Swine Flu 2009

We’ve been getting a few phone calls with several questions about Swine Flu. This is what we know about it so far:

The typical flu symptoms that we already know are as follows. Please call us for an appointment if you have:

• High fever – 103-104 and any three of the following: sore throat, muscle aches, mild cough, stuffy nose. Most kids that have influenza look like they were hit by a truck. They are not typically playing around or happy looking.
• The yearly flu shot for human influenza will not protect you from this disease, since swine flu viruses are very different antigenically.
• Antiviral antibiotics (Tamiflu or Relenza) are indicated if we are still within the 48 hour window of fever. Some pediatricians feel that there is little or no benefit to using them, unless there is an additional predisposing risk for severe complications from flu infection. Treatment regimenst typically last 5 days and may shorten the duration of symptoms by a day or so.
  
• Under certain conditions, it might be advisable to use these antivirals on close family contacts of a confirmed case of swine flu. Prophylactic antiviral antibiotics are typically given once daily for ten days.
  
• We believe that if your child has been effectively treated with antiviral antibiotics, and has not had fever for 24 hours, you can probably send them back to school safely.
• For the most accurate up to date information, please visit the CDC’s Swine Flu Page.

We make a diagnosis based on the clinical findings, and reinforce it with the Binax Influenza test for both Flu A and B. Although it was not designed to find swine flu, it seems to have been effective at picking quite a few cases over the summer months. We are not sending samples out for confirmation at this time, because the overwhelming majority (90-95%) of these samples were confirmed to be the novel swH1N1 subtype, and there was no clinical difference in the management of positive cases – ie you were treated with the same medications for both seasonal and swine varieties of the flu. The outcome of treatment in so far all of our patients has been very positive. The youngest one was 7 months of age, but we’ve seen large number of preteens and teenagers come back positive. What puts you at greatest risk is being a close contact with a person that is positive. What we mean by close contact includes:

• Home family contacts, 
  
• Car pool buddies.
  
• Day care contacts – they share all sorts of stuff don’t they? 

Our schools are faced with the difficult task of trying to keep our kids healthy, and they do not always have the necesary nursing coverage to adequately triage probable cases of flu from less complicated illneses such as colds or ear infections. In light of this, we recommend being patient with them, and try avoid sending your children to school with any sort of fever, because this will lead to further angst.

Yahoo news has an interesting piece on how to prevent swine flu – or any flu, for that matter.

Windermere Pediatrics will not be getting the supply of swine flu vaccine that we ordered a couple of months ago.