Swine Flu in Babies, Toddlers & Kids: Everything You Need To Know

As the outbreak of swine flu in Delhi, Kolkata, Rajasthan and other parts of the country is again in news, it is natural for parents to become anxious regarding the protection of their little ones by this highly contagious viral infection. Hence the article will provide you with comprehensive information about the symptoms, treatment and prevention of swine flu in babies, toddlers and kids.

Swine flu: General fact sheet

Swine flu is similar to any other type of flu but it is caused by different strains of virus that are relatively new strains of influenza virus that is H1N1 and H3N2 virus. It is a highly infectious disease that affects the respiratory system comprising of nose, throat, trachea and bronchi. The infection is known as swine flu because it first originated in pigs.

H1N1 virus is basically a combination of virus that contains genes of swine flu, bird flu and human flu. In 2009, this strain of virus was new to humans and the immune system was not equipped to fight against the new strain so the infection spread so rapidly from person to person across many countries and the outbreak was so serious that WHO has to declare the disease as pandemic. The outbreak lasted till 2010 but when it came to India another major outbreak occurred in 2015 and also resulted in a number of deaths.

Right now H1N1 virus is similar to any other flu that happens to be seasonal in nature most commonly happening in the months between January to March. However it reaches it's peak before the monsoons.

Mode of transmission is through airborne droplets that spread from close contact with the affected person like while sneezing or coughing or hands contaminated with infected secretions. The virus in the droplets remain alive for about 24 hours. The infection no longer spreads from pigs or by eating pork or ham. Hence the spread is only through person to person contact. However if a person comes in contact with the infected pig there is a high probability of getting infected with the H1N1 virus.

Incubation period is longer than the seasonal flu. After getting exposed the person usually starts showing the first sign and symptoms of the disease at around 4-6 days. Since we don't have natural immunity against this virus the attack rate of this infection is high.

Signs and symptoms of swine flu in babies, toddlers and kids

Signs and symptoms of swine flu is very much similar to any other type of regular, seasonal flu. They are as follows:

1. Fever of 100 F or above that is more severe in babies under six months of age
2. Sore throat
3. Runny nose
4. Cough
5. Fatigue
6. Muscle pain and body aches
7. Headache
8. Vomiting and diarrhoea but they are always accompanied by other above mentioned symptoms and are not the sole symptoms.

Most individuals affected with swine flu usually present with mild to moderate signs and symptoms however, babies and small kids, particularly who belong to a high risk group, can present with certain complications like – dehydration, bronchiolitis, pneumonia, ear or sinus infection, febrile convulsions and can even lead to death in some rare cases.

Expected course of the disease: the fever usually continues for 2-3 days, runny nose for 1 -2 weeks and cough for 2-3 weeks.

If the baby has high fever, is extremely sleepy,  is dehydrated and stopped taking fluids or food, slows down in interaction then it's better to consult a doctor for swine flu screening. Immediate medical attention is required if the baby exhibits seizures, doesn't wake up, shows bluish discoloration and has difficulty in breathing.  

The baby is contagious one day prior to the onset of infection till 7- 10 days of infection. According to the guidelines issued by the Centre of Disease Control (CDC) the affected kid should remain at home and discontinue school or day care at least 24-48 hours after the fever has subsided. However it is advisable to keep the child at home until atleast 7 days past infection.

High risk group that can contract complications from swine flu

CDC has provided a list of conditions that if present in any child can bring him or her under the HIGH RISK group for development of complications from swine flu. They are – lung disease like asthma, congenital heart disease, kidney disease, diabetes, cancerous lesions and other immunocompromised state, liver disease, muscular dystrophy and children less than 2 years of age.

Diagnosis

The doctor would take a swab from nose or throat and send the sample to the laboratory to find out the exact strain of the virus by genetic analysis. This may take around 2-3 days.

Prevention of swine flu

1. Maintaining good hygiene is the best preventive measure to protect the child from getting swine flu. Remember to make all the family members including the baby to wash their hands thoroughly with soap and water. The environment around the kid should also be cleaned by a disinfectant which includes floor, table, toys, door knob, windows, phones and everything. Kids should be discouraged to put their hands in nose or mouth or touch eyes with hands.
2. Since the virus spreads through infected droplets and these droplets can remain suspended in the air and travel up to a meter it is necessary that close contact with the affected person is completely avoided. The infected person should be quarantined to prevent spreading of infection. The person should wear a disposable face mask, use disposable tissues during sneezing or coughing.
3. Avoidance of taking the babies and small kids to crowded and enclosed spaces like theatres, malls, day care or any other closed spaces should be done at the time of outbreak since children especially under 5 years of age are vulnerable to infectious diseases.

