Beware of these INFLUENZA- like symptoms

Are any of the following signs or symptoms present?

Age 12 weeks to > 5 years:

• Fast breathing of difficulty breathing or retractions present.
• Dehydration ( no urine output in 8 hours, decreased tears or no tears child is crying, or not drinking enough fluids).
• Severe or persistent vomiting / unable to keep fluids down.
• Lethargy (excessive sleepiness, significant decrease in activity level, and/or diminished mental status).
• Irritability (cranky, restless, does not want to be held or wants to be held all the time).
• Flu - like symptoms improved but then returned or worsened within one to a few days.
• Pain in chest or abdomen (for children who can reliably report)
  

Age ≥5 years

• Fast breathing or difficulty breathing.
• Dizziness or lightheadedness.
• Severe or persistent vomiting /unable to keep fluids down.
• Flu - like symptoms improved but then returned or worsened within one to a few days.
• Pain in chest or abdomen.
  
  

Does the ill child have any of the following conditions?
1. Neurological disorders such as:

• Epilepsy
• Cerebral palsy, especially when accompanied by neurodevelopmental disabilities (e.g., moderate to profound intellectual disability (mental retardation or developmental delay).
• Brain or spinal cord injuries.
• Neuromuscular disorders (e.g., muscular dystrophy), especially when associated with impairment in respiratory functioning.

2. Chronic respiratory diseases such as :

• Conditions associated with impaired pulmonary function and/or difficulty handling secretions.
• Technology dependent children (e.g., those requiring oxygen, tracheostomy, or a ventilator).
• Asthma.

3.Moderate to profound intellectual disability (mental retardation) or developmental delay, especially when associated with specific conditions ( see 1 & 2 above).
4. Deficiencies in immune function or conditions that require medications or treatments, (e.g., certain cancer treatments, HIV infection) that result in significant immune deficiencies.
5. Cardiovascular disease including congenital heart disease.
6. Significant metabolic (e.g., mitochondrial) or endocrine disorders.
7. Renal, hepatic, hematological (including sickle cell disease) disorders.
8. Receiving chronic aspirin therapy.
9. Pregnancy.

Child falls into a group that appears to be at lower risk for complications from influenza and may not require testing or treatment if their symptoms are mild. Should symptoms worsen (e.g., shortness of breath, unresolving fever) or should the child’s caregiver have further questions or concerns about the child’s health, recommend the caregiver contact the child’s healthcare provider.

In order to help prevent spread of influenza to others, these patients should be advised to:
Keep away from others to the extent possible, particularly those at higher risk for complication from influenza (see box below). This may include staying in a separate room with the door closed.
Cover their coughs and sneezes.
Avoid sharing utensils.
Wash their hands frequently with soap and water or alcohol-based hand rubs.
Stay home (e.g., no school, child care, group activities) until 24 hours after their fever resolves without the use of antipyretics (i.e., acetaminophen, ibuprofen).

More information available at: http://www.cdc.gov/h1n1flu/guidancehomecare.htm

In addition, remember that vaccination for seasonal influenza and pandemic (H1N1) influenza is recommended for all children 6 months through 18 years old and household contacts and out of home caregivers of children less than 6 months old.