A Message for Concerned Parents

Posted by:
Dr. Lauren Smith, Department of Public Health

 

Lauren Smith is a pediatrician and the Medical Director for the Department of Public Health.

As parents, we want to do everything we can to protect our kids, especially when we are dealing with something new.  As a parent of 3 school-aged kids, I understand your concern.  But we don’t think that parents need to keep their kids home from school- even if that school has a confirmed a case of H1N1 Flu.

There are a couple of reasons for this:
1) Whether or not there is a confirmed case in your community or in your school, it is most likely there.  You should assume that you could be exposed to this new flu at school, at work or at the grocery store (in other words, anywhere you go).  So, it is really important to take common sense precautions to protect yourself.  That means washing your hands frequently with soap and warm water, or using an alcohol based hand-sanitizer, and staying away from people who are coughing or sneezing.

You can also help ensure that you don’t spread an illness to others by covering your mouth when you cough or sneeze.  Use a tissue, or cough into your sleeve if you don’t have one. 

Take this opportunity to reinforce both of these messages with your kids.  Teach them how to keep themselves from getting sick, and how not to spread disease to others when they do get sick- whether it’s a cold, the flu or some other illness.

2) Another reason we don’t feel it’s necessary to close schools, even with a confirmed case of H1N1, is that it doesn’t seem to be any more severe than a regular seasonal flu. We don’t close schools down for seasonal flu, so it wouldn’t make sense to close them now.

Although this new flu doesn't seem to be more severe that the regular flu, there is currently no vaccine to protect against it.  Therefore, it becomes even more important to make sure you're practicing those precautions I outlined above.

Becuase this is a new virus with no vaccine to protect against it, we have been, and will continue to, closely monitor the situation in coordination with schools.  If the number of absences starts to grow, we will work with individual school districts to reassess the situation.

And one last important note, some children have significant underlying medical conditions that put them at increased risk for any flu – seasonal or swine.  It makes sense for parents in this situation to talk to their child’s doctor about what is best for their child, just as they do when regular flu season starts. I want to reinforce that we think it is safe for kids to go to school just like they would during flu season, but ultimately, it’s a parent’s decision.  If you have questions, you should consult your child’s doctor so you can have the information you need to do what you feel is best for your child.

Comments

[barb]

There is a new book out "The History of the Peanut Allergy Epidemic" by Heather Fraser. Heather is a historian and mother of a child who has a possibly fatal peanut allergy.

She found some interesting historical facts.

The World Health Organization, the FDA, and a number of other health agencies determined that highly refined peanut oil (even though it still has a trace amount of peanut protein in it) is "generally recognized as safe" and does not have to be listed as an ingredient on the package insert of vaccines, vitamins, and other pharmaceuticals.

Doctors, patients, and parents do not have the right to know which vaccines or pharmaceutical products contain peanut oil because it is a protected trade secret.

There is a peanut allergy epidemic among our vaccinated children. 1 in 125 children now have a possibly fatal peanut allergy.

[Misti]

I understand and have explained the precautions to take in order to prevent getting the flu. My concern is this- how can a child "stay away" from other kids who might be sneezing or coughing when they are pretty much jammed into a classroom for 6 hours each day, sometimes elbow to elbow! You can "bathe" in hand sanizing gel and even that is not going to provide you with a barricade against the virus that is spread in the air (especially in air thst is recirculated, or poorly ventilated). It doesn't take rocket science to assume that if we keep sending unvaccinated children into schools, it will just continue to breed and spread continously! Sunjay Gupta recently reported that if a person coughs or sneezes within 6 FEET of another person, the virus can be transmitted. This is definately cause for concern for any parent with a child in school. Why did people in Mexico and other countries wear masks for protection, while Americans I guess are afraid of not being fashinable or something?

[Drinkwater Road]

Suffocation blues - why do you assume that schools are the only places where the disease is being spread? Or do you suggest closing every public place?

[J.Adamo]

Seeing that the current situation points to widespread but mild outbreak, I am wondering if past pandemics have shown any evidence that those who recovered from the mild, first wave flu were any better off once the second, more fatal wave hit?
In other words, is there any history or scientific evidence that those who test positive for H1N1 this time around would have an increased immunity if/when the fall/winter cycle hits?

Also, will authorities being enforcing truancy consequences for parents who keep their children out of school currently to protect them from H1N1?

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Dr. Lauren Smith responds: People who have been exposed a particular type of virus generally build up some immunity. However, the question of whether they would be somewhat immune to a new, more severe strain would depend on how much the virus has mutated.

Suzanne Crowther responds: DPH is working very closely with schools to prevent further spread of this virus and to keep sick children home. If a parent's decides to keep their child out of school when they are not ill, they would need to speak directly to their school about truancy issues, however, we are encouraging schools to be lenient with concerned parents.

[David Ozonoff]

This is a reasonable policy for this moment although, as you say, reassessment might be necessary. I would add some additional words of caution to those you have expressed.

It is important to point out that this is not seasonal flu. It is a strain to which there appears to be no or little natural immunity in the school population (either students or staff), so it can spread more quickly and more widely; and, as is typical with such novel flu viruses, the age distribution is shifted to the left, making the school population possibly more vulnerable than with seasonal flu.

And while it doesn't seem particularly virulent for a flu virus, flu viruses are nasty and unpredictable as a group, something to keep emphasizing. The public's experience with flu as a familiar and known danger is likely to engender a misguided complacency about this disease.

[Shana]

Obviously, there is a difference between seasonal flu and H1N1---those of us with at-risk (very young) children have had them immunized (and the rest of the family) for seasonal flu. It gives them immunity protection. That's why they are immunized, right? I have a 1 year old and an older child in school. We take every precaution, but our 1 year-old still catches every virus that seems to be out there. My perception is that there seems to be little concern for school-age children that have very young siblings. Is this being taken into account when making the decision to not close schools with confirmed/suspected cases?

That said, what symptoms are being seen in very young children with H1N1? Are they the same as adults?

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Dr. Al DeMaria responds: Even if we closed the schools, infected children will be there when they re-open. Young children have mild symptoms. If a young child is at high risk for the complications of influenza, consideration to antiviral treatment while the sibling is sick could be discussed with the healthcare provider. However, that young child will most likely be exposed to other sick children and cannot remain on prophylaxis indefinitely.

Flu viruses are always tricky, but despite being a novel virus, it does not seem to be spreading any faster in the presumed susceptible population than ordinary flu, and maybe somewhat less fast. It may be that some young have enough experience of non-swine N1H1 to convey some resistance. However, flu viruses are always unpredictable and this bears close watching.

As for symptoms, like the seasonal flu, symptoms in children and adults are similar. However, children may be more likely to expeience vomiting and diarrhea.

[Suffocation Blues]

Thanks so much, Lauren. I appreciate your concern for the respiratorily distressed people and chronically ill out there in the land of MASS. Keep them skewls open and spread that disease around. Real nice. I'm glad I pay taxes so people like you can be in charge.