Is it H1N1? Published Oct. 23, 2009 By By 75th Medical Group By 75th Medical Group HILL AIR FORCE BASE, Utah -- Important actions to take if you think your child has H1N1 flu: Do not panic! Most cases of H1N1 influenza are mild and resolve on their own with time. Most children with flu do not need to be seen in the clinic. 1) Keep your child at home and avoid contact with other people. Staying at home means that the sick person should not leave home except to seek medical care. This means avoiding normal activities, including work, school, daycare, travel, shopping, social and public gatherings until at least 24 hours without fever. 2) Contact your health care provider if you have questions, if your child has severe symptoms or if you or a family member are at high risk for flu complications. Patients enrolled at Hill Air Force Base should call (801) 728-2600. 3) Seek emergency medical care if your child becomes ill and experiences any of the following emergency warning signs: Fast or troubled breathing Bluish skin color Exhibits signs of dehydration such as dizziness when standing, absence of urination or, in infants, a lack of tears when crying Severe or persistent vomiting Not waking up or interacting Being so irritable that the child does not want to be held Flu-like symptoms improve but then return with fever and worse cough Individuals are at high risk for flu complications with the following: Younger than 5 years of age Pregnancy Immuno-compromised Chronic conditions of the immune, respiratory, cardiac or renal systems -- examples of such conditions include diabetes and asthma Blood disorders, including sickle cell disease Cancer Again, keep your child home from school or daycare for at least 24 hours after their fever is gone. The U.S. Centers for Disease Control recommends that people with influenza-like illness remain at home until at least 24 hours after they are free of fever (100 degrees Fahrenheit or 37.8 degrees Celsius), or free of signs of a fever without the use of fever-reducing medicines. Steps to lessen the spread of H1N1 influenza in the home: Important steps to take to protect yourself and others when caring for household members who are sick with the flu include the following: Keep the sick person away from other people as much as possible -- especially others who are at high risk for complications from influenza Remind the sick person to cover their coughs and clean their hands with soap and water or an alcohol-based hand sanitizer often, especially after coughing or sneezing Have everyone in the household clean their hands often, using soap and water or an alcohol-based rub. Keep unclean hands away from your face! Ask your health care provider if household contacts of the sick person -- particularly those contacts who may be pregnant or have chronic health conditions -- should take antiviral medications to prevent the flu Protecting the caregiver If you are the caregiver: Avoid being face-to-face with the sick person When holding small children who are sick, place their chin on your shoulder so that they will not cough in your face Clean your hands with soap and water or use an alcohol-based hand rub after you touch the sick person or handle used tissues or laundry items If you are at high risk of influenza-associated complications, contact the clinic for further instructions. Additionally, avoid being the primary caretaker, if possible. Try to avoid close contact (within six feet) with household members who are sick with influenza. If close contact with a sick individual is unavoidable, consider wearing a facemask H1N1 and breastfeeding Breastfeeding protects babies. Breast milk passes on antibodies from the mother to a baby. Antibodies help fight off infection. Flu can be very serious in young babies. Babies who are breastfed do not get as sick and are sick less often from the flu than babies who are not breastfed. Is it ok to breastfeed my baby if I am sick? A mother's milk is made to fight diseases in her baby. This is really important in young babies when their immune system is still growing. Do not stop breastfeeding if you are ill. Limit formula feeds if you can. This will help protect your baby from infection. Be careful not to cough or sneeze in the baby's face, wash your hands often with soap and water. Your doctor might ask you to wear a mask to keep from spreading this new virus to your baby. If you are too sick to breastfeed, pump and have someone give the expressed milk to your baby. Is it OK to take medicine to treat or prevent H1N1 flu while breastfeeding? Yes. Mothers who are breastfeeding can continue to nurse their babies while being treated for the flu Antiviral medications Antiviral medications can sometimes help lessen influenza symptoms, but require a prescription. Most children do not need these antiviral drugs to fully recover from the flu. However, children with certain chronic conditions who are at higher risk for severe flu complications may benefit from antiviral medications. Contact your provider for more information about antiviral medication. Children older than 5 years of age can take medicines without aspirin, such as acetaminophen (Tylenol) and ibuprofen (Advil, Motrin, Nu-prin) to relieve symptoms of fever and body aches. Call the clinic if you have questions about medications. Children younger than 5 years of age should not be given over-the-counter cold medications without first speaking with a health care provider. The safest care for flu symptoms in children younger than 2 years of age is using a cool-mist humidifier and a suction bulb to help clear away mucus. Over-the-counter cold and flu medications used according to package instructions may help lessen some symptoms such as cough and congestion. However, these medications will not lessen viral shedding. Check the package label to see if the medication contains acetaminophen or ibuprofen. Do not give aspirin (acetylsalicylic acid) to children or teenagers who have the flu; this can cause a rare but serious illness called Reye's syndrome. Check ingredient labels on over-the-counter cold and flu medications to see if they contain aspirin. H1N1 symptons in adults For adults, again as in the case of children -- do not panic! Most cases of H1N1 influenza are mild and resolve without treatment. Most people with flu do not need to be seen in the clinic. 