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.

Our society tends to be germ-phobic.  And we have good reasons.  In the past most of the things that killed people were infections; infected wounds led to loss of limbs and lives, and epidemic diseases like fevers and plagues have swept through societies killing untold millions.  Plus today we face a new wave of antibiotic resistant diseases created through the overuse, improper use, and abuse of antibiotics such as MRSA.

But many scientists and doctors, myself included, feel that our germ phobia has gone too far.  The hygiene hypothesis states that exposure to bacteria both good and bad is necessary to develop a properly functioning immune system.  The hygiene hypothesis is one attempt to make sense of the sky-rocketing rates of allergies and auto-immune diseases in children.  Keeping children excessively clean does not give their bodies and immune system sufficient exposure, and thus education to learn to function normally.

The role of good bacteria in the maintenance of health is becoming increasingly understood.  New studies are showing that every exposed part of our body, every square inch of our skin, and our digestive tract from our mouth to our rectum are home to a huge diversity of bacteria.  In fact the Human Biome project is setting out to map the genetic code of bacteria that live with us in a similar way the Human Genome project set out to map our genetic code. Far from being simply passengers we are gaining greater and greater understanding that bacteria are necessary for our health and well-being.  They protect us from pathogenic (‘bad’) bacteria and parasites, help us digest food, and help our immune system to function properly.  If you are interested in learning more about the role of good bacteria, here is an interesting article, and here is a TED talk on it (see my post on TED).

A recent study published last month in the scientific journal Pediatrics has shown that using probiotic supplements (‘good’ bacteria) can dramatically reduce the chance that your children will get the cold or flu.  And with tremendous concern over Swine Flu this year, using natural methods to strengthen our immunity can alleviate fear and help keep us healthy.

In the double-blind, placebo-controlled study 326 kids aged 3-5 were assigned to take either placebo, a single strain probiotic (containing 1 type of bacteria; L. acidophilus) or a double strain probiotic (containing L. acidophilus and Bifidobacterium) twice a day for 6 months.

The results were dramatic.  Compared to kids on placebo (not taking probiotics), kids taking probiotics:

• Fever incidence – 53% less for kids taking the single strain, 72.7% less for kids taking the double strain
• Coughing incidence – 41.4% less with the single strain, 62.1% less with the double strain
• Runny nose incidence – 282.% less with the single strain, 58.8% less with the double strain
• Duration of fever, coughing and runny nose were decreased 32% with the single strain, and 48% with the double strain
• Need for antibiotics was reduced by 68.4% with the single strain, and 84.2% with the double strain
• Days absent from day care were reduced by 31.8% with the single strain, and 27.7% with the double strain

Bottom line:  Giving your kids a quality multi-strain probiotic with at least 10 billion cfu (colony forming units) every day as was done in the study can reduce their risk of getting a fever, cough, and runny nose by about 2/3.  If they get a cold it would be reduced in duration by ½.  Their need for antibiotics would be reduced almost 85% and the number of days they would need to miss day care would be reduced by 1/3.

This is a huge benefit for a generally moderately priced supplement that is virtually without side effects.  While many supplements are as good over the counter as through practitioners, probiotics are one supplement I do highly recommend you purchase from a practitioner.  Studies have shown that many over the counter probiotics are poorly manufactured and do not contain the levels of beneficial bacteria stated on the label, and some even were found to be contaminated with harmful bacteria.  The practitioner brands Naturopathic doctors use as well as other practitioners tend to be a little more expensive but are produced with very stringent quality control, making them safe and therapeutically effective.

If you would like to look up the study yourself it is:

Pediatrics. 2009 Aug;124(2):e172-9. Epub 2009 Jul 27. Probiotic effects on cold and influenza-like symptom incidence and duration in children. Leyer GJ, Li S, Mubasher ME, Reifer C, Ouwehand AC.

What are your thoughts?  Should we be so germ phobic?  We’d love to hear your thoughts.  Please feel welcome to post below.