• Since Swine Flu is widespread in your community and your child has flu symptoms (cough, sore throat, runny nose) with fever, your child probably has Swine Flu.
• Special tests are not needed.
• You don't need to call or see your child's doctor unless your child develops a possible complication of the flu (such as an earache or difficulty breathing).
• For healthy people, the symptoms of Swine Flu are similar to those of the common cold.
• With flu, however, the onset is more abrupt and the symptoms are more severe. Feeling very sick for the first 3 days is common.
• The treatment of Swine Flu depends on your child's main symptoms and is usually no different from that used for other viral respiratory infections.
• Bed rest is unnecessary.

• The nasal mucus and discharge is washing viruses and bacteria out of the nose and sinuses.
• Blowing the nose is all that's needed.
• For younger children, gently suction the nose with a suction bulb.
• Apply petroleum jelly to the nasal openings to protect them from irritation. ( Cleanse the skin first.)

• Use saline nose drops or spray to loosen up the dried mucus. If not available, can use warm tap water.
• STEP 1: Instill 3 drops per nostril. (Age under 1 year, use 1 drop and do one side at a time)
• STEP 2: Blow (or suction) each nostril separately, while closing off the other nostril. Then do other side.
• STEP 3: Repeat nose drops and blowing (or suctioning) until the discharge is clear.
• Frequency: Do nasal washes whenever your child can't breathe through the nose.
• Saline nasal sprays can be purchased without a prescription.
• Saline nose drops can also be made: add 1/2 teaspoon (2 ml) of table salt to 1 cup (8 ounces or 240 ml) of warm water.
• Reason for nose drops: suction or nose blowing alone can't remove dried or sticky mucus.
• Another option: use a warm shower to loosen mucus. Breathe in the moist air, then blow each nostril.
• For young children, can also use a wet cotton swab to remove sticky mucus.
• Importance for a young infant: can't nurse or drink from a bottle unless the nose is open.

• Cold medicines are not recommended at any age. (Reason: they are not helpful. They can't remove dried mucus from the nose. Nasal washes can.)
• ANTIHISTAMINES are not helpful, unless your child also has nasal allergies.
• DECONGESTANTS: OTC oral decongestants (Pseudoephedrine or Phenylephrine) are not recommended. Although they may reduce nasal congestion in some children, they also can have side effects.
• AGE LIMIT: Before 4 years, never use any cough or cold medicines. (Reason: unsafe and not approved by FDA) (Avoid multi-ingredient products at any age.)
• NO ANTIBIOTICS: Antibiotics are not helpful, unless your child develops an ear or sinus infection.

• Goal: reduce the irritation or tickle in the throat that triggers a dry cough
• AGE 3 months to 1 year: Give warm clear fluids (e.g., water or apple juice) to treat the cough. Dosage: 1-3 teaspoons (5-15 ml) four times per day when coughing. Avoid honey until 1 year old.
• AGE 1 year or older: Use Honey 1/2 to 1 tsp (2 to 5 ml) as needed as a homemade cough medicine. It can thin the secretions and loosen the cough. (If not available, can use corn syrup.) Drugstore cough medicines are not as helpful as honey.
• AGE 6 years or older: Use Cough Drops to coat the irritated throat. (If not available, can use hard candy.)

Fever Medicine:

• For fever above 102° F (39° C) or discomfort, use acetaminophen or ibuprofen (See Dosage table)
• AVOID ASPIRIN because of the strong link with Reye syndrome.
• FOR ALL FEVERS: Give cold fluids in unlimited amounts. Avoid excessive clothing or blankets (bundling).

• For optimal results, antiviral drugs (such as Tamiflu) should be started within 48 hours of the onset of flu symptoms. They can be started later in some cases.
• The CDC recommends they be used for any patient with severe symptoms AND for all HIGH-RISK CHILDREN (see that list).
• The CDC doesn't recommend antiviral drugs for LOW-RISK children with mild or moderate Swine Flu illness.
• Their benefits are limited: they usually reduce the time your child is sick by 1 to 1.5 days. They reduce the symptoms, but do not eliminate them.
• Side effects: Vomiting in 10% of children.

• Symptoms usually start within 4-6 days of exposure to a person with Swine Flu (7 days is an outer limit).
• Your child can return to child care or school after the fever is gone for 24 hours and your child feels well enough to participate in normal activities. (CDC, August 2009).

• Breathing becomes difficult or rapid
• Retractions (pulling in between the ribs) occur
• Dehydration occurs
• Earache or sinus pain occurs
• Fever lasts over 3 days
• Nasal discharge lasts over 14 days
• Cough lasts over 3 weeks
• Your child becomes worse

Treating Swine Flu - Tamiflu:

• Tamiflu can reduce the symptoms of Swine Flu illness.
• The benefits are limited: they usually reduce the time your child is sick by 1 to 1.5 days. They reduce the symptoms, but do not cure the disease.
• For optimal results, antiviral drugs (such as Tamiflu) should be started within 48 hours of the onset of flu symptoms.
• Indications: Severe symptoms OR underlying health problems (HIGH-RISK group)
• Most patients have mild to moderate symptoms and Tamiflu treatment is not necessary.
• Unnecessary overuse of Tamiflu causes resistant strains of the virus. (8/2009 some resistance has occured)
• Tamiflu also has side effects: Vomiting in 10% of children.

• The drug Tamiflu may help prevent Swine Flu (prophylaxis).
• Indications: Recent close contact with person with confirmed Swine Flu AND the exposed person is in HIGH-RISK group (see that list)
• It is effective only while your child is taking it and ceases once your child stops taking it.
• Your child should only take Tamiflu if your child's physician recommends it.

• Definition: Some people request a prescription for Tamiflu for all family members just in case they come down with flu symptoms. They currently are well and have not been exposed to Swine Flu.
• Doctors are opposed to this practice, as is the CDC and your State's Public Health Department.
• The supply of Tamiflu is limited and needs to be kept available for patients who have severe symptoms OR have underlying health problems.

• Wash hands often with soap and water.
• Alcohol-based hand cleaners are also effective.
• Avoid touching the eyes, nose or mouth. Germs on the hands can spread this way.
• Try to avoid close contact with sick people.
• Try to avoid unnecessary visits to the ER and urgent care centers because those are the places where you are more likely to be exposed to Swine Flu, if you don't have it.

• Cover the nose and mouth with a tissue when coughing or sneezing.
• Wash hands often with soap and water, especially after coughing or sneezing.
• Limit contact with others to keep from infecting them.
• Stay home from school or work for at least 24 hours after the fever is gone (CDC, August 2009).

• Face masks refer to disposable masks labeled as surgical or dental masks.
• Face masks may help reduce the risk of getting swine flu in crowded settings.
• Avoiding sick people and frequent handwashing are more effective preventive measures.
• HIGH-RISK people: If crowded setting cannot be avoided, face masks are recommended.
• LOW-RISK people: Face masks are not necessary. (Possible exception: households where a family member has Swine Flu).
• Sick people with suspected influenza should wear a face mask if they must leave their home to seek medical care.

• The best way to prevent Swine (H1N1) Flu is to get a yearly seasonal flu vaccine.
• This year, H1N1 is included in the regular flu vaccine and no separate flu shot is needed.

• Tamiflu can be used for prevention following close contact with a person who has Swine Flu.
• It is only recommended for HIGH-RISK patients (CDC).