H1N1 has sure made our lives more complicated, hasn’t it?

It used to be complicated enough staying up to date with one influenza virus, the “seasonal” or winter flu, now we have H1N1, swine flu, to worry about, too. In other words, we now have two flu seasons instead of one.

H1N1 and “seasonal” flu have a few important differences:

1. H1N1 is a distinct virus from “seasonal” flu.
2. H1N1 doesn’t have a distinct season the way “seasonal” flu actually has. H1N1 seems to be perennial, meaning it seems to be able to run through all the seasons.
3. H1N1 seems to be more mild than “seasonal” flu, so far, but can still make people very ill and has cost people their lives.
4. H1N1 is very widespread and that hasn’t changed so far.

What is similar with H1N1 and “seasonal” influenza?

1. They are both members of the influenza family.
2. They both give people, kids and adults, the flu.
3. They can both be controlled via simple measures such as hand washing and isolating sick people until they are fever free for 24 hours from healthy people.
4. Both can make people either very sick or not very sick. They both can be controlled by widespread immunization of high risk people such as health care workers and children 6months to 18 years.
5. Keep in mind that because H1N1 is a different virus from seasonal flu, each needs it’s own immunization, it’s own vaccine. So, that means your child will need two shots this year to be covered for the flu season: one for the flu you know and love, the seasonal flu, and another for H1N1.

For the most uptodate information about the H1N1 flu shots and where to find the clinic nearest to you, and how is considered high risk, click here. The high risk people and kids are going to get vaccinated first and then everyone else will be offered the vaccine.

In addition to vaccination and isolation, Luckily, both flu illnesses are so similar that you can manage them at home with similar products. To help you be prepared, here’s a shopping list of a few simple items to pick up as you do your back to school shopping:

1. Tissue
2. Hand sanitizer
3. Fever buster medication: acetaminophen (ex. Tylenol), ibuprofen (ex. Motrin, Advil)
4. Rehydration drinks: Pedialyte or the equivalent for infants; Gatorade low sugar for toddlers and older kids.

Please note that over the counter cold and cough medications are not on this list as they are not routinely recommended in children or even teens.

We all have a bit of H1N1 fatigue but it’s important to be prepared with the right information and know how to stay healthy even if we don’t have the shot on board.

(Originally posted September 2009; updated December 2009)

You know one of these days it will happen. On the day when you least expect it (and often when it is least convenient) the school nurse will call in form you that your child has “flu like symptoms with a fever” and needs to be picked up. Now what?

The 2009-2010 school year game plan was simple enough: avoid the wide spread school closings that occurred at the end of the 2008-2009 school year when H1N1 first came into our lives. This certainly appeared to be a challenge with  2 influenza strains to contend with, an intensity of flu season predicted to be quite strong, and 55 million students and 7 million staff in 130,000 public and private schools, according to the CDC, to keep healthy.

Reassuringly, the CDC had learned a great deal about H1N1 since it first arrived on the scene, and recognized that we can manage the upcoming flu season as we always have but use last year’s aggressive plan if the situation ends up becoming much more intense in any way from anticipated.  To this end, the CDC  prepared two tiers of guidelines for schools and health professionals to follow which will come into play as the 2009-2010 school year progress and as the flu season develops with enough details to know which guidelines  make the most sense to follow:  http://www.cdc.gov/h1n1flu/schools/schoolguidance.htm

The highlights for the expected flu season include:

1. Keep sick people home until fever free for 24 hours.
2. Separate sick students and staff from healthy if someone becomes sick at school.
3. Wash hands, cough into your elbows, blow noses into tissue!
4. Clean, clean, clean all public areas frequently.
5. High risk folks need early treatment with anti-viral medications.
6. “Selective school dismissals” only.

If the flu season becomes a whopper, the CDC suggests that

1. Screening of influenza virus should start.
2. High risk folks should consider staying home until the situation is more under control.
3. Contacts of people stay home for 5 days.
4. Schools need a plan for this: homework to kids, separate kids while at school more.
5. People with the flu stay home for 7 days.
6. School dismissals become considered in consultation with local CDC chapters.

Your pediatrician is the best person to help you decide what family members are “high risk” so you can be prepared to know that ahead of time. Keep in mind, though, that all kids are considered “high risk” in that they are the ones at most risk for becoming the sickest from either flu strand. So please immunize all your kids ages 6months to 18 years against both the H1N1 and seasonal flu. If you don’t, you may very well find it’s your child that ends up in the ER…or worse.

Arming yourself with the latest information today is what will give you peace of mind tomorrow. So, check back often for the latest information and as the flu season unfolds we’ll regroup and adjust as needed to keep ourselves and our kids as healthy as possible.

