H1N1 (Swine) Flu Virus: Facts for Parents (& Expecting)
- Pregnant and recently pregnant women are a priority group for the H1N1 flu vaccine. 更多資訊……
- Vaccinating children is a priority. Flu is more dangerous than the common cold for children. 更多資訊……
- Antiviral Drugs to Treat H1N1. 更多資訊……
- Clinicians should consider these facts before prescribing antivirals. 更多資訊……
- Do not stop breastfeeding if you are sick. Your breast milk is good for the baby. 更多資訊……
- The symptoms for all flu, including H1N1 flu, are similar. However, be on the lookout for signs of serious illness. 更多資訊……
- Don’t wait; call your doctor immediately if your child gets sick with flu-like symptoms. 更多資訊……
- Relieve the symptoms of H1N1 flu with certain over-the-counter medications. 更多資訊……
- Emergency medical care may become necessary. Know the signs. 更多資訊……
- Talk to children about H1N1 flu. 更多資訊……
- Flu during the school year. 更多資訊……
Vaccinating Children
All people from 6 months through 24 years of age are a priority group for the H1N1 flu vaccine. Getting your child vaccinated as soon as possible is the best method for protecting him or her from the flu. Use our Flu Shot Locator to get vaccinated where you live.
- There are separate vaccines for seasonal flu and H1N1.
Seasonal Nasal (LAIV)
Seasonal Flu Shot
H1N1 Nasal (LAIV)
Minimum two weeks between vaccinations
May be given in same visit.
H1N1 Flu Shot
May be given in same visit.
May be given in same visit.
- Children should get both vaccinations as soon as possible.
- Flu vaccine will be available in different settings, such as vaccination clinics organized by local health departments, healthcare provider offices, schools, and other private settings, such as pharmacies and workplaces.
- The 2009 H1N1 influenza vaccine is expected to have a similar safety profile as seasonal flu vaccines, which have a very good safety track record. Over the years, hundreds of millions of Americans have received seasonal flu vaccines. More information on vaccine safety
- The H1N1 vaccine is provided at no cost by the government. Some, but not all, clinics may charge to administer the vaccine. More information on vaccine cost
For more information on priority vaccinations see CDC Advisors Make Recommendations for Use of Vaccine Against Novel H1N1.
Antiviral Medications for Treatment of H1N1
If your child gets sick, antiviral drugs can make the illness milder and make him or her feel better faster. They may also prevent serious influenza complications. Most people do not need these antiviral drugs to fully recover from the flu.
- Children younger than 5 years old and children with chronic medical conditions, such as asthma and diabetes, might benefit from antiviral medications. Ask the doctor about any special treatment requirements.
- Even if the child is feeling a little better, he or she should continue taking antiviral medication as directed by the doctor.
Mixing Tamiflu® with Sweet Liquids If your doctor prescribes Tamiflu® capsules for your child and your child cannot swallow them, the prescribed capsules may be opened and mixed with a sweet thick liquid. |
Oseltamivir (Tamiflu ®) | Zanamivir (Relenza ®) |
Find more information and recommended dosage of oseltamivir at http://www.cdc.gov/h1n1flu/eua/pdf/tamiflu-patients.pdf |
Find more information and recommended dosage of zanamivir at |
PERAMIVIR IV |
PERAMIVIR and Nursing Mothers |
Considerations for Clinicians: Prescribing Zanamivir and Oseltamivir
Zanamivir (Relenza®) is approved by the U.S. Food and Drug Administration (FDA) for treatment of H1N1 flu patients 7 years of age and older who have had flu symptoms for no more than 2 days, and for the prevention of influenza in patients 5 years of age and older.
Oseltamivir (Tamiflu®)is approved by the FDA to treat and prevent influenza in children 1 year old and older.
Table 1. Antiviral medication dosing recommendations for treatment or chemoprophylaxis of 2009 H1N1 infection.
(Table extracted from IDSA guidelines for seasonal influenza. 
