Influenza A (H1N1) in Children

From its symptoms to the treatment of swine flu in children, learn more about the condition that’s now known as Influenza A (H1N1), a highly contagious virus that typically affects children and youth more than adults.

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What is Influenza A (H1N1)?

Previously known as swine flu, Influenza A (H1N1) is a respiratory disease caused by a strain of influenza virus that spreads through direct contact with an infected person’s bodily fluids. It presents with flu-like symptoms and has been found to infect more children and young adults than those from older age groups. 

Similar to catching a flu, your child may contract the H1N1 virus if he or she is in close proximity to a person infected with the virus. This could mean coming into contact with mucus or saliva released in a sneeze or cough, or touching a surface like a doorknob or toy that is contaminated with the virus.

Symptoms of Swine Flu in Children

The symptoms of H1N1 in children are similar to the symptoms of seasonal flu. These symptoms can vary from mild to severe and often include the following:
A fever
Runny nose
Sore throat
Headaches
Cough
Fatigue
Body aches
Diarrhoea and vomiting

​How to Tell If Your Child Has H1N1

It may be difficult to tell if your child has H1N1, especially when the symptoms of H1N1 are similar to that of a common cold. Some signs to look out for that distinguishes H1N1 from seasonal flu are: 
A fever, with a temperature higher than 38 degrees Celsius
Dry cough
Severe body aches and pains
Moderate to severe fatigue
Headaches
Chest discomfort
Diarrhoea and vomiting

What to Do If Your Child Has H1N1 

If your child falls sick with flu-like symptoms, keep him or her at home, limit contact with others and bring him or her to the doctor. Your doctor will then decide if testing or treatment is needed. 

Bring your child to the Children's Emergency immediately if he or she develops any of these symptoms:
Difficulty breathing or shortness of breath
Pain or pressure in the chest or abdomen
Sudden dizziness
Confusion
Severe or persistent vomiting
Decreased or no movement, lethargy

What to Expect at the Hospital

Your child will undergo a screening process if he or she is admitted to hospital. 

Here is a step-by-step guide on what to expect:

Step 1: Your child will be screened by a nurse in the Emergency Department. The nurse will take your child’s temperature and measure other parameters. You will be asked about your travel history and your child’s symptoms. 

Step 2: A doctor from the Children's Emergency service will assess your child's condition as well as risk factors for a severe H1N1 virus. In the absence of risk factors and complications, your child will be treated symptomatically and discharged as appropriate.

Step 3: A nasal swab for H1N1 testing will be conducted for your child if he or she is deemed to be at higher risk for a more severe H1N1 virus. 

Step 4: A doctor or nurse will collect a nasal or throat swab sample from your child. Your child will be asked to tilt his or her head backward while the doctor or nurse inserts a swab into the nostrils or the back of the throat. The swab will be held in position for a few seconds, which may cause a slight discomfort to your child.

Step 5: The swab sample will be sent to the laboratory for processing. This process will take approximately 36 hours.

Step 6: Your child will be discharged after the swab if his or her condition is stable. You will be informed of the test result when it is available.

Treatment of Swine Flu in Children

Treating H1N1 in children is similar to treatment methods for other influenza viruses. The doctor will likely prescribe plenty of rest and fluids for a speedy recovery. The doctor may also offer symptomatic treatment for a fever, sore throat, runny nose and cough to alleviate your child’s discomfort.

The doctor will decide if your child needs antiviral drugs such as Tamiflu® (oseltamivir) or Relenza® (zanamivir) to fight the flu and prevent it from spreading. These medicines may enable your child to feel better faster and reduce the severity of symptoms. 

Use of Influenza Antiviral Drugs to Treat H1N1 in Children

Oseltamivir and zanamivir can be used on children, but they are now not routinely prescribed as most younger patients recover without the use of any medications. 

Children who have a high risk of complications from influenza, including those with chronic lung and heart disease, compromised immune systems or presenting with more complicated and severe symptoms, will be given these antiviral drugs. These medicines work best when they are taken within two days after they start presenting symptoms.  

Antiviral treatment usually lasts for a period of five days. 

Side Effects of Influenza Antiviral Drugs Used to Treat H1N1 in Children

The common side effects of influenza antiviral drugs are nausea and vomiting. There have been reports of unusual behaviour in children and adolescents, like self-injury and confusion after taking oseltamivir. In rare cases, severe allergic skin reactions may occur.

Reducing the Risk of H1N1 in Children

To reduce your child’s risk of contracting the H1N1 virus, practise good personal hygiene and be socially responsible by:
Washing your child’s hands regularly and thoroughly with soap and water, especially before touching the eyes, nose or mouth
Teaching your child to cover his or her mouth and nose with a tissue whenever he or she needs to cough or sneeze
Avoiding close contact with sick people or someone who has H1N1 
Using an alcohol-based hand sanitiser
Reducing unnecessary social contact and avoiding crowded settings
Wearing face masks to reduce the risk of contracting influenza

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Influenza A (H1N1) in Children

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