www.inclusivechildcare.org || Concordia University, College of Education
Cindy Croft, Director || croft@csp.edu || 651.603.6265
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CICC E-News, Issue #12, September October 2009
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Influenza (flu) - Information for Early Childhood Educators and Care Practitioners
Identification, Prevention, and Treatment
Influenza is a contagious respiratory disease, caused by a virus that attacks the nose, throat, and lungs. Although it is very common, the spread of the disease may be limited by taking simple preventive measures such as getting immunizations and practicing good hygiene (i.e. hand washing).
A new strain of flu called H1N1 emerged this year. It is important for early childhood educators and care practitioners to know the important health implications for children affected by the flu. The flu can cause serious illness and, in some extreme cases, may even result in death. Groups that are at the highest risk for developing serious complications from the flu include: the elderly, people with chronic health conditions, and children less than two years of age. It is important to note, however, that there have been documented cases this year of the new H1N1 strain affecting teenagers as well as adults under 50.
Influenza symptoms can come on suddenly in the form of a sore throat, headache, fever, extreme tiredness, dry cough, nasal congestion, and body aches. These symptoms can be severe and can keep you confined to your bed for a number of days. A child suffering from a cold will usually keep up his or her normal activities. Conversely, a child with the flu will often feel too sick to play.
The flu vaccine is recommended for all children ages 6 months to 18 years of age. The flu vaccine is particularly important, however, for children ages 6 to 59 months old, and for children affected by the following: chronic diseases (e.g. heart disease), pulmonary diseases (e.g. asthma), metabolic diseases (e.g. diabetes), immune deficiencies, and blood disorders (e.g. anemia).
Vaccination is also recommended for those who care for children. This includes parents, childcare workers, and other household contacts. Given that children under six months of age cannot receive the influenza vaccine, people caring for children less than six months of age, their close contacts, and out-of-home caregivers should be vaccinated in order to protect an infant from contracting the flu.
Vaccination is recommended every year, because the virus that causes influenza is constantly mutating and consequently, health officials must produce a new vaccine specific to that season's strain each year.
PREVENTION: To keep the flu from spreading, do the following:
- wash your hands, as well as your children's hands, frequently with soap and water or with an alcohol-based, waterless hand sanitizer;
- cover your nose and mouth with a tissue whenever you cough or sneeze and throw the tissue away (cough or sneeze into your sleeve if you don't have a tissue);
- frequently clean commonly touched surfaces (door knobs, refrigerator handles, phones, water faucets, toys, table surfaces);
- avoid sharing anything that goes into the mouth;
- request that parents keep children at home if they show any symptoms of the flu;
- avoid exposing yourself to others who are sick with a flu-like illness;
- if you are experiencing flu-like symptoms, stay at home and, if you are a home day care provider, avoid contact with children. Have a backup plan for a substitute caregiver until you recover.
For a screening tool for parents and caregivers to use with children demonstrating influenza-like symptoms visit: http://www.health.state.mn.us/divs/idepc/diseases/flu/childcare/parentscrncare.html
2009 H1N1 Flu
2009 H1N1 is a new influenza virus causing illness in people. This virus was first detected in people in the United States in April 2009. This virus was originally referred to as "swine flu" because laboratory testing showed that many of its genes were very similar to influenza viruses that normally occur in pigs (swine) in North America. However, further study has shown that this new virus is very different in that it has two genes from flu viruses that normally circulate in pigs in Europe and Asia and bird (avian) genes and human genes. Scientists call this a "quadruple reassortant" virus.
The 2009 H1N1 virus is thought to spread in the same way that seasonal flu spreads. Its symptoms are also similar to the seasonal flu, however, symptoms that may be more severe with H1N1 include: fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, fatigue, and stomachaches (i.e. nausea, vomiting, and diarrhea-all of which are more common in children as opposed to adults). These symptoms are usually referred to as "influenza-like illness symptoms or ILI."
