Is it swine flu? When parents should call a doctor

As kids, parents and teachers start the school year, CTV.ca offers answers to your most frequently asked questions about how to spot swine flu in kids, when to treat it at home and when to call your doctor.

How do I know if my child has swine flu or a regular flu?

Without laboratory testing, it's difficult to tell the difference between swine flu and seasonal flu. Because swine flu has established itself in communities all across Canada, and because most cases are mild, doctors are no longer testing to determine which types of flu people have. Those who are hospitalized with severe flu or flu-like illness, and those with chronic disease are tested.

The symptoms of swine flu in kids older than five are similar to those of regular flu. They are:

• fever of 38 C (100.4 F) or higher when measured orally
• coughing, and sore throat
• fatigue
• lack of appetite
• sometimes vomiting and diarrhea, especially in younger children

Babies and toddlers under the age of five can have different symptoms:

• Fever may be the only symptom. Toddlers and babies usually have higher temperatures, often over 39.5C (103.1F) when measured orally
• About half of children under three years old have symptoms that include nausea, vomiting, diarrhea and stomach pain
• Ear infections and red, sore eyes are more frequent in young children
• Some babies may not be able to drink fluids or breastfeed
• Stiff neck may appear in some babies
• Toddlers and babies may have a hoarse cry and a barking cough.

When should I keep my child home from school?

If your child has a fever, they should stay at home, even if they seem to have a mild case. That way your child won't infect other children, including those who could develop severe illness.

In most kids, the flu will run its course over a week, though the cough and fatigue can last a few weeks in some patients.

How long should I keep my children at home if they have mild cases?

People infected with swine flu -- or any flu for that matter -- can infect others from one day before showing symptoms to up to seven days afterward. Just like with seasonal flu, swine flu is most contagious during the first days a patient starts showing symptoms, when they have "a high viral load."

Most experts agree it's best to keep sick kids home for at least five days or until they are able to resume daily activities, whichever is shorter.

If your child's symptoms do not improve after a week, call your doctor, as your child may have developed complications.

How do I treat flu in my kids?

• To bring down the fever, use acetaminophen (Tylenol) according to instructions on the label or advice from a health care provider
• Ibuprofen can treat muscle aches but should not be used for babies younger than six months of age. Children younger than 18 years of age should not take Aspirin or any products containing acetylsalicylic acid (ASA)
• Encourage your child to rest or engage in quiet activities. Do not allow them to socialize with others.
• Offer water or juice often
• Dress your child in lightweight clothing and keep room temperature at 20C (68F). Do not use cool baths or alcohol rubs
• Try saline nose drops to help relieve stuffy nose or cough


When should we see a doctor?

You should seek medical care immediately if your child or teen develops flu symptoms and has any of the following medical conditions:

• lung or heart disease
• any chronic health problem that requires regular medical attention
• an illness that might affect their immune systems, such as diabetes, cancer, or HIV/AIDS
• is pregnant

If your child develops any of the following warning signs, you should call your child's doctor:

• Severe or persistent vomiting
• Not drinking enough fluids. Goes to the bathroom less often than every six hours while awake if two years of age or older
• Not waking up or not interacting. Loses interest in playing, watching TV, eating or drinking
• Being so irritable that the child does not want to be held and cries a lot
• Flu symptoms improve, but then return with fever and worse cough

Call 911 right away if your child:

• has severe trouble breathing and it is not caused by a stuffy nose
• has blue lips or hands, suddenly becomes pale, or has cold legs up to their knees
• is so sleepy that he doesn't respond when you try to get him up, or isn't able to move
• seems confused
• has a seizure

How can I protect my children from getting sick?

Swine flu is spread from person to person in the same way as seasonal flu: through coughing or sneezing and by touching surfaces contaminated with infected droplets.

Proper hand hygiene is one of the best ways to guard against the flu. Flu viruses can live on your hands for up to five minutes, and can live on hard surfaces, like countertops and telephones, for up to two days. To reduce transmission:

• encourage your kids to clean their hands and clean them often to keep them and others from passing the flu. They should clean their hands after sneezing or coughing, before and after eating, after going to the washroom, and after playing outside.
• keep alcohol-based sanitizers handy in gel or wipe form, at home or in their backpack for times when they can't wash their hands.
• teach your children to cough or sneeze into their arms or sleeves
• encourage your child not to share personal items or drinks
• consider having your child vaccinated against swine flu once the vaccine becomes available, sometime in November

Sources: Public Health Agency of Canada, Government of Alberta Health and Wellness, Ontario Ministry of Health, B.C. Ministry of Health Services