Why parents shouldn't ignore certain H1N1 symptoms

 

• Mary McDermott
• Edited by Hyacinth Williams

INDIANAPOLIS (WISH) - The death of a South Bend girl this week possibly because of the H1N1 virus shows just how serious this illness may be. And it's leading parents to this question: How will I know if this virus is threatening my child's life?

A Fishers doctor 24-Hour News 8 spoke with said there is one very important thing you can focus on; your child's breathing.
"Watch your child's respiratory rate," said Scott Ries, M.D.

Dr. Ries is with the American Health Network practice in Fishers.

"If your child seems to be breathing fast, real labored breathing, that's the biggest thing we're seeing probably in some of these cases - a higher incidence of pneumonia or a bacterial infection on top of influenza virus. For some reason that seems to be happening a little more frequently with this strain of influenza than the typical seasonal influenza,” said Dr. Ries.

A sixth-grader in South Bend, Mercedes Lewis, died Tuesday after being admitted to the hospital Monday morning.

Her symptoms included a sore throat.

The girl reportedly was healthy before Monday, without any other medical complications.

"She was loved greatly by not only me, her uncles, her grandparents; I mean she was greatly loved by everyone," said the girl's aunt.
The Indiana Department of Health reported Tuesday that it was investigating a suspected death from flu-related complications in St. Joseph County.

The health department has not identified the victim.

Dr. Ries told 24-Hour News 8 said he is seeing a lot of cases he suspects are H1N1.

"Probably just in our office about 12 to 15 cases a day; there'd probably be more, but we just don't have capacity for those patients on a daily basis. A lot of calls," Dr. Ries said.
He emphasized the difference between flu symptoms a child will likely work through on his own and those that will likely need medical treatment.

"They're going to have coughing either way, they're going to have some coughing spells, but if they seem okay between the coughing spells and do all right, then they're probably going to do okay,” said Dr. Ries. “But if they have a high fever, a lot of cough, again, get them to the doctor. Let's find out because we can put them on some medicine to shorten that course right now, especially for the children."

So far, four people in Indiana have died from the virus.

Influenza A(H1N1) and your family

Written for BabyCenter Malaysia
Approved by the BabyCenter Malaysia Medical Advisory Board

 

• What is H1N1 flu?
  
• What are the symptoms of H1N1 flu?
  
• How does H1N1 flu spread?
  
• What should I do if my child shows symptoms of H1N1 flu?
  
• Is there any treatment for H1N1 flu?
  
• What can I do to avoid H1N1 flu?
  
• How long will I be contagious if I have H1N1 flu?
  
• Is there a vaccine for H1N1 flu?
  
• Where can I find more information?
  

What is H1N1 flu?

Influenza A(H1N1) is a very contagious respiratory disease. It is also called swine flu because it is a new form of a virus that affects pigs. However, the virus that has caused the current outbreak can also affect people. Usually, people affected by swine flu have been in direct contact with pigs. The reason why there is such concern about the current outbreak of H1N1 flu is that it is now spreading from person to person -- and this is happening in Malaysia, too. That's why the World Health Organisation has raised a worldwide pandemic alert.

What are the symptoms of H1N1 flu?

Advertisement

H1N1 flu has different effects in different people. Some people who catch the virus only have mild symptoms. But others can develop complications and in extreme cases H1N1 flu can cause death.
The symptoms of H1N1 flu are very similar to regular flu symptoms:
• fever;
• tiredness;
• cough;
• headache;
• muscles and joint pain.
H1N1 flu can also cause:
• acute abdominal pain;
• diarrhoea;
• vomiting.
A fever caused by H1N1 flu can be very high: if you have regular flu, your fever is unlikely to go above 39 degrees C (102.2 degrees F). If you have H1N1 flu it could reach 39 degrees C and higher.

How does H1N1 flu spread?

H1N1 flu spreads from person to person in the same way as other flu viruses: through coughing and sneezing of people who are infected. H1N1 flu is very contagious and spreads easily, particularly in enclosed spaces where there is close contact between infected people and healthy people.
Swine viruses are not spread from eating or preparing pork.

What should I do if my child shows symptoms of H1N1 flu?

Call your doctor and explain what's happening. Tell her how old your child is and whether he, or anyone else in your household, has any other health problems. H1N1 flu can be more severe in people with compromised immune systems. Because the virus is very contagious, your doctor will tell you whether you should go to the clinic or if you should stay at home.
You may be asked to take your child to hospital to have a sample taken from his respiratory system. This will be analysed in order to find out if his symptoms are caused by H1N1 flu.

Is there any treatment for H1N1 flu?

There is no cure for H1N1 flu but antiviral drugs will relieve the symptoms and help you to recover faster. We don't yet know for certain that the antiviral drugs that are used to treat H1N1 flu are safe to take in pregnancy. Your doctor will only suggest treatment if she feels that the potential benefit justifies the possible risk to your baby.

What can I do to avoid H1N1 flu?