Studies have shown that people infected with the seasonal and 2009 H1N1 flu viruses may be able to infect others from one day before getting sick to five to seven days after. This varies and may be longer in some people. While most people who have been sick have recovered without needing medical treatment, hospitalizations and death as a result of infection with this virus have occurred.
As previously mentioned, certain groups are at high risk of developing serious complications due to infection with the virus. These include children younger than five years old, pregnant women, and people of any age with certain chronic medical conditions.
The Minnesota Department of Health (MDH) continues to investigate possible H1N1-related deaths on an ongoing basis. In Minnesota, the total number of confirmed deaths related to H1N1 since April 2009 is 12 people. http://www.health.state.mn.us/divs/idepc/diseases/flu/stats/index.html.
Methods of prevention for H1N1 are similar to the seasonal flu. Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub. Vaccination is recommended and child care providers and people who care for children six months and under are considered a priority group. Studies have shown that the influenza virus can survive on environmental surfaces and can infect a person for two to eight hours after being deposited on the surface. It is important to disinfect toys and all other surfaces that children can get to more frequently.
To prevent the spread of influenza virus, it is recommended that tissues and other disposable items used by an infected person be thrown into the trash. Additionally, persons should wash their hands with soap and water after touching used tissues and similar waste. Eating utensils and dishes belonging to those who are sick do not need to be cleaned separately but such items should not be shared without washing them thoroughly first. Linens should be laundered using household laundry soap and then tumble dried on a hot setting. The influenza virus is destroyed by heat (167-212°F [75-100°C]). Furthermore, several chemical germicides, including chlorine, hydrogen peroxide, detergents (soap), iodophors (iodine-based antiseptics), and alcohols are effective against influenza viruses if used in the proper concentration for a sufficient length of time.
The Center for Disease Control (CDC) recommends that people with the 2009 H1N1 flu avoid contact with others as much as possible, follow the directions of health officials, and watch for emergency warning signs. Please check the CDC and MDH web sites for updates and other useful recommendations.
Special Considerations for Children:
Aspirin or aspirin-containing products (e.g. bismuth subsalicylate - Pepto Bismol) should not be administered to any children, 18 years old and younger, due to the risk of Reye syndrome. For relief of fever, other anti-pyretic medications such as acetaminophen or non-steroidal anti-inflammatory drugs are recommended.
Children younger than four years of age should not be given over-the-counter cold medications without first speaking with a healthcare provider.
The CDC recommends the use of antiviral drugs like oseltamivir or zanamivir for the treatment and/or prevention of infection with the 2009 H1N1 flu virus. Antiviral drugs are prescription medicines (pills, liquid or an inhaled powder) that fight against the flu by keeping flu viruses from reproducing in the body. Antiviral medications can reduce the severity and duration of the influenza illness and can reduce the risk of influenza-related complications, including severe illness and death. Early treatment (within the first 48 hours) with oseltamivir or zanamivir is very important for persons with suspected or confirmed influenza who are at higher risk for complications. Persons who are at a higher risk for complications include:
- children younger than two years of age
- persons aged 65 years or older
- pregnant women
- women up to two weeks postpartum (including after pregnancy loss)
- persons of any age with certain chronic medical or immunosuppressive conditions
- persons younger than 19 years of age who are receiving long-term aspirin therapy
This season, H1N1 vaccines are to protect against the 2009 H1N1 influenza virus. There are two types of 2009 H1N1 vaccines being produced. One is an inactivated vaccine, which contains killed virus, given with a needle, usually in the arm, and the second is given via a nasal sprayer, generally referred to as LAIV "Live Attenuated Influenza Vaccine" which is a vaccine made with live, weakened virii that cannot grow at normal body temperature. Get vaccinated for both seasonal and H1N1 novel influenza as soon as the vaccine becomes available for you. Strongly encourage childcare and early childhood program staff who care for children younger than six months of age to get vaccinated. For more information please visit: http://www.cdc.gov/h1n1flu/vaccination/general.htm For more information and updates, please visit the Minnesota Department of Health web site http://www.health.state.mn.us/divs/idepc/diseases/flu/childcare/index.html