)
Agent, group | Treatment (5 days) | Chemoprophylaxis (10 days) | |
Oseltamivir | |||
Adults | 75-mg capsule twice per day | 75-mg capsule once per day | |
Children ≥ 12 months | 15 kg or less | 60 mg per day divided into 2 doses | 30 mg once per day |
16-23 kg | 90 mg per day divided into 2 doses | 45 mg once per day | |
24-40 kg | 120 mg per day divided into 2 doses | 60 mg once per day | |
more than 40 kg | 150 mg per day divided into 2 doses | 75 mg once per day | |
Zanamivir | |||
Adults | Two 5-mg inhalations (10 mg total) twice per day | Two 5-mg inhalations (10 mg total) once per day | |
Children | Two 5-mg inhalations (10 mg total) twice per day (age, 7 years or older) | Two 5-mg inhalations (10 mg total) once per day (age, 5 years or older) | |
Children Under 1 Year of Age
Children under one year of age are at high risk for complications from seasonal human influenza virus infection. The characteristics of human infection novel (H1N1) influenza virus are still being studied, and it is not known whether infants are at higher risk for complications associated with H1N1 influenza virus infection compared to older children and adults. Oseltamivir is not licensed for use in children less than 1 year of age. However, limited safety data on oseltamivir treatment for seasonal influenza in children less than one year of age suggest that severe adverse events are rare.
Because infants experience high rates of morbidity and mortality from influenza, infants with H1N1 influenza virus infections may benefit from treatment using oseltamivir. (Tables 2 and 3, Emergency Use Authorization of Tamiflu (oseltamivir)).
Table 2. Dosing recommendations for antiviral treatment or chemoprophylaxis of children younger than 1 year using oseltamivir.
Age | Recommended treatment dose for 5 days |
<3 months | 12 mg twice daily |
3-5 months | 20 mg twice daily |
6-11 months | 25 mg twice daily |
Table 3. Dosing recommendations for antiviral chemoprophylaxis of children younger than 1 year using oseltamivir.
Age | Recommended prophylaxis dose for 10 days |
<3 months | Not recommended unless situation judged critical due to limited data on use in this age group |
3-5 months | 20 mg once daily |
6-11 months | 25 mg once daily |
Healthcare providers should be aware of the lack of data on safety and dosing when considering oseltamivir use in a seriously ill young infant with confirmed H1N1 influenza virus infection or who has been exposed to a confirmed H1N1 influenza case, and carefully monitor infants for adverse events when oseltamivir is used. Additional information on oseltamivir for this age group can be found at: Swine Flu: Emergency Use Authorization (EUA) of Medical Products and Devices.
Guidance on Breastfeeding
Mothers who are breastfeeding should continue to nurse their babies while being treated for the flu. Breast milk passes on antibodies from the mother to a baby. Antibodies help fight off infection.
- If possible, only adults who are not sick should care for infants, including providing feedings.
- If you are too sick to breastfeed, pump and have someone give your milk to your baby.
- Your doctor might ask you to wear a facemask to keep from spreading this new virus to your baby (See Facemasks and Respirators).
- Be careful not to cough or sneeze in the baby’s face; wash your hands often with soap and water.
Symptoms of H1N1 Flu
It is important to watch for any signs that your child doesn’t feel well and to pay attention to any unusual behavior. Although the symptoms for all flu are similar, infants could have a fever or be lethargic, but may not have a cough or other respiratory symptoms.
季節性感冒 | H1N1流感 |
All types of flu can cause:
| Same as seasonal flu, but symptoms may be more severe.
There may be additional symptoms. A number of H1N1 flu cases reported:
|
What to Do If Your Child Gets Sick
Call your doctor right away if your child gets sick. Antiviral medications used to treat H1N1 flu in some patients work best when started within the first 2 days (48 hours) of getting sick.
- The doctor may start your child on antiviral drugs even after 48 hours when symptoms began, especially if the child has been hospitalized or is at high risk for flu-related complications.
- Children younger than 5 years old and children with chronic medical conditions, such as asthma and diabetes, may be at higher risk for complications from flu. Check with your doctor about any special treatment requirements for them.
- Some over-the-counter medicines are approved for children to use to relieve flu symptoms.
- If your child has a fever, use fever-reducing medicines that your doctor recommends based on your child’s age.
- A fever is a temperature taken with a thermometer that is equal to or greater than 100 degrees Fahrenheit (37.8 degrees Celsius). If you are not able to measure a temperature, the child might have a fever if he or she feels warm, has a flushed appearance, or is sweating or shivering.
- Keep your sick child home until at least 24 hours after the child no longer has a fever or signs of a fever (100°F or 37.8°C) (without the use of a fever-reducing medicine, such as Tylenol®). Read detailed information about how long to stay away from others.
