Marc Avner, M.D., Greenwood Pediatrics
The symptoms of the Swine (H1N1) Flu have been very similar to those of seasonal flu and include cough, fever, runny nose, sore throat, headaches, chills and body aches. Thus far in the US and Canada, cases of the Swine Flu have been mild to moderate in severity. Like many other viral upper respiratory tract illnesses or colds, the Swine Flu tends to be self-limited and resolves on its own without the use of any medication. Fever may last up to 3 days; runny nose 1-2 weeks; cough2-3 weeks.
Most children and adults who have the Swine Flu do not need specific treatment other than symptomatic care. The anti-viral medications used to treat seasonal flu and Swine Flu, at best, shorten the duration of the illness by one to one and a half days. They do not cure the illness. Furthermore, these medications have been linked to GI and behavioral side effects. At this time, antiviral medications such as Tamiflu are being reserved for hospitalized patients and those in high risk categories, including children under two years and those with chronic illness such as asthma, heart disease, diabetes and immune system disorders. As with the overuse of other antibiotics, the overuse of Tamiflu can select out resistant organisms and render it ineffective for those who most need it.
Even the most sensitive rapid flu tests miss positive cases about 30% of the time (almost one in three patients with Swine Flu will have a negative test). Given that Swine Flu tends to be self resolving and that most healthy children do not need antiviral medication, a positive flu test does not change the course of action for most children and adults
Most seasonal flu and Swine Flu is self-resolving, and healthy children with mild to moderate symptoms are best treated with symptomatic care. However, some children may need to be seen by a medical provider, including those in high risk groups, as well as those with more severe symptoms or worrisome appearance. In some cases, secondary bacterial infection may occur. Signs of a secondary bacterial infection which would indicate the need to be seen include: difficulty breathing, ear pain, a fever that resolves for a few days and returns, acutely worsening symptoms after three days of illness, or persistent symptoms without improvement after 10 days.
If your child has flu-like symptoms, she should stay home from school until she has no fever for 24 hours without the use of anti-fever medications such as Tylenol or Ibuprofen.
Copyright 2012 Marc Avner, M.D., All Rights Reserved
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