540 children in the US have died so far this year from known or suspected H1N1 flu. This tragic number is more than six times higher than in an entire typical flu year, and the current flu season may only be getting started. This tragic number is very low, however, compared to the more than seventy million children in the US.

Medications to treat H1N1 flu work better the earlier they are started. Many children who would benefit from these medications are getting them late or are not getting them at all. But the flip side is also true: many children who don’t need treatment are being dragged to clinics and ERs, creating cost, inconvenience, and risk for that child and for the community.

The simple tool at www.feelingflu.com* was designed to help you make the right decision for you and your child.

When you get the flu, whether it’s H1N1 (swine) flu or not, you want relief. It’s even worse when your little one gets sick and you watch him suffer. It’s understandable that we’d want to seek immediate care, especially with the news stories about the flu epidemic.

Most people who get the H1N1 flu – or regular flu – do not need an emergency room, a doctor’s visit, or anti-viral drugs. While it’s true that the flu can be serious and, in some cases, deadly, mostly the flu is mild (as opposed to dangerous – mild flu victims may still feel awful!).

Nevertheless, healthcare facilities around the country have been inundated with flu and cold sufferers.

Symptoms of the flu include a fever above 100.40 F along with cough or sore throat. Some people also experience runny or stuffy nose, body aches, chills, headache, fatigue, diarrhea or vomiting. (You should click here to watch a video on recognizing the difference between colds and flu.) If you think you have the flu, usually the best choice is to manage the symptoms at home, minimizing contact with other people.

Seek advice of a medical professional (perhaps a phone call vs. a visit, depending on severity) if someone with flu-like symptoms falls into one of the following categories that might benefit from treatment:

• Children younger than 5, and especially children younger than 2 years old
• People 65 and older
• Pregnant women
• People who have other serious medical conditions
• Otherwise healthy people who have severe flu symptoms

Remember, when treatment is needed, starting early is best. Err on the side of calling rather than deciding to just wait and see.

You might need to visit an emergency room if you experience any of the following:

In children

• Fast breathing or trouble breathing
• Bluish skin color
• Severe or persistent vomiting
• Not drinking enough fluids
• Being so irritable that the child does not want to be held
• Flu-like symptoms that improve but then return with fever and worse cough
• Not waking up or not interacting

In adults

• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting

This flu should not be taken lightly. Thankfully, great emergency treatment and supportive care is available. And most children who need to be hospitalized will recover completely. Seeking early care when needed improves the odds.

*www.feelingflu.com was developed by A.D.A.M., Inc. where Dr. Greene serves at the Chief of Future Health.

The Centers for Disease Control say all people from 6 months through 24 years are in a high priority group for getting the flu shot this year. But I can understand the fear some parents have about the vaccine for the swine flu (H1N1). It has just now become available, and it’s natural for parents to question whether it’s safe to give their little ones.

The bottom line is I’m getting it happily because I work in a hospital and am around people with it so often – and don’t want to spread it, never mind being sick. And I’m giving it to all my kids. I do prefer the version of the vaccine that comes in single dose vials without the added preservative, rather than the multi-dose vials with them – though not enough to sway the decision either way. I wouldn’t argue with parents either way they chose, though, because I see advantages and disadvantages both ways, and parents need to make their own decisions about the health of their family.

I trust the new vaccine. The H1N1 vaccine being offered in the US at first is less dangerous than people fear. It’s very similar technology to the flu vaccine given to millions every year – just aimed at a different strain. The new experimental vaccines with adjuvants to make them more potent are NOT being released at this time (though they are being used in Europe and other countries). These experimental vaccines, which contain an interesting ingredient called squalene, may be released if supplies run out or if the epidemic takes a turn for the worse.

From what we know so far, this flu is more contagious than recently thought. We used to think that, like other flus, you wouldn’t stay contagious for more than about 24 hours after the last fever. Now we know people can stay contagious for up to a week after the fever, and a few days before it, so people who think they’re not sick or getting better will unknowingly spread the virus.

Thankfully, even though it is more contagious than expected, it appears to be less serious than expected, with a smaller percentage of people who get it dying from it than do from the regular flu each year, though more people probably does mean more deaths. But of the few hundred who have died so far, more of those have been healthy people age 24 or younger than would happen with a typical flu in part, probably, because this one kills because of an over-exuberant immune response, not from being overwhelmed with virus. Not to be too graphic, but with so many secretions, people are more or less drowning in their own fluids.

So, even though many folks I know who have had it say they have never ever felt so miserable – it looks like H1N1 will probably be much less serious than feared. But it is nonetheless a condition that can be avoided with the vaccine.

