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Caring for a Child With H1N1 Influenza

If your child has been diagnosed with H1N1 influenza (swine flu) you might be worried about how to provide home care. The truth is, there isn't much difference between caring for a child with the H1N1 flu versus one with the seasonal flu.

The H1N1 flu is still a flu virus — so rest, relaxation, and drinking plenty of fluids should be at the top of the treatment list.

Still, parents should be aware of some special considerations when it comes to this new flu strain:

  • Younger kids and those with chronic conditions are more at risk for problems. Ask your doctor about antiviral medicines (which can prevent symptoms from worsening) for kids 5 years old or younger or who have a chronic condition like heart disease, asthma, or diabetes. For the maximum benefit, these should be given as early as possible.
  • H1N1 flu passes easily from person-to-person. Since relatively few people are currently vaccinated against the virus, it's important to follow care measures that limit the spread of the illness in the home and community.

Fortunately, most kids who get this flu virus will do just fine and get better on their own within a couple weeks.

To keep your child as comfortable as possible during this time, while also limiting the spread of flu germs to others, here are some guidelines:

When to Keep Kids Home

Kids who start to have flu-like symptoms should kept out of school or childcare. Symptoms of the H1N1 flu are fever (100° F or 37.8° C or above) plus any one or more of the following:

  • cough
  • sore throat
  • runny or stuffy nose
  • body aches
  • chills
  • fatigue
  • diarrhea
  • vomiting

Keep your child home at the first sign of illness and call your doctor to see if an office visit is necessary. To prevent the spread of the virus, your child should only leave the house for medical care or other necessities.

Caretakers, siblings, and other family members of kids with flu-like symptoms can continue to go to work or school, but it's especially important for them to avoid germs by washing their hands often and avoiding face-to-face contact with the infected person.

Some schools and employers may request that family members stay home for a couple of days.

When to Go to the ER

Having symptoms of the H1N1 flu or the seasonal flu is not a reason to go to the emergency room. If your child has flu-like symptoms, consult your doctor for treatment advice.

However, if your child is in medical distress, immediate medical care is needed. Go to the ER or dial 911 if your child:

  • has fast breathing or trouble breathing
  • has bluish skin color
  • is not drinking enough fluids
  • is very sleepy or lethargic
  • is a baby, and is so irritable that he/she doesn't want to be held
  • has fever with a rash
  • has flu-like symptoms that improve, then return with fever and a worse cough

Treating Symptoms

Kids without chronic health conditions usually tolerate infection with the H1N1 flu virus fairly well and get better on their own without medical treatment.

Those who have developed a serious illness and require hospitalization or who are at risk for complications from the flu (including kids younger than age 5 and those with chronic conditions like heart disease, diabetes, asthma, and other lung problems) may be given antiviral medicines to ease symptoms, shorten the duration of the illness, and prevent complications.

When caring for a sick child at home, make sure to:

  • Offer plenty of fluids (fever, which can be associated with the flu, can lead to dehydration). Offer water, sports drinks, juice, and soft drinks, but you can also try ice pops, icy drinks mixed in a blender, and flavored gelatin to maintain hydration.
  • Encourage your child to rest in bed or on the couch, with a supply of magazines, books, quiet music, and perhaps a favorite movie.
  • Give acetaminophen or ibuprofen for aches and pains (but do not give aspirin because of the risk of Reye syndrome).
  • Don't give kids younger than age 2 over-the-counter cold medicines without speaking to your doctor first.
  • Dress your child in layers so you can add and remove layers during bouts of chills or fever.

If your child has a chronic condition, like asthma, make sure to check with your doctor to help ensure the condition is under control.

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

Preventing the Spread of Infection

Part of caring for a child with the H1N1 flu is trying to make sure that other family members do not get infected with the virus.

There's no surefire way to completely stop the spread of germs, but you can reduce the chances that others will become sick with these steps:

  • Get family members vaccinated. People can avoid catching the flu by getting vaccinated against the seasonal flu now and against the H1N1 flu when that vaccine becomes available in October.

    The Centers for Disease Control and Prevention (CDC) specifically recommends the H1N1 flu vaccine for:
    • pregnant women
    • people who live with (or care for) kids younger than 6 months old
    • children and young people between the ages of 6 months and 24 years old
    • people ages 25 to 64 with chronic health conditions or compromised immune systems
    • health care and emergency services personnel
  • Keep infected persons away from others. Have kids with the flu stay in a separate room away from common areas and, if possible, use a separate bathroom that they don't share with other family members. If possible, have only one adult care for a sick child. Limit close, face-to-face contact with family members as much as possible, especially those who are at risk of catching the flu or having complications from it (like other kids, those with chronic illnesses, and pregnant women).

    Those in at-risk groups should maintain a distance of 6 feet when around anyone with H1N1 flu, and — if at all possible — they should not be the primary caretakers of someone with the H1N1 flu. If you're a caretaker and are pregnant or have a chronic condition, wear a facemask when caring for your child and wash your hands frequently.

    Kids with H1N1 flu who can tolerate wearing a facemask should wear it when in common areas of the house or when leaving the house for medical care or other necessities.
  • Teach family members to avoid contact with germs. Encourage those in your household to:
    • cover their noses and mouths with a tissue when sneezing or coughing, and put used tissues in the trash
    • cough or sneeze into an upper arm sleeve (not their hands) if a tissue is not available
    • clean hands after coughing or sneezing — wash with soap and water or use alcohol-based hand cleaner
    • avoid touching their eyes, nose, and mouth

Combating Germs at Home

H1N1 spreads in the same way that other flu viruses do — through the air when someone who has the virus sneezes, coughs, or speaks. People also can catch the virus after touching a contaminated surface of an object that someone with the virus touched, sneezed, or coughed on.

Germs can survive on tabletops, kitchen counters, toys, and doorknobs for up to 8 hours after being deposited there, so it's important to sanitize these areas throughout the course of a day. Use a household disinfectant to wipe areas clean.

Linens, dishes, and eating utensils should not be shared with a sick person, but can be used by other family members after a thorough cleaning. Kitchen items can be washed by hand with soap and water or in the dishwasher with detergent. Wash linens with laundry soap and tumble dry on "hot" — and try to limit touching the laundry prior to washing it (for instance, carry it to the washer in a basket, not in your arms).

Whenever possible, air out common areas by opening windows.

Sending Kids Back to School

Kids are no longer considered contagious and can return to school after their fever is gone for at least 24 hours without the aid of fever-reducing medicines. Some kids might need to stay home longer, depending on how they feel. If you have questions or concerns, check with your doctor.

Reviewed by: Mary L. Gavin, MD
Date reviewed: September 2009