(Originally posted October 2009; Updated December 2009)

Swine Flu is Influenza H1N1. This virus is very, very similar to season flu mentioned above. Important points to focus on:

1. You have to have flu symptoms to worry about having Swine Flu.

2. The people most at risk are the people who have either visited Mexico recently or come in contact with people exposed to the virus through those people.

3. The best way to avoid further spread of the virus is to

• Stay home if you feel sick for 7 days
• Seek medical care if you are not getting better or have concerning symptoms such as lethargy, very high fever, or trouble breathing.
• Wash your hands vigorously.
• Cough in the crook of your arm.
• Stay informed! Visit the CDC website for more information.
• Don’t panic! This virus has spread quickly but the spread is slowing and the viral strength is not as intense as we are used to with seasonal flu.
• Call your physician with any questions.

Do you really have to worry about H1N1, Swine Flu? Where is the infamous H1N1 vaccine and do you really need to get it for you and your kids? Is the H1N1 illness really “mild”?

Despite how long we’ve been talking about this year’s flu season and H1N1 there are still many questions and a great deal of confusion.

I’m going on WBUR Radio’s Radio Boston hosted by Jane Clayson, David Boeri at Noon ET today with a panel of incredible health experts to help sort out the issues and bring up the latest information.

Tune in…and call in! This is a live show and we want to help you get your questions answered.

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Yesterday, New England Cable News hosted a 2 hour prime time special on H1N1. I was honored to be invited on air as the pediatric health expert along with the area’s top health professionals in emergency medicine, OB/GYN, public health and infectious disease. We covered a great deal of ground in the 2 hours including clearing up the popular myths circulating around:

Vitamins, Diet and the H1N1:

NECN: H1N1 What you Need to Know Resource Page

Flu Update

At last weekend’s American Academy of Pediatrics meeting, a few of us were asked to comment to Good Morning American Weekend about our feelings about H1N1 (Swine Flu) and the vaccine, in particular.

None of us were privy to the comments each other made and I think you’ll find the consistency of what we all had to say incredibly reassuring: Pediatricians on Swine Flu Confusion

Yesterday, GMA ran a segment on “The Scramble for Swine Flu Shots” which includes advice from me and other experts about the delay in the H1N1 vaccine. This segment does a nice job putting the entire situation in a very healthy perspective.

And, just to clarify, my entire family will be receiving the H1N1 vaccination when it becomes available in our area. That’s how comfortable I am with it!

Yes, even doc-mom bloggers get sick! It hit me last week out of the blue like a Mack truck that decloacked on a superhighway with out warning. So, I suspect it was one of the flu viruses that have been on our minds recently.

I thought about attempting to blog, even fired up the computer at one point to give it a whirl, but my mind was too foggy and I just didn’t have the oomph. So, I took the advice I give out so many times during the flu season to others: I rested!

This was no ordinary rest, though. I found myself in bed for the entire long weekend and for most of that time I actually slept, which is unusual for me with a bug of any kind.

That’s how I know I likely had one of the flu bugs. I just don’t get sick like that.

Luckily, I had received my seasonal flu vaccine earlier in the month. So, while it could have been seasonal influenza, more likely I suspect I had H1N1. I’ll never know…but as it’s going around and I haven’t yet received that vaccine yet, it’s a safe bet!

Regardless of whether I had H1N1 or one of the many other viruses that circulate with the flu viruses this time of year, I did what I was supposed to do: I stayed away from other people and rested!

To go a step further, let me give you a sense of some other steps I took to get back on my feet and help contain the spread of whatever I had in my home and community:

1. I called my doctor. I have a form of inflammatory arthritis so I know a simple cold or virus in me can become a big deal. But, even without an underlying condition, I felt lousy enough that this wasn’t the time to be patient and doctor to myself!

2. I called out sick. I missed not only a clinical shift but stayed away from some media work, too. I  didn’t want to expose others, health or sick, to what I had.

3. We went to plan B for our kids’ schedules. My husband did some kid running and we actually cancelled some things.

4. Early in my illness we stocked up on anything I would need at home – sports drinks, soup, crackers, etc. The key was making sure I didn’t have to leave home!

5. One of our daughter’s came home from school last Friday with a fever so over the weekend we did a mini isolation. My husband kept our healthy daughter busy while I took care of our sick daughter, with his help when needed. The feeling was, I already had the bug!

6. We made sure we had tissue, hand sanitizer, fever control medication and a functional thermometer as soon as we realized I was sick…and stocked up in case illness recurred later in the flu season.

