Name of Child: Date: The Flu. Seasonal Influenza and H1N1

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1 The Emily Center The Flu Seasonal Influenza and H1N1 Diagnosis/Disease/Illness Si usted desea esta información en español, por favor pídasela a su enfermero o doctor. Name of Child: Date: The Flu Seasonal Influenza and H1N1 How do I know if my child has the flu? Your child may have the flu if they have some or all of these symptoms: fever (not everyone with the flu will have this) cough sore throat runny or stuffy nose body aches headache chills fatigue diarrhea and throwing up (not everyone with the flu will have this) #1076 What should I do if I get sick or my child gets sick? Everyone who has symptoms of the flu should stay home and keep away from other people. Go out only to see a doctor. Most people with the seasonal flu or H1N1 in 2009 have had mild illness. They did not need medical care or medicine that kills viruses. However, some people are more likely to get flu complications. These people should ask their health care provider if they need to be examined if they get flu symptoms this season. They are: Children younger than 5, but especially children younger than 2 years old People 65 and older Pregnant women 1 of 7

2 People who have: Cancer Blood disorders, including sickle cell disease Chronic lung disease, including asthma or COPD (chronic obstructive pulmonary disease) Diabetes Heart disease Kidney disorders Liver disorders Neurological disorders, including nervous system, brain or spinal cord Neuromuscular disorders, including muscular dystrophy and multiple sclerosis Weakened immune systems, including people with AIDS It s also possible for healthy people to develop severe illness from the flu. Anyone concerned about their illness should talk to a health care provider. Emergency warning signs Some things are emergency warning signs for severe influenza. Anyone who has these signs should get medical care right away. What are the emergency warning signs? In children Fast breathing or trouble breathing Bluish skin color Not drinking enough fluids Not waking up or not 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 Fever with a rash In adults Difficulty breathing or shortness of breath Pain or pressure in the chest or abdomen Sudden dizziness Confusion Thowing up that is very bad, or doesn t stop 2 of 7

3 When should someone go to the emergency room? If you have emergency warning signs, go to the emergency room. The emergency room should be used for people who are very sick. If you go to the emergency room and you are not sick with the flu, you may catch it from people who do have it. If you have flu symptoms and are at high risk of flu complications, or you are concerned about your illness, call your health care provider for advice. How long should I stay home if I m sick? The Centers for Disease Control (CDC) asks that you stay home for at least 24 hours after your fever is gone. Your fever should be gone without the use of medicine, such as Tylenol. You should only go out to do things you have to do and no one else can do for you. You should stay home from work, school, travel, shopping, social events, and public places like malls and movie theaters. Can you do a test to tell if my child has influenza? There are tests that can be done to tell if someone has the flu. It may not be necessary to do these tests if your child is not sick enough to be admitted to the hospital. Healthcare workers have identified a group of symptoms that can help tell if your child may have H1N1 influenza. The use of these symptoms to diagnose H1N1 influenza is a very effective method. It is more effective than using lab tests. There are rapid influenza tests, but they do not work very well in telling us who has Influenza A H1N1. Research has shown these tests fail 30-90% of the time. Because of this, the Centers for Disease Control (CDC) and the Arizona Department of Health Services (ADHS) have asked that decisions about treatment and health care be made based on symptoms. More reliable tests exist, but they are used in the hospital with children who have other severe medical problems. It takes time to get the results back from these tests. And if the child is not sick enough to stay in the hospital, the test results would not change the treatment. Children admitted to the hospital may be tested for other germs that cause respiratory infections in addition to influenza. 3 of 7

