On October 24, 2009, President Obama signed an emergency declaration calling the pandemic of H1N1 influenza (“swine flu”) a national emergency. The special problem H1N1 poses for children and adults with neurological and other chronic disorders deserves special emphasis.
First seen in people in April 2009, H1N1 flu is a new virus that has been detected throughout the world. The virus spreads from person to person in the same way the seasonal flu is spread, by an uninfected person touching a surface with the virus on it and then touching his mouth or nose. By June 11, 2009, the World Health Organization announced that a pandemic (an epidemic of an infectious disease that spreads across a large region) of H1N1 flu was underway.
The Centers for Disease Control (CDC) first reported neurological complications of H1N1 in children in Dallas, TX, in May 2009. The Dallas County Department of Health and Human Services described four children (ages 7 to 17 years) admitted to Dallas hospitals with H1N1 infection who also had seizures and confusion. All four children received anti-viral therapy and recovered without permanent neurological problems, underscoring the need to seek prompt medical attention for any child experiencing a flu-like illness and unexplained seizures or confusion for the correct diagnosis and treatment with antiviral medication.
As our story in “Waiting Room” describes, children and adults with chronic neurological conditions may be at increased risk for developing H1N1 infection—and for having serious complications from the virus. The CDC has identified other groups of people who may also have a higher risk, including children younger than five years old; people 65 years and older; pregnant women; individuals with cancer, blood disorders, respiratory conditions, diabetes, heart disease, kidney disorders, liver disorders, any type of central nervous system disorder, or muscular dystrophy; and those with a weakened immune system (such as HIV/AIDS). Approximately 70 percent of people who have been hospitalized with this 2009 H1N1 virus have had one or more of these medical conditions. Anyone with one or more conditions should indeed go to the head of the line for the vaccine, and should also be treated with antiviral medications if symptoms of the flu appear. Other members of the patient's household should also be vaccinated or treated early to prevent the household spread of infection.
The signs and symptoms of H1N1 include fever, cough, sore throat, runny nose, body aches, headaches, chills, and fatigue. Some people may have vomiting and diarrhea. People who have H1N1 can infect other people from one day before symptoms appear to five to seven days after. This infectious period can be even longer in children and adults with a weakened immune system.
The CDC recommends that you take these steps to protect your health:
1. Wash your hands often with soap and water for 15 to 20 seconds or use an alcohol-based hand-rub if soap and water are not available;
2. Avoid touching your eyes, nose, or mouth, as germs spread this way;
3. Avoid close contact with sick people;
4. Get vaccinated against H1N1;
5. If you are sick with a flu-like illness, stay home for at least 24 hours after your fever is gone to avoid spreading the flu. However, if adults or children develop trouble breathing, dizziness, confusion, or severe vomiting with a flu-like illness, seek medication attention quickly, as antiviral medications may help to lessen the severity of the symptoms and prevent complications.
Following the CDC recommendations doesn't guarantee that you won't get sick, but they make good sense. They are also a reminder that keeping ourselves healthy and protecting those around us often go hand in hand.
Take good care,
Robin L. Brey, M.D.