Vaccination against swine flu

H1N1 virus is a strain that belong to the influenza A virus category so the vaccine against seasonal flu or influenza A virus provides protection against the H1N1 virus also hence, a separate vaccine is not required. However the flu vaccine is not recommended for babies less than 6 months of age because the vaccine fails to produce enough immune response in such small babies. However, if the mother had received a flu vaccination during pregnancy then the same would provide protection to the baby during the first six months of life.

The vaccine doesn't guarantee that the child will not get H1N1 infection as it takes about 2 weeks for the vaccine to get effective. Moreover it works only for 6 to 12 months so flu vaccine should be given every year particularly when a seasonal change occurs. At present this vaccine is not recommended on a routine basis and only those children that belong to the HIGH RISK category should be vaccinated on a priority basis.

Children more than 6 months but under 10 years of age who never got flu vaccine should be given two doses of Influenza A vaccine at 4 weeks interval  if an outbreak occurs and they are more prone to contract the infection. Children above 10 years of age require only one shot similar to adults.

Treatment of swine flu

The treatment of Swine Flu is very much similar to that required in a regular seasonal flu that is control of the symptoms displayed by the child. Most often the child (unless the child is a high risk patient) revives on his own without any comprehensive medical attention.

1. Runny nose and cold: for runny nose the only effective measure that is required is to wash out the viruses and bacteria from the nose. This can be done by blowing out nose or by using nasal suction accompanied by using nasal wash in the form of saline drops or warm water. They loosen up the dried nasal mucous. Saline drops can be purchased over the counter or can be easily made at home by adding ½ tablespoon of salt to 1 cup or 8 oz of water. About 3 drops of saline ( 1 drop for babies less than one year of age) is instilled in each nostril and then the nostril is blown out one at a time. Cold medications like antihistamines and decongestants shouldn't be used before the age of 4 years. Antihistamines won't help unless cold is due to some kind of allergy. Decongestants have many side effects so their use should be restricted to severe cases. Antibiotics in cold are of no use unless the baby has ear or sinus infection. Humidifiers in the room can be used to keep the surrounding air moist and prevents the nasal mucous from drying up.
2. Fluids : more amount of fluids should be encouraged in order to prevent dehydration. Infact for babies less than one year of age, warm clear fluids like water or apple juice may work wonders in providing relief from cough.
3. Cough and sore throat: for babies less than 6 months of age breastfeeding should be done as much as possible as it contains antibodies to fight against viral infection. For babies more than 1 year of age ½ to 1 tbsp of honey is one of the best remedy to treat cough. Warm chicken broth can treat mild sore throat. After 6 years of age cough drops or hard cough candies can be used to coat the irritated throat.
4. Fever Medicine: for fever above 102° F (39° C) or discomfort, paediatric paracetamol drops or syrups is recommended. ASPIRIN is avoided because of it's strong link with Reye's syndrome. Excessive clothing should be avoided.
5. Pain relief for muscle and body aches: paracetamol every 4 hours or ibuprofen every 6 hours provide relief.

Antiviral drugs for swine flu

Use of Antiviral drugs is restricted to the HIGH RISK category and in patients with severe symptoms. Antiviral drugs like Tamiflu or Relenza give optimal results when given within 48 hours of the onset of symptoms . These drugs only reduce the symptoms by one or two days and are not supposed to eliminate them.

A Final Word to the parents

It is advised that the parents shouldn't panic just by watching a few headlines of swine flu outbreak in the television or newspaper. After the outbreak of 2009 and 2015 this infection has now somewhat become a kind of seasonal flu that will continue to circulate every year as the season changes. Moreover the news that we hear are most often the extremely severe cases that failed treatment due to ignorance. The need is to remain calm as well as alert regarding the possible symptoms of swine flu. Most of the times infection is mild enough to be resolved on its own. However if the symptoms persist for more than 5 days or worsen with time better to consult the doctor immediately. Always look for preventive measures as prevention has always been better than cure.

Dr. Supriya Mishra – The author is a Periodontist by profession, a Post Graduate Diploma in Maternal and Child Health Care, a mother of a sweet little girl and a writer by passion. Her posts usually talk about everyday pregnancy and parenting issues, pregnancy and parenting tips and stories of experiences of going through the period of pregnancy, postpartum and during raising up a child.