Important resources about the H1N1 flu:

• FeelingFlu.com  – an online assessment tool from our partners at A.D.A.M.
• Flu.gov  – The government’s portal to critical flu information, such as Myths and Facts, a Flu Shot Locater and FAQs.
• Should you get the flu vaccine?
• Is it a cold or is it the flu?

How can you tell the difference between cold and flu? I recorded this video with A.D.A.M. to give you information that will help you determine the difference between the two.

How do you know if you have swine flu (H1N1)? There’s a great new online tool that can help you find out — and it’s free! Just go to http://www.FeelingFlu.com

We’ve all been hearing about the worst case scenarios regarding the H1N1 flu, otherwise known as the swine flu. We don’t know how bad H1N1 will be this fall, but it looks like it could be several times worse than the usual seasonal flu (which kills about 36,000 people a year in the US), but with this one children, college- and grad school-age adults, and pregnant women are especially vulnerable. Boys who catch H1N1 in particular seem to get a lot sicker than the regular flu, and children are the largest group of flu sufferers who end up needing hospitalization.

This year may be the most important year in recent history to get your flu shots. It’s important to note that this year we’ll see a regular flu shot as well as one for H1N1, which should be available this October. The regular flu shot may help some, by keeping people healthier and stronger overall, and reducing fevers that will keep people out of school or work, but won’t be a major help for the current strain for H1N1.

The data on the newest H1N1 vaccine look very good so far – but we don’t yet know the whole story. So far the H1N1 vaccine has not resulted in significant side effects, but I expect we’ll see some side effects emerge when larger populations are immunized. After all, if we gave enough people bananas or spinach we would see a few serious side effects and allergic reactions. I expect the benefits of the vaccine to still outweigh the risks. People will not get the flu from the H1N1 vaccine: unlike some other vaccines, this one is not a live virus; it’s bits and pieces that prompt to the body to later recognize and attack the flu virus. Some people will almost certainly have reactions to the vaccine, but it may be those same individuals who would be overwhelmed by the virus itself.

At this point, based on all that we know so far, I plan on getting both flu vaccines for myself and for my four children. For all shots, I prefer the versions with no added mercury as a preservative (the ones that come in single dose vials). – but this is a smaller issue than the risks from the flu itself. I’ll continue to keep an open mind as more data become available, and our understanding of both the risks and the benefits becomes clearer.

Infants under 6 months should not receive flu shots, but other adults in their home should. We should all be taking preventative steps to stop the spread of the virus, including…

1. Keeping babies away from people with fevers.
2. Keeping kids and adults with fevers home from school and work until the fever has been gone 24 hours.
3. Using hand sanitizers.
4. Using good sense when it comes to spending time in public places, especially if you’re not feeling good.

Although we as pediatricians are concerned about H1N1, there’s no reason to panic. The CDC has a plan for dealing with outbreaks, and the plan seems sound to me. Keep an eye on news reports from reputable sources to help guide you on the best way your family can stay healthy. I’ll post more here on DrGreene.com as soon as any major developments occur. We should know much more about what the fall will hold in the next 4 weeks or so.

If you think you may get pregnant in the next year, this may be the most important year to get a flu shot – and an H1N1 flu shot, when it becomes available. When pregnant, it’s generally best to avoid all medications unless the benefits clearly outweigh the risks. With this year’s flu season, this appears to be the case.

Swine flu hits pregnant women extra hard, according to the U.S. Centers for Disease Control and Prevention. Compared to the general population, health officials are reporting a fourfold increase in hospitalization rates for pregnant women ill with the disease. Although the statistics are tough to measure because the numbers so far (thankfully) are so small, pregnant women seem to account for an unusually higher proportion of the complications and deaths from this disease. Flu season is still coming.

If you are already pregnant or think you may be pregnant, you should know that both the CDC and the American College of Obstetricians and Gynecologists recommend that all pregnant women get a flu shot because even in a regular flu year, pregnant women have a higher risk of severe disease from the flu.

Your body is working overtime to grow a healthy little baby (or babies!) inside you, and you want to do all you can to prevent infection and illness. This is the most important time to be taking regular precautions to keep yourself healthy, such as eating right, exercising, visiting your doctor regularly and avoiding contact with people who are ill. If you suspect you may have the flu, the CDC recommends an antiviral treatment within 48 hours.

Read more about staying healthy during your pregnancy with the series Eating for Two: A Guide to Mother’s Nutrition during Pregnancy