4 Is there medicine that can help my child get better? Medicines that treat viruses can sometimes help decrease influenza symptoms, but a prescription is needed to get them. Most people do not need these antiviral drugs to fully recover from the flu. However, people at higher risk for severe flu complications, or those with severe flu illness who need to be in the hospital, might benefit from antiviral medications. Ask your health care provider if your child needs antiviral medication. Influenza infections can lead to or happen at the same time as infections by bacteria. Because of this, some people will also need to take antibiotics. More severe illness, illness that lasts a long time, or illness that seems to get better, but then gets worse again may be signs that a person has a bacterial infection. Call your health care provider if you have concerns. 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. Warning! 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. Children 5 years of age and older and teenagers with the flu can take medicines without aspirin, such as acetaminophen (Tylenol) and ibuprofen (Advil, Motrin, Nuprin), to relieve symptoms. Patients with kidney disease or stomach problems should ask their health care provider before taking medicine. Children younger than 4 years of age should not be given over-the-counter cold medicine unless your doctor tells you to. Over-the-counter cold and flu medications used according to the package instructions may help decrease some symptoms such as cough and congestion. These medicines will not stop germs from spreading. Different medicines may have the same ingredients. Read the labels. Make sure you are not giving your child too much of one medicine, like acetaminophen, because it comes in different packages. 4 of 7

5 Check the ingredients on the package label to see if the medication already contains acetaminophen or ibuprofen before taking additional doses of these medications don t double dose! Some medicines are not safe to take at the same time. If you are giving your child other over-the-counter or prescription medications not related to the flu, check with your health care provider or pharmacist before you add any new medicines. How can we keep from spreading the flu at home? When giving care to someone in your house who is sick with influenza, the best ways to protect you and others who are not sick are to: Keep the sick person away from other people as much as possible. Stay away from people who are at high risk of getting very sick from influenza. Sick people should cover their coughs, and clean their hands with soap and water often. If soap and water are not available, they should use an alcohol-based hand rub. This is very important after coughing and/or sneezing Have everyone in the home clean their hands often, using soap and water or an alcoholbased hand rub, if soap and water are not around. You may need to remind or help children keep their hands clean. Clean your hands with soap and water often. Ask your health care provider if the people living with the sick person should take antiviral medicine, especially if they are pregnant or have chronic health problems. If you are at high risk for getting very sick from the flu you should try to avoid being close (within 6 feet) to people who are sick with influenza. If you cannot avoid being close to a sick person, consider wearing a facemask or respirator if you have one. If possible, infants who are healthy should not be cared for by sick family members. 5 of 7

6 Household cleaning, laundry, and getting rid of waste Throw away tissues and other disposable items used by the sick person in the trash. Wash your hands after touching used tissues and similar waste. Keep surfaces, especially bedside tables, bathroom, and toys, clean by wiping them down with a household disinfectant according to directions on the label. Linens, eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately. Do not share them until they are washed. Eating utensils should be washed either in a dishwasher or by hand with water and soap. Wash linens like bed sheets and towels with laundry soap, and tumble dry on a hot setting. Before you wash these, don t carry them against your body (hugging them). That could spread germs. Wash your hands with soap and water right after touching dirty laundry. If soap and water are not available, use an alcohol-based hand rub. If you want to learn more: The Centers for Disease Control and Prevention (CDC) Hotline CDC-INFO or is available in English and Spanish Centers for Disease Control and Prevention website: Arizona Department of Heath Services website: For more information about Reye s syndrome: 6 of 7

7 Now that you ve read this: p Tell your nurse or doctor how you will treat your child sick with flu symptoms at home. (Check when done.) p Tell your nurse or doctor when you need to take your child to the emergency room (Check when done). p Tell your nurse or doctor when you need to call your doctor. (Check when done.) p Tell your nurse or doctor how you can keep from spreading the flu. (Check when done.) If you have any questions or concerns, p call your child s doctor or p call If you want to know more about child health and illness, visit our library at The Emily Center at Phoenix Children s Hospital 1919 East Thomas Road Phoenix, AZ Facebook: facebook.com/theemilycenter Disclaimer The information provided at this site is intended to be general information, and is provided for educational purposes only. It is not intended to take the place of examination, treatment, or consultation with a physician. Phoenix Children s Hospital urges you to contact your physician with any questions you may have about a medical condition. Friday, October 19, 2012 #1076 Written by Esther Muñoz, RN, BSN, CIC Illustrated by Dennis Swain 7 of 7