- Make sure your child gets plenty of rest and drinks clear fluids (such as water, broth, sports drinks, electrolyte beverages for infants, Pedialyte®) to keep from being dehydrated.
- Keep your sick child in a separate room in the house as much as possible to limit contact with household members who are not sick.
- Consider having just one person be the main caregiver for the sick child.
- You can consider sending your child back to school after at least 24 hours has passed since his or her temperature returned to normal WITHOUT the use of medications.
Over-the-Counter Medication Guidance
Your child or teen will probably feel miserable with body aches, sore throat, and other symptoms of the flu. Taking certain over-the-counter medicines can help relieve their flu symptoms. A doctor will decide if antiviral medications are necessary.
Call the doctor’s office if your child experiences any side effects, such as nausea, vomiting, rash, or unusual behavior. See Medications to Help Lessen Symptoms of the Flu for more details.
Patient Age | DOs | DON’Ts |
Children/teenagers 5 – 18 years old | DO take acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®, Nuprin®), to relieve symptoms. They do not contain aspirin. DO Check ingredient labels on over-the-counter cold and flu medications to see if they contain aspirin. | DON’T take aspirin or products that contain aspirin (e.g. Pepto-Bismol®). This can cause a rare but serious illness called Reye’s syndrome. |
Children younger than 4 years of age | DO ask your doctor before using over-the-counter medications (e.g. Children’s Tylenol®, Children’s Motrin®). DO follow the doctor’s instructions exactly to avoid dosing errors. | DON’T give children over-the-counter cough and cold drugs containing antihistamines to help them sleep. |
Children younger than 2 years of age | DO use a cool-mist humidifier and a suction bulb to help clear away mucus. DO follow the doctor’s instructions for care. | DON’T give over-the-counter cough and cold drugs to children younger than 2 years old. |
When to Get Emergency Medical Care
If your child has any of these signs, seek emergency medical care right away:
- fast breathing or trouble breathing
- bluish or gray skin color
- not drinking enough fluids
- severe or persistent vomiting
- not urinating or no tears when crying
- not waking up or not interacting
- being so irritable that the child does not want to be held
- flu-like symptoms improve but then return with fever and worse cough
Talking To Children About H1N1
Educate yourself first. Know the basic facts about H1N1—the symptoms, how it spreads, and how you can help protect yourself and your child from getting sick. Consider following some of these helpful tips:
- Share information about H1N1 in a calm, reassuring manner. Be careful not to worry children.
- Limit their exposure to media and adult conversations about H1N1.
- If your children are watching television, try to watch with them or make sure you are available to answer questions about H1N1.
- Use their questions as an opportunity to talk about what they can do to avoid getting H1N1 flu.
- Keep activities as consistent and normal as possible even if your normal routine changes (due to daycare or school closures).
- Be a good example. Show children that you wash your hands frequently with soap and water. When you cough or sneeze, cover your mouth or use a tissue then throw the tissue away.
查看 Talking With Children About Flu for more tips.
View the Sesame Street public service announcements about flu featuring Elmo.
Flu During the 2009-2010 School Year
Before you are faced with a sudden school dismissal or a sick child, or household member discuss leave procedures with your employer.
- If working from home is not possible, plan ahead for child care at home if your child gets sick or their school is dismissed.
- Identify a separate room in the house for the care of sick children or other household members.
- Update emergency contact lists.
- Have workbooks, learning videos, and other materials available at home that support classroom exercises.
- Collect games, books, DVDs and other items to keep your family entertained if anyone must stay home for an extended period of time.
- If school is dismissed, monitor the school’s Web site, local news, and other sources for information about returning to school.
Learn More
- Interim Guidance for Clinicians on the Prevention and Treatment of Novel Influenza A (H1N1) Influenza Virus Infection in Infants and Children
- Antiviral Agents for Seasonal Influenza: Side Effects and Adverse Reactions
- Messages for Pediatricians' Offices and Clinics Caring for Children
This 3.5-minute message available in English and Spanish can be used by health care providers to deliver information to their patient's families when they call the office after hours. The message, developed for recording on the office telephone answering service, includes basic H1N1 flu information, advice on when to seek emergency care, tips on keeping your child healthy, and resources for additional information.