1) Stay home and avoid contact with other people. Staying at home means that you should not leave your home except to seek medical care. This means avoiding normal activities, including work, school, daycare, travel, shopping, social and public gatherings. 2) Contact your health care provider if you have severe illness or if you or a family member are at high risk for flu complications. Patients enrolled to Hill Clinic should call (801) 728-2600. 3) Adults should seek emergency medical care if they become ill and experience any of the following warning signs: Difficulty breathing or shortness of breath Pain or pressure in the chest or abdomen Sudden dizziness Confusion ÇSevere or persistent vomiting Flu-like symptoms improve but then return with fever and worse cough If you or a family member experiences those symptoms please report to the Emergency Room. Specific actions for active duty members 1. Contact your supervisor and stay home. Call your supervisor (or other designee per unit policy) to let them know you are sick and stay home. If you have any of the adult warning signs discussed above, call the Appointment Line at (801) 728-2600 or go to the Emergency Department. 2. You should make phone contact with your unit each day while you are on quarters. 3. Your supervisor is authorized to put you on 24 hour quarters. 4. If you are sick for more than 24 hours, contact the Appointment Line at (801) 728-2600. 5. Quarters means stay home. Members on quarters are required to remain in their homes and away from others, except to obtain medical care. Basic information about the flu What is the novel strain of H1N1 influenza? Influenza is caused by a virus. Each year, several different strains of influenza virus circulate around the world. The flu vaccine we use each year contains the three strains of the virus that are most common that year. Unexpectedly, this past spring a new type (novel strain) of the virus, H1N1, began to circulate around the world. Because it is a new strain, a limited supply of the vaccine is anticipated sometime between late October and late November. Is H1N1 influenza any different than other strains of influenza virus? In the U.S., nearly 36,000 people die each year from seasonal flu. This virus appears to be about as dangerous as other strains of the virus. H1N1 influenza is circulating widely in the southern United States and will almost certainly spread across the Mountain West. Symptoms include: A fever of 100 degrees Fahrenheit (37.8 degrees Celsius) or more, and a cough or a sore throat. As the flu season begins this fall, expect to see other strains of influenza virus circulating again. People with H1N1 influenza commonly report runny or stuffy nose, body aches, headache, chills and fatigue. Some have also reported diarrhea and vomiting. Flu viruses are commonly spread from person to person through coughing or sneezing. People may also become infected by touching something with a flu virus on it and then touching their mouth or nose. The virus can survive and infect a person for as long as two to eight hours after being deposited on a surface. Follow the same actions that you take to prevent any flu -- a healthy lifestyle practice and the avoidance of the viruses spread by people who are sick. Prevention ... avoid getting the flu Everyday actions can help prevent the spread of viruses that cause respiratory illnesses like flu: Keep unwashed hands away from your face. Follow public health advice regarding school closures, avoiding crowds and other social distancing measures. Be prepared in case you get sick and need to stay home for several days. Purchase a supply of over-the-counter medicines, alcohol-based hand rubs, tissues and other related items you might need to avoid trips out in public while you are sick and contagious. Be sure you have a thermometer and know how to use it. Practice good health habits A healthy diet, sufficient rest, and regular exercise can help your immune system fight off infections. Stay informed -- know the facts. Because this is a new strain of influenza, public health recommendations may change as we learn more about it. Identify sources you can count on for up-to-date, reliable information. Some suggested Web sites are: .cdc.gov/h1n1flu/ flu.gov pandemicflu.gov. What should I expect from the Hill Clinic if I get the flu? The 75th Medical Group is here to provide care when you are sick. However, because H1N1 is contagious, we will likely provide home care instructions over the phone and recommend that those with uncomplicated flu avoid coming to the facility. Patients will be given home care instructions, but most will not need to be seen in the facility. All patients with flu-like symptoms who come to the facility are expected to wear a mask while in the facility. Home care advice ... for people with the flu The actions below can help you feel better while you are sick and help keep you from spreading the flu to others. To help you feel better: Drink lots of fluids -- drink clear fluids such as water, broth, sports drinks, electrolyte beverages (for infants) to keep from getting dehydrated. Medications -- Take non-prescription medications like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) and cough medicine to relieve symptoms of fever, pain and cough. You do not need to take these medicines regularly if your symptoms improve. Do not give aspirin (acetylsalicylic acid), or products that contain aspirin, to children less than 18 years of age. To avoid spreading H1N1 flu: Stay home. Avoid going to school, work or public places until you are fever-free for at least 24 hours without the use of fever-reducing medicines. Wear a mask. If you are sharing a common space with other household members or if you must go out, wear a facemask to help prevent spreading the virus to others. Handwashing. Wash hands often with soap and water, especially after coughing or sneezing. Alcohol-based hand cleaners are also effective. Reduce contamination. Linens, eating utensils, and dishes used by those who are sick do not need to be cleaned separately, but should not be shared without washing thoroughly. Linens should be washed using household laundry soap and tumbled dry on a hot setting. Wash hands with soap and water or alcohol-based hand rub immediately after handling dirty laundry. Eating utensils should be washed either in a dishwasher or by hand with water and soap. Keep surfaces (especially bedside tables, bathroom surfaces, kitchen counters and toys for children) clean by wiping them down with a household disinfectant according to directions on the product label.