Just as with regular flu, there are some things you can do to avoid infection and minimise the spread of the disease:
• Cover your nose and mouth with a disposable tissue when you cough and sneeze, and throw it away after using it.
• If you don't have a tissue to hand, cover your mouth with the inner part of your elbow when you cough or sneeze. This will avoid spreading the infection to your hand and will minimise spreading the disease.
• After coughing and sneezing, wash your hands with warm water and soap. Rub both sides of your soapy hands for at least for 15 seconds and rinse with lots of water. If soap and water are not available, use alcohol-based disposable hand wipes or gel sanitisers.
• Don't touch your eyes, nose or mouth because the germs spread very quickly.
• Wash your hands frequently – the virus can live for up to two hours on surfaces like doorknobs and telephones.
• Eat a healthy diet, including plenty of fresh fruit, vegetables and wholegrain foods – a balance of these will give you minerals and antioxidant vitamins, such as vitamin C, which help to fight infections.

How long will I be contagious if I have H1N1 flu?

If you have the H1N1 flu virus you can be contagious for up to seven days after the start of the illness. Children, especially younger ones, may be contagious for longer periods.

Is there a vaccine for H1N1 flu?

Not at the moment. Researchers are working on an effective vaccine for H1N1 flu but it will take several months to produce. We do not yet know if it will be offered to pregnant women. During pregnancy it's not usually recommended that you have a flu vaccine unless your doctor advises you otherwise or you are a healthcare professional working directly with patients.

Where can I find more information?

You can call the Health Ministry's information hotline, 03-88810200 or 03-88810300.
Read more about H1N1 flu in pregnancy.

Novel H1N1 Influenza A Swine Flu

What is swine flu (novel H1N1 influenza A swine flu)?

Swine flu (swine influenza) is a respiratory disease caused by viruses (influenza viruses) that infect the respiratory tract of pigs and result in nasal secretions, a barking-like cough, decreased appetite, and listless behavior. Swine flu produces most of the same symptoms in pigs as human flu produces in people. Swine flu can last about one to two weeks in pigs that survive. Swine influenza virus was first isolated from pigs in 1930 in the U.S. and has been recognized by pork producers and veterinarians to cause infections in pigs worldwide. In a number of instances, people have developed the swine flu infection when they are closely associated with pigs (for example, farmers, pork processors), and likewise, pig populations have occasionally been infected with the human flu infection. In most instances, the cross-species infections (swine virus to man; human flu virus to pigs) have remained in local areas and have not caused national or worldwide infections in either pigs or humans. Unfortunately, this cross-species situation with influenza viruses has had the potential to change. Investigators think the 2009 swine flu strain, first seen in Mexico, should be termed novel H1N1 flu since it is mainly found infecting people and exhibits two main surface antigens, H1 (hemagglutinin type 1) and N1 (neuraminidase type1). Recent investigations show the eight RNA strands from novel H1N1 flu have one strand derived from human flu strains, two from avian (bird) strains, and five from swine strains.

Why is swine flu (H1N1) now infecting humans?

Many researchers now consider that two main series of events can lead to swine flu (and also avian or bird flu) becoming a major cause for influenza illness in humans.

First, the influenza viruses (types A, B, C) are enveloped RNA viruses with a segmented genome; this means the viral RNA genetic code is not a single strand of RNA but exists as eight different RNA segments in the influenza viruses. A human (or bird) influenza virus can infect a pig respiratory cell at the same time as a swine influenza virus; some of the replicating RNA strands from the human virus can get mistakenly enclosed inside the enveloped swine influenza virus. For example, one cell could contain eight swine flu and eight human flu RNA segments. The total number of RNA types in one cell would be 16; four swine and four human flu RNA segments could be incorporated into one particle, making a viable eight RNA segmented flu virus from the 16 available segment types. Various combinations of RNA segments can result in a new subtype of virus (known as antigenic shift) that may have the ability to preferentially infect humans but still show characteristics unique to the swine influenza virus (see Figure 1). It is even possible to include RNA strands from birds, swine, and human influenza viruses into one virus if a cell becomes infected with all three types of influenza (for example, two bird flu, three swine flu, and three human flu RNA segments to produce a viable eight-segment new type of flu viral genome). Formation of a new viral type is considered to be antigenic shift; small changes in an individual RNA segment in flu viruses are termed antigenic drift and result in minor changes in the virus. However, these can accumulate over time to produce enough minor changes that cumulatively change the virus' antigenic makeup over time (usually years).

Second, pigs can play a unique role as an intermediary host to new flu types because pig respiratory cells can be infected directly with bird, human, and other mammalian flu viruses. Consequently, pig respiratory cells are able to be infected with many types of flu and can function as a "mixing pot" for flu RNA segments (see Figure 1). Bird flu viruses, which usually infect the gastrointestinal cells of many bird species, are shed in bird feces. Pigs can pick these viruses up from the environment and seem to be the major way that bird flu virus RNA segments enter the mammalian flu virus population.

Figure 1.