2/15/10 Although there have been very few cases of H1N1, the CDC still recommends vaccinating for it.  Seasonal flu still lies ahead and vaccine is available.  If a parent wishes to be vaccinated, Alger Pediatrics will accommodate your vaccine needs.

11/10/2009  See specific vaccine availability in the Flu Clinic box to your left.

11/5/2009  We still have not received enough  H1N1 to open flu clinics.  The federal regulation of H1N1 vaccine has been inefficient and frustrating, and we appreciate your patience!  We will keep you posted.

10/30/2009  We have received very, very few H1N1 vaccines from the health department today.  These vaccines will be used to protect our staff and our most vulnerable patients.  Our staff will call our patients with the most severe metabolic disorders, cardiac lesions, chronic lung disease (ex. trach, on oxygen), or immunodeficiencies.  Due to the restrictions, vaccines will be for these patients only at this time -- not whole families.  Vaccine is so limited that we cannot cover asthmatic patients or  premature babies yet.  We hope to get more vaccine next week and will update this sight.  If you believe your child qualifies for this initial group, please call the office.

Influenza- indications for treatment

10/19/2009 (information is based on the CDC guidelines of 10/16/2009):  H1N1 influenza is now widespread in our community!  Symptoms of the illness are listed below.  Most people with influenza will recover without any complications.  Some people are at more risk for flu-related complications.  The CDC (Center for Disease Control) has recommended that "at risk" patients may be treated with an antiviral medication (Tamiflu or Relenza).  Antiviral medications should be given within 48 hours of the onset of symptoms.  Antiviral medications shorten the course of influenza by about one day. 

Patients "at risk" for influenza complications include: 

Pregnant women, children less than 2 years old, adults over age 65,  children under 19 years on chronic aspirin therapy, patients ill enough to be hospitalized with confirmed influenza, patients with chronic medical or immunosuppressive conditions (including chronic asthma, cystic fibrosis, heart conditions, cancers, neuromuscular or metabolic disorders, diabetes, etc.)

Children 2 to 4 years old are more likely to require hospitalization or urgent medical evaluation for influenza compared with older children, although the risk is much lower than for children younger than 2 years old.  Children aged 2 years to 4 years without high risk conditions and who are not severely ill do not necessarily require antiviral treatment.

Children who are getting worse (ex.  difficulty breathing or other concerns) might receive antiviral treatment regardless of previous health.

Treatment may be given even if presenting after 48 hours of symptom onset if indicated. 

Influenza Testing:  Patients may be tested in the office for influenza A or B by a swab in the nose.  Yet influenza testing is not necessary as the rapid tests have many false negatives for H1N1.  At this time, we presume that all Influenza A positive patients have H1N1.  The state will only allow us to specifically check for H1N1 in patients admitted to the intensive care unit or for pregnant patients.  Regardless, treatment should be based on clinical symptoms and treatment should not be delayed while waiting for results.

FLU VACCINE

We do our best to have both flu shots and mist available, but due to shipping delays, product availability may vary.

*Flumist is an inhaled flu vaccine--no pokes! It is available for patients 2 to 49 years of age. Flumist may not be given to patients who have an egg allergy, who receive aspirin or aspirin containing therapy, or who have asthma or recurrent wheezing. Flumist is generally well-tolerated, but common side effects include runny nose, sore throat, or fever.

Fluzone is an injectable flu vaccine for patients of all ages. Fluzone may not be given to patients with an egg allergy.  We also have preservative free Fluzone, available for children 6 to 35 months of age.

Please be specific with the nurse which type of vaccine you want your child to have.

FLU VACCINE GUIDELINES:

*Any flu vaccine should NOT be given to a person with a severe egg allergy.*

1.  H1N1 and seasonal influenza vaccines each come as a shot or as a mist.  (Mist is only available to children 2 years of age and older who do not have asthma or wheezing.)

2.  A child may receive H1N1 and seasonal flu vaccine on the same day if they receive either two shots or one shot and one mist.

3.  A child may receive both seasonal Flumist and H1N1 mist; but the vaccines must be separated by at least 30 days.

4.  If a child has already received seasonal Flumist, he must wait 30 days before he can receive H1N1 mist.

5.  If a child has already received seasonal flu shot, he may receive H1N1 shot or mist at any time (when it becomes available).

6. Children 9 years of age and younger will need two doses of H1N1 vaccine, given 1 month apart.

SWINE FLU  The media coverage has created much anxiety regarding swine flu. Every year 36,000 people in the U.S.A. die due to regular influenza. Every illness is important, but we must not panic. It is important to continue safe, healthy habits (handwashing); but we must also keep things in perspective.

Swine Flu (better named H1N1 Influenza) is a variety of Influenza A. If your child does not have Influenza A, they do not have Swine Flu. An excellent information site is from the CDC. http://cdc.gov/h1n1flu/swineflu_you.htm

Why should we vaccinate for H1N1?   Although this is not likely to be like the pandemic of 1918, it is good to review the previous pandemics to underscore the value of vaccine.  In 1918-1919, it hit it three waves.  Mild influenza spawned the first wave in the spring and into the summer of 1918.  The next wave, this time more severe than its precursor, occured in the fall.  The final wave returned in the spring of 1919.  This pandemic took with it about 20 million lives globally (675,000 in the United States).  The impact of the epidemic was far reaching with many orphaned children and collapsed municipal infrastructure.  Schools and stores were closed indefinitely.

In 1957-58 influenza (H1N1) returned to the US causing more than 70,000 deaths.  Another pandemic in 1968 saw 33,000 lives claimed.

As it stands now, the 2009 pandemic does not appear as serious as 1918 or 1967.  But we are better prepared to deal with it.  These vaccines are extremely safe and are manufactured in the same fashion as seasonal influenza vaccine.

INFLUENZA

Influenza is a viral illness that is highly contagious and transmitted person to person via the airborne route by aerosol transmission (sneezes, coughing).

Prevention: The best way to prevent influenza is to wash your hands frequently. Teach your children to cough or sneeze into their elbows or a tissue to avoid spreading germs.

Influenza symptoms start suddenly and include:

1. Fever (102 - 105 F) and chills for 2-5 day

2. Cough: the hacking, "irritating" type

3. Myalgia (muscle aches)

4. Sore throat

5. Runny nose

6. Dizziness

7. Irritated eyes

8. Headaches

9. Fatique ("washed out", feeling "awful all over".)

Please note that infuenza generally does not include vomitting and diarrhea. Vomitting/diarrhea "flu" is not influenza.

If your child has a high fever and some or all of the above symptoms you may contact our office to set up an appointment to have your child tested for Influenza.

Supportive care for your child includes:  Bed rest; Liquids; Humidity (vaporizer or shower "steaming" will help relieve congestion and soothe sore throats); Do not give your child aspirin for fever. Only acetaminophen or ibuprofen should be used.

Complications of Influenza:  Ear Infection, Pneumonia. 

Call our office if the fever lasts more than four days, your child's cough worsens, breathing becomes more labored, your child is not improving, or for any other concern.