H1N1 or “Swine Flu” has been huge in the news this year, with a fresh batch of stories airing lately with the start of flu season. One of the most reasonable articles I’ve read lately on H1N1 is by Sanjay Gupta, MD. I’ve clipped out and rearranged the pieces I found most worthwhile (for the full, unedited article click here). My comments are in [ ].
Bottom line: “Remove the term H1N1 from the equation.” If your child had regular flu, would you take him to the hospital? If the answer is no, then don’t take him/her to the hospital now.
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People were scared [mainly due to the media’s hype and constant coverage of H1N1, along with declarations by governments and health organizations of pandemics and national emergencies]. Health care professionals were blaming the media — accusing them of being alarmist [most health care professionals working with patients, not those working in government or for the media, are not overly concerned about H1N1]. The doctor who met me [in a pediatric (kids) emergency room] started by saying he was giving the media a C+ in its overall coverage of H1N1, and blamed his busy ER, in part, on the media for stoking fears.
There is no question that pediatric emergency rooms are much busier than this time last year — about two to three times busier at the ER I visited, [but] many of the patients sitting in the waiting room were there with flu-like symptoms, worried about H1N1. [In the media we hear that emergency rooms are slammed with patients and barely able to keep up, giving us the impression that most of these people are deathly ill, when in fact the vast majority are there with colds or flu-like symptoms that do not need medical attention. Most are briefly examined and told to go home.]
[Dr. Gupta’s recommendations for parents:]
Point 1. As things stand now, the vast majority of children who develop flu-like symptoms this fall will have a few miserable days, and nothing more. And those days are best spent at home — not in the ER or a doctor’s office.
Point 2. If you are worried, you should call your pediatrician’s [or Naturopathic doctor’s] office first. Don’t take your child in without calling. Two reasons: Your child may not have H1N1, but could become exposed by being around sick children. And, after several hours of waiting, you are still likely to be told the basics — plenty of fluids, rest and dose-appropriate acetaminophen for a fever [I strongly disagree with the recommendation to bring down a mild-moderate fever with aspirin or acetaminophen as research has shown that doing so will INCREASE the length and severity of an illness. A fever is part of the body's natural defenses against an illness. In children if the temperature is less than 104 F and the child is tolerating it well there is no need to bring the fever down, simply make sure the child does not become dehydrated by supplying plenty of fluids. If the fever needs to be brought down a short bath in tepid (luke warm) water is the best way to do so.] After all, it is still the flu we are talking about.
Point 3. One doctor told me a way to think about things that was helpful. He said “remove the term H1N1 from the equation.” If your child had regular flu, would you take him to the hospital? If the answer is no, then don’t take him/her to the hospital now.
Point 4. Yes, hearing between 30,000 and 90,000 could die from H1N1 is scary, but keep in mind — around 40,000 people die from the regular or seasonal flu every year. The numbers may not be that much different, yet there is not panic about the regular flu. As things look now, H1N1 is causing only mild to moderate illness, not the widespread deaths people are worried about.
Point 5. There are some children who should be seen by their doctor. Call your doctor if:
• A baby younger than 12 weeks has a fever greater than 100.4 degrees Fahrenheit
• A child, older than 12 weeks has a fever for three days
• A child’s fever returns after a 12-24 hour time period
• A child is not passing urine or making tears for more than six hours
• A child does not smile or show interest in playing for several hours
Dial 911 if:
• A child cannot speak while trying to breathe
• Has a blue or dark purple color to the nail beds, lips or gums
• Is not responding to you because he is too tired or weak
One point that was reinforced to me over and over again by the pediatricians is the best place for a sick child is at home. And, with regard to school — after 24 fever-free hours without the aid of medications, he or she can go back.
This is the advice that my wife and I will be following this fall for our own children. Hope it is helpful to you, and the media can score an “A,” at least this time around.
[Full unedited, article here]
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Very reasonable advice. If you or your child comes down with a flu-like illness, don’t panic. As long as the sick person is handling the illness well, there is no need for further treatment or concern. The most important therapies are to stay home, rest, and get plenty of fluids. If things take a turn for the worse (high fevers, extreme lethargy or trouble responding, or any of the warning signs listed above) get a medical professional involved. But remember, for the vast majority of people, H1N1 is a mild to moderate illness, not a life-threatening one.
What do you think? Have you had swine flu this year? How did you treat it? We’d love to hear your thoughts. Please post below.
[Dr. Gupta’s recommendations for parents:]