Allercy and Asthma Health
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Your Questions Answered: Pediatric Physician Dr. Michael Anderson Addresses Parents’ Concerns about H1N1 Flu


The new H1N1 flu is scary enough for parents whose children have normal respiratory systems. But if your child has asthma or another pulmonary condition, you’re no doubt especially concerned.

In the following interview, AARC member Michael R. Anderson, MD, a pediatric critical care specialist at Rainbow Babies & Children’s Hospital in Cleveland, OH, and member of the National Commission on Children and Disasters, answers your most pressing questions about how to keep your child safe from this disease.

Allergy & Asthma Health: Children with underlying respiratory conditions appear to be at greater risk of complications from the H1N1 flu. Why are these children at special risk and what symptoms should trigger a trip to the emergency room?

Dr. Anderson: Like previous flu seasons, we believe that children with underlying respiratory disease may have less reserve to fight off influenza-like illness such as H1N1. The signs and symptoms a parent should be concerned about include any signs of respiratory distress, including increased respiratory rate, difficulty breathing, difficulty completing sentences, use of accessory muscles to breathe, cyanosis, and/or lethargy. If any of these symptoms are severe enough, the patient’s family should consider a trip to the emergency department.

Online Maps Keep You Up To Date on H1N1

Wondering where the new flu is striking right now? You can keep up with the outbreak on the FluView page of the Centers for Disease Control and Prevention (CDC) web site. The map is updated on a weekly basis.

Another site — FluTracker — let’s you see where H1N1 is happening not just here in the United States, but around the world, as well.

Allergy & Asthma Health: Since this flu could pose special problems for kids with respiratory conditions, should parents go ahead and ask their doctors for a prescription for Tamiflu so they’ll have it on hand if their child comes down with symptoms?

Dr. Anderson: Most pediatricians are advising against pre-writing prescriptions for Tamiflu for children. It is believed that the parent should seek medical attention from their primary care physician, and decision for Tamiflu should be made at that time. Most pediatricians feel that pre-writing Tamiflu could potentially cause a family not to seek medical attention and to self treat. Thus, once again, most pediatricians are recommending that families not be given pre-filled prescriptions for Tamiflu, but seek medical attention if and when influenza-like illness appears in their child.

Allergy & Asthma Health: How effective is the H1N1 vaccine for preventing the flu, and is it safe for children with respiratory conditions like asthma?

Dr. Anderson: According to initial reports from the Centers for Disease Control and Prevention (CDC) in Atlanta, the H1N1 vaccine is very safe. Parents of children with respiratory diseases such as asthma should consult their child’s physician for their appropriateness of receiving the H1N1 vaccine.

Likewise, the CDC has labeled children with respiratory diseases such as cystic fibrosis, or other diseases such as bronchopulmonary dysplasia and congenital heart disease, as high risk in children as well. Parents of these children should seek advice from their child’s physician or primary care providers regarding H1N1 vaccine. Other high-risk individuals who should receive H1N1 vaccine include caregivers of children under 6 months, health care workers, and pregnant women, as well as children between the ages of 6 months and 18 years with underlying diseases.

Don’t Forget: Take the Seasonal Flu Shot, Too

H1N1 may be getting all the attention these days, but we’re also in the midst of the regular flu season, and parents with children who have asthma and other respiratory problems should talk to their doctors about getting not only the H1N1 vaccine, but also the seasonal flu vaccine as well. The Centers for Disease Control and Prevention (CDC) recommends the seasonal vaccine for children age 6 months to 19 years, including those with certain chronic medical conditions. Caregivers of these children should also receive the vaccine, particularly caregivers of children too young to be vaccinated themselves. Read more about it here.

The CDC has also recommended vaccine for children between the ages of 6 months and 5 years, as these patients could potentially be at high risk for complications from H1N1. However, many pediatricians feel that healthy children between the ages of 2-5 may actually not be at significant risk for complications, and thus parents should seek out the advice of their pediatrician regarding H1N1 vaccine.

Allergy & Asthma Health: We’ve all read about the importance of hand washing in curtailing the spread of H1N1 flu. But we’ve also heard this flu is mainly spread by airborne particles. What other measures should people be taking to keep the disease from spreading and why?

Dr. Anderson: Basic infection control parameters such as good hand washing, sneeze and cough etiquette, and encouraging people with influenza-like illness to stay at home while they are still symptomatic are the mainstays for preventing spread of H1N1. The liberal use of alcohol-based hand sanitizer, as well as good droplet precaution, such as sneezing into one’s elbow — and staying home while contagious — appear to be the best ways to prevent the spread of most viruses, including H1N1.

Allergy & Asthma Health: Schools and day care centers are trying to implement measures to control the spread of H1N1. Are there any special measures they should be taking to make sure the special needs of kids with respiratory conditions are being met?

Dr. Anderson: Typical influenza season precautions, including frequent hand washing and use of alcohol-based hand cleansers, as well as cleaning of surfaces, should take place in schools and daycare centers, just as they do any flu season. Likewise, encouraging children to practice good cough and sneeze etiquette, as well as encouraging frequent hand washing, should be the foundation for preparedness for H1N1.

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