.
• Throw your used tissue in the trash instead of stuffing it in your pocket.
• Try to avoid touching your eyes, nose and mouth, which give germs a fast track to infection.
• Remind kids not to share cups, utensils and plates with friends.

Getting Kids to Wash Their Hands

Yes, you know they should wash those dirty mitts often, but what you really need to know is how to get them to do it sans whining. We've got some tips and tricks for making washing up fun:

• To get them to soap up for the required 20 seconds (or more), belt out "Happy Birthday" twice. Everyone sounds better in the bathroom anyway, right?
• Fill the sink with water, and let them go to town with foam soaps and bath toys. (Ignore the water on the floor.)
• Lather up, Mom! Be a good example for your kids, and encourage them to "teach" their dolls to wash up, too.
• Make sure they can reach the sink easily. If you don't have one already, get a colorful stool to give them a boost.
• Keep their fingernails clipped -- less real estate for germs!

Is it Allergies, the Flu, or a Cold?

Here's how to tell.

Cold Symptoms
• Runny or stuffy nose
• Muscle aches (slight)
• Cough
• Fever (occasional, and mild)
• Sore throat
• Sneezing
• Chest congestion (mild to moderate)

Flu Symptoms
• Runny or stuffy nose
• Muscle aches (often severe)
• Cough (can become severe)
• Fever (usually high)
• Sore throat
• Chills
• Chest congestion (can become severe)
• Extreme tiredness (especially at the beginning of the illness)
• Headache
• Diarrhea and vomiting
(especially in kids)

Allergy Symptoms
• Runny or stuffy nose
• Coughing
• Itchy throat
• Sneezing
• Headache
• Hives
• Itchy, bloodshot or dry eyes