A Parent's Guide to H1N1 Influenza

How Can My Family Avoid Catching the H1N1 Flu?

The seasonal flu vaccine protects against three strains of influenza, including the H1N1 flu that appeared in 2009. The flu vaccine is recommended for all people 6 months of age and older. These precautionary guidelines also can help:

• Cover noses and mouths with a tissue when sneezing or coughing and put the used tissues in the trash.
• Cough or sneeze into an upper sleeve (not into hands) if a tissue is not available.
• Clean hands after coughing or sneezing — wash with soap and water or use alcohol-based hand sanitizer.
• Avoid touching the eyes, nose, and mouth.

Do My Kids Need to Get Vaccinated?

Yes. All children 6 months of age and older should receive the seasonal flu vaccine to help protect against H1N1 flu and other flu viruses. Children younger than age 9 who never had a flu shot or did not get the H1N1 vaccine during the 2009-2010 flu season will need two doses of the vaccine (either through a nasal mist or shot). Older kids and teens need just  one dose.

Though it is recommended that everyone 6 months of age or older get the seasonal flu vaccine, the Centers for Disease Control and Prevention (CDC) stresses the importance of vaccinating:

• high-risk groups and their contacts
• people who live with (or care for) children younger than 6 months old
• health care and emergency services personnel

Is the Flu Vaccine Safe?

While very few people get side effects from the seasonal flu vaccine, those who do may have soreness or swelling at the site of the injection or mild side effects, such as headache or low-grade fever. Some people who get the nasal spray vaccine also may develop mild flu-like symptoms, including runny nose, headache, vomiting, muscle aches, and fever.

Although these side effects might last for a day or so, flu viruses like H1N1 flu can potentially sicken someone for weeks and cause health problems that could require hospitalization, especially in young children or people with chronic diseases. As a result, doctors believe that the benefits of getting the flu vaccine outweigh any potential risks.

When and Where Is the Vaccine Available?

The seasonal flu vaccine becomes available each fall. It is given in places like hospitals, clinics, community centers, pharmacies, doctor's offices, and schools. Many kids receive the flu vaccine at school.

Pregnant women, kids age 5 or younger, and children with chronic medical conditions should receive the vaccine as soon as it becomes available. People in these groups (along with their close contacts and health care providers) will be given preferential treatment when getting the vaccine or in times of limited vaccine supply.

What if There's an Outbreak Before We're Vaccinated?

If an outbreak occurs, you can help protect your family by being cautious about avoiding germs. Keep kids away from public places, like sporting events, theaters, churches, and places where they're likely to come in close contact with others. Take recommended precautions, like washing hands or using a hand sanitizer often, and do not touch the eyes, nose, or mouth.

Schools will follow flu outbreak preparedness plans, which may include keeping kids with siblings who have the flu or those with chronic conditions separated from others or home from school for a few days.

If your child is at risk of developing complications from the flu and has been in close contact with someone who has the flu, call your doctor. In some cases, the doctor may prescribe antiviral medicines as a precaution against the flu.

What Are the Symptoms of H1N1 Flu?

Symptoms of the H1N1 flu are similar to the seasonal flu. They include fever (100º F or 37.8º C or above) plus one or more of the following: cough, sore throat, body aches, headache, chills, fatigue, diarrhea, or vomiting. The flu also can cause pneumonia, which can make it hard to breathe. The H1N1 flu can last anywhere from 7 to 14 days.

Kids who develop any of these symptoms need immediate medical attention:

• fast breathing or trouble breathing
• bluish skin color
• not drinking enough fluids
• very sleepy or lethargic
• in babies, being so irritable they don't want to be held
• fever with a rash
• flu-like symptoms that improve, then return with fever and a worse cough

What if My Child Has Flu-like Symptoms?

If your child begins to have flu-like symptoms, do not send your child to school or childcare. This will help limit the spread of the virus. Keep your child home, and call the doctor to see whether an office visit is recommended. Only have your child leave the house for medical care.

Healthy kids usually don't get complications from the H1N1 flu and get better on their own without medical treatment. But some kids who develop severe complications from the flu or have chronic medical conditions might need antiviral medicines or hospitalization to ease symptoms, shorten the duration of the illness, and prevent complications.

At home, make sure your sick child:

• drinks lots of fluids to prevent dehydration
• gets plenty of sleep and takes it easy
• takes acetaminophen or ibuprofen to relieve fever and aches (but do not give aspirin due to the risk or Reye syndrome)
• wears layers, since the flu often makes kids cold one minute and hot the next
• does not return to school or childcare until fever (of 100º F or 37.8º C or above) is reduced for at least 24 hours without the use of fever-reducing medicines

Call your doctor if your child seems to get better but then feels worse, develops a high fever, has any trouble breathing, or seems confused.

If your child has a chronic condition, like asthma, make sure to check with your doctor to help ensure the condition is under control. Likewise, if you're pregnant or breastfeeding and come down with flu symptoms or have been exposed to someone who has the flu, contact your doctor right away. You may need to take antiviral medications as a precaution for yourself and your baby.

How Do I Keep My Child From Infecting Others?

Since the H1N1 flu spreads in the same way that other flu viruses do — through the air when a person who has the virus sneezes, coughs, or speaks, or when someone touches a contaminated surface and touches the nose, mouth, or eyes — it's important to have kids follow the precautions mentioned earlier.

A person infected with the flu can spread the virus to others the day before symptoms start and up to 5 to 7 days after they begin. Some people may be contagious for longer, especially if they have chronic health conditions that weaken their immune systems.

Once flu-like symptoms start, do not send your child to school or childcare. Your child should only leave the house for medical care or other necessities. Call your doctor before bringing your child in. At the doctor's office, make sure your child coughs or sneezes into a tissue.

At home, keep visitors from coming over, and make sure your child limits contact with family members. If possible, have only one adult care for the sick child. Siblings, pregnant women, and others who are at risk for flu complications should avoid getting closer than 6 feet to an infected person and should never get face-to-face, share cups or utensils, or handle dirty tissues (or other objects that may have been sneezed or coughed on). Make sure that hand sanitizer or soap and water is readily available for frequent hand washing and keep surfaces clean with disinfectant.

Kids can go back to school or childcare once their fever is gone for 24 hours without the use of fever-reducing medicines. Some might need to stay home longer, depending on how they feel. If you have questions or concerns, check with your doctor.

What Should I Say To Kids About H1N1 Flu?

Tell kids that there's no need to panic about H1N1 flu. As with other kinds of flu, most people with the virus recover within a week.

During the 2009-2010 flu season, the H1N1 flu was a new virus and wasn't included in the seasonal flu vaccine. Many people were concerned about H1N1's ability to spread and its potential to cause life-threatening complications, especially in people at high risk of developing flu complications. Fortunately, the virus turned out to be less serious than anticipated, and most people who caught the H1N1 flu quickly recovered without the need for medicines.

Because the 2010-2011 seasonal flu shot includes vaccination against H1N1 flu, there's little need to worry about the H1N1 flu. Governments and health organizations are still monitoring outbreaks of H1N1 flu (when and if they do occur), and will be offering vaccines to those who are at the greatest risk of developing complications from the flu.

Reviewed by: Mary L. Gavin, MD
Date reviewed: August 2010