7. We talked about a plan of attack should one of us get sick later in the flu season. Who would get the kids to their activities? What if both of us get sick at the same time? Do we each have all the doctor’s number programmed into our phones? Good to catch up on all those details…and be sure all the grownups in the home have all those details!

By the end of Columbus Day, we were all healthy again!

Had we not been so aggressive in resting and letting our illnesses run their course, we may not have been so luck with how brief and uncomplicated our illnesses ended up being.

Illness this time of year packs a punch on families logistically and financially. If parents don’t work, paychecks don’t come in. If parents are not healthy, kids don’t get where they need to be after school.

As parents, we don’t hesitate to keep our children home from school when they are sick but not so great in staying home when we are sick. Your body will recover much faster if you don’t force it to work when it’s battling a war against an illness. You are essentially burning the candle at both ends by doing so and your illness will last longer that way.

I hope my family’s recent dip in the illness pond will give you a bit of a road map should illness enter your home this flu season. If you get sick this flu season, don’t feel a bit of guilt for caring for yourself. Feel empowered that you are taking the responsible path not just for your health but for the health of the people you care about the most and who count on you each and every day…your family, friends and co-workers.

There’s a disturbing statistic floating about parents’ view of H1N1. According to a recent survey by CS Mott Children’s Hospital, only 40% of parents plan to get their kids the H1N1 shot. The reason: “they are not worried about H1N1”.

This statistic completely stuns me given the amazing amount of coverage and data on H1N1. As a parent and a pediatrician, I’m floored that more parents are unable to see just how serious H1N1 is and why they need to immunize their children for this flu season.

Let’s tease through the facts so you have a better understanding why H1N1 isn’t a virus to take lightly, or for granted:

1. There are two influenza flu seasons occurring at once this year each requiring its own flu shot: seasonal flu and H1N1.

2. Each flu shot is specific for the flu season it is designed to protect against. In other words, the seasonal flu shot will not protect you or your kids against H1N1 and the H1N1 shot will not protect you or your kids against the seasonal flu.

3. The neither flu is not a mild illness. H1N1 is often described as being less intense than the seasonal flu but that does not make it less significant or potentially deadly.

In fact, H1N1 hits people under 24 the hardest with a preference for small kids. For a more visual picture of how H1N1 infects people and causes it’s complications check out these charts from the CDC:

(This chart shows infection rate by age. Not only is the under 24 age group is the group at risk from H1N1 infection by a wide margin but the 0-4 age group is one of the groups at particular risk.)

(Hospitalization rates parallel infection rates with H1N1..under 24 at highest risk with 0-4 most vulnerable.)

(This is the chart we don’t want to consider – the death rate from H1N1. Note that there are documented deaths in all ages with the 0-24 group accounting for close to 20% of the total deaths from this virus.)

The data really speaks for itself. Our healthy kids and young adults are at more risk than other groups from infection and complications from H1N1. As parents, our job is to protect our kids from things they can’t protect themselves from. We can’t keep them from being exposed to H1N1 but we can give their bodies a way to battle it once they come into contact with it. It’s not a matter of if they will be exposed, but when.

Sometimes as parents we have to stop over thinking a situation and do what we have to in order to keep our children safe. I believe this is one of those situations. Instead of questioning data and acting out of fear, we need to start trusting the doctors and scientists working hard to keep our communities safe. After all, they have families and children, too.

My entire family is getting the H1N1 vaccine this year. I believe in this vaccine and it’s safety. Please consider doing the same for your kids.

(Addendum, 10/8/09: much thanks to Universal Hub for pointing out a typo in the last sentence than is now corrected! Dr. Gwenn)

For information on H1N1 and the new school year, click here.

The Pediatrics Now September update is live and has all the latest information on H1N1 and the Seasonal flu to help you stay informed and up to date.

This month’s highlight’s include:

New School Year, New Flu Season
H1N1 has sure made our lives more complicated, hasn’t it?As if one flu season wasn’t enough now we have H1N1 to contend with. In this month’s Dr. Gwenn Is In, I cover all the highlights of why this year’s flu season is so unique and how you can get your family prepared to ward off the germs already lurking at all of our front doors.

Fox News appearances covering Flu Shot: Fact vs. Fiction and H1N1 Tips for Prevention.

Flu Season Activity Update Hot off the presses H1N1 and Seasonal Flu highlights for the top experts in the fields.

Don’t forget to check out the home page for other updates to Ask Dr. Gwenn, Bug of the Month, and Fit Tips: Small Changes, Big Results.

If you don’t see what you are looking for, let me know! I’ll hunt down the info for you and put it in next month’s update.