For Patients and Families

Some other simple steps include:

• Don't share cups and utensils with other people
• To the extent possible, stay away from sick people
• Try to keep the touching of surfaces (banisters, etc) in public places to a minimum (and wash hands afterward)
• Don't touch your eyes, nose, or mouth, as that spreads germs

How does H1N1 spread?
H1N1 appears to be spread by droplets, the same way as regular seasonal flu. Coughs and sneezes send germs out onto hands and other surfaces, and when other people come in contact with them, they get sick. That's why it's so important to wash your hands, and to cover coughs and sneezes with the inside of your elbow, rather than your hands (since you don't usually touch things with the inside of your elbow).

What should parents do if their child has flu-like symptoms?
The most important thing to do is not panic! While some people with H1N1 get very sick and need hospitalization, the majority of them recover fully within a few days. Keep your child at home (that's important to reduce the spread of the flu), make sure they rest and get plenty of fluids. Acetaminophen and/or ibuprofen can help with the aches and fevers (never give aspirin to a child!). A humidifier and salt water nose drops can help with the congestion; if your child is older than a year, a spoonful of honey can help calm a cough.

Call your doctor if your child:

• Has flu-like symptoms and is less than 6 months old
• Has a high fever (102 or greater) that won't come down easily
• Has any trouble breathing
• Has a serious health problem, such as diabetes, asthma that requires daily medication, or a problem with their immune system
• Won't drink, or has signs of dehydration (dry mouth, sunken eyes, decreased urination)
• Complains of severe pain or, if an infant, is extremely cranky
• Is much sleepier than usual
• Has a seizure
• Is getting worse, or doesn't get better in 3 to 5 days

How do we know that the vaccine is safe, despite being fast-tracked for approval?
Everything possible is being done to be sure that the vaccine is safe, including clinical trials on volunteers. New vaccines are only approved after a review of the safety data from the trials. Vaccines are only fast-tracked when experts believe that the benefits of vaccination outweigh the risks from using a new vaccine.

Who should get the H1N1 vaccine when it is released?
The Centers for Disease Control and Prevention (CDC) recommends that the following groups of people get the vaccine first:

• Pregnant women
• People who live with or care for children less than 6 months old
• Health care and emergency medical services personnel
• People between the ages of 6 months and 24 years (especially those younger than 4 years, and those who are 5 to 18 and have chronic medical conditions)
• People ages 25 to 64 with chronic health disorders or problems with their immune systems
• If there is enough vaccine once these people have been vaccinated, those over 65 would be next on the list

Will there be enough vaccine for everybody?
We don't know exactly how much vaccine there will be, but we hope to have enough to vaccinate at least the highest priority groups of people.

How can H1N1 be treated in children?
H1N1 can usually be treated with oseltamivir or zanamivir. If started early enough in the illness, these medications can lessen the severity and duration of symptoms. However, most people recover fully without treatment. If your child is an infant, or has a serious health problem, or there's someone in the house with a serious health problem, treatment may be a good idea. Check with your doctor.

For more information on H1N1, visit the website of the Centers for Disease Control and Prevention: www.cdc.gov/h1n1flu/qa.htm.

Source: Claire McCarthy, MD, Medical Director of Children's Hospital Boston's Martha Eliot Health Center.