Reports of widespread swine-flu infection in Mexico, Japan, and the United States, and as many as eight deaths in the U.S. — some suspected flu fatalities remain unconfirmed — have shaken parents and grandparents across the country. Pharmacies have sold out their supplies of face masks and schools have closed for disinfecting. The World Health Organization has raised this virus strain's classification to level 5, which means it has confirmed widespread human-to-human transmission.
Grandparents.com spoke to Dr. Joseph Bocchini, chairman of the department of pediatrics at Louisiana State University Health Science Center and chair of the American Academy of Pediatrics' committee of infectious diseases, about how grandparents and parents should prepare for the possible threat of swine flu in their families.
Grandparents.com: How does the swine flu spread, and how can we protect ourselves and our grandchildren from possible infection?
Dr. Joseph Bocchini: Everyone should realize that this virus spreads the same way that other strains of influenza spread. For individuals who are sick: Don’t go to work, don’t go to school, and don’t participate in public activities. Avoid large crowds, and do frequent hand washing. Handwashing is probably the best way to protect yourself because this virus will survive on surfaces. If you touch someone who is contaminated, you get the virus on your hands, and then if you touch your eyes or your nose or your mouth you could spread the virus.
GP: What else can we do?
JB: People who are coughing or sneezing should have Kleenex and they should sneeze into the Kleenex and then throw the Kleenex in the trash. That will help reduce the spread of the organisms into the community or to the people around them.
GP: Is it safe to take grandchildren to the supermarket, to play dates, and to public parks?
JB: The Centers for Disease Control will update on a regular basis what’s happening and provide recommendations for if we need to change what we are doing. If people are staying home as they should when [they have] an acute illness, then routine things that you do in a community [including] playgrounds would be fine unless there is a high degree of activity in your area for which the public health authorities [would advise] not to. If a grandparent is in good health, has no underlying major medical problems and normally goes out, I would continue to do that unless there was some recommendation by the public-health people to avoid that.
GP: What possible changes would public-health authorities recommend?
JB: Public-health authorities will do things that will try to reduce contact. They will close schools, they will close daycare centers, movie theaters, and other public areas to try to reduce the risk of transmission.
GP: Should families prepare for such measures?
JB: I think what families can do right now is think about what they need to do to prepare just in case a school closes and their children will be at home, or if the daycare closes and their children will be at home. Obviously, if we closed school or a daycare, we would rather those children stay at home rather than go out into the community to malls and places where they still might be exposed to the virus. [Discover 7 ways to stay active indoors.]
GP: If grandparents are able to babysit for the grandchildren, should they offer to do so in lieu of sending the kids to daycare?
JB: Not now. I would ask those people to see what their local health authorities are proposing. Much of the response to influenza is going to be on a community-by-community basis. [Read about 5 tricks to staying well when sitting for sick grandchildren.]
GP: How long does it take for swine flu to incubate in a person?
JB: Influenza has a very short incubation period. Usually one-to-three days after exposure would be when we would expect symptoms to begin. The longest incubation period is probably a week. So if someone, for example, has come back from Mexico City and they don’t get sick within a week, they probably don’t have influenza. A week is probably the longest time.
GP: What are the signs of swine flu that we should be alert to?
JB: It is very important that if someone has the classic signs of influenza — sudden onset of chills, high fever [100.3 degrees Fahrenheit], a bad headache, cough, mild nasal congestion, mild nausea, sometimes even vomiting and diarrhea — they should seek advice from their physicians. Tests can be done to determine if they have influenza, and then if they do, they can be treated with Tamiflu or Relenza, antivirals the organism is susceptible to. Our goal would be to treat anybody with influenza early to see if we could modify the course of the infection. The influenza virus that is spreading has been tested and is susceptible to some of the antiviral drugs we normally use.
GP: How can we tell the difference between swine flu symptoms and those of the common cold?
JB: Influenza is a very characteristic illness. Most viruses that produce colds produce a very little fever, and the children who have them usually don’t feel too bad, so that they tend to be able to continue to play or do other things they normally would. Influenza is different. Influenza starts abruptly with hot fever, and the symptoms that we have talked about. Younger kids are irritable, fussy; they don’t want to do things; they want to lie around. Older children will tell you that they've got severe headaches, or muscle aches and pains, or lower-back pain — these patients with influenza look different from patients who just have a cold. Any child who has a respiratory illness with significant fever, that’s a patient that needs to be seen by their physician to decide whether they need to be tested for flu. [Learn more about responding to medical emergencies when you're watching your grandchildren.]
GP: How should families prepare in case their children get infected?
JB: Having your pediatrician’s telephone number available, knowing their office and how it runs and what to do after hours is always good so that you can call and get information and make decisions about what to do for your children.
GP: If a school has been closed because cases of swine flu have been confirmed in the student body, does that mean the street or neighborhood is contaminated?
JB: The virus will survive for a short period of time on clothing or other areas [like money] but outside in the environment, after a very short period of time, the virus is not going to be viable.
GP: What is a "short period of time"?
JB: We’re talking within minutes. For example, if someone has their hand contaminated and they touch the door of a car as they enter the car, and then somebody follows that within five or ten minutes, the chances are that that virus is still viable and if they touch their eye or nose or mouth then they may transmit the virus. An hour later, that is not going to be a problem.
GP: Will wearing a face mask help protect us from swine flu?
JB: Well, that’s arguable. There is very little data on the effectiveness of face masks. If someone is coughing or sneezing, some of the virus that is in the air could be stopped. That’s a small benefit. You’re better off [washing your hands]. Certainly if someone wants to add a mask, it could offer some help but we wouldn’t recommend that as a major way to reduce infection risk.
GP: Should we avoid pork and vegetables grown in Mexico?
JB: There is no evidence of transmission from any food product.
GP: How long will it be before we know how badly the global community will be affected by swine flu?
JB: It is going to depend on whether we reach a peak of activity and it disappears or if the activity just keeps going. I think within a week we will know a lot more. Whether that’s enough to tell us the extent of severity, I wouldn’t be ready to predict.
For more of the American Academy of Pediatrics' recommendations for responding to the swine flu scare, visit its website. The academy also has specific flu-prevention advice for childcare providers. Visit slate.com to learn about the limitations of face masks in preventing the flu.
To find out about specific swine-flu warnings that may be in place in your area (or your grandchildren's), check the federal Centers for Disease Control and Prevention, state-government websites, or your local newspaper.
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