Swine Flu: How Does a Family Contain the H1N1 Virus?

I can relate to your dilemma and subsequent anxiety as I too have a daughter who attended East Campus and was positive for H1N1 by the time I got there to pick her up Thursday morning.

I sent my son to stay with a friend, and luckily my huband is working out of town. I have been torn between providing my baby with the close contact and nuturing that I know she needs (long embraaces; tiny kisses on the forehead) and following the doctor's advice to remain masked and avoid unnecessary contact. I've chosen to physically nuture my child and throw caution to the wind.

This is day four and I am not ill, but she uses Lysol spray every time she coughs and tries to cough only in a mask which is quickly disposed of. She uses hand sanitizer before touching anything and does not reuse tissue, cups, etc...

Like you, I did some research to find out what we really know about this virus to date and for the most part, it spreads just like the normal flu virus only it is heavier and does not stay airborne as long (which is a plus).

Sharon,

Thanks so much for the comment. One other word to pass on: It seems some of the side effects of Tamiflu can mimic flu symptoms. I've been on it for three days (as my daughter's caretaker, I requested it from my personal physician), but yesterday was beginning to think I was getting the flu--joint and muscle pain, lightheadedness, fatigue. But I haven't had a fever, and feel much better after a night's sleep. Despite some of the comments about Tamiflu's side effects on user Internet sites, I've decided to complete my five-day course.

I think the thing with the swine flu is that we aren't used to making such committed life changes even for a week. In the school that I work in, during the last week of school in June, we had four children in my class with supposely flu-like symptoms. Because they all had fevers they weren't allowed back for seven days. So of course, we had one child sent to school the very next day, and of course the school nurse had to be the "bad guy" and send her home. Another child's mother wanted to know that since she was one of the class mom's could she bring in her daughter just for the end-of-the-year party? Answer of course-no. For the rest of the school, there was literally a line up down the hallway of students that needed to be picked-up because of similar symptoms. I think come the fall and winter we are really going to see this flu take off. Precautions need to be taken now.

So sorry to hear your daughter is ill. I can relate as The Mother who came down with The Flu. I was out of commission for over 1 week and was literally unable to move. What does a household do, when the one who Runs the household is stopped cold? Everything stops. If it wasn't for my mother who rescued us, I don't know what we would have done. Like you, mothers come thru no matter what age!

At the risk of being an alarmist, i have to admit that I have thought about the other children that could have been just showing the symptoms Thursday and Friday morning and caught flights out alone to return home. It makes me wonder if we are actually prepared to effectively handle a situation like this in our schools and workplaces.

Pam- like you, I came down with the flu as well, but was lucky to not infect my family! (My kids had the flu shot- dont know if that is why or not.) I teach at Middlesex County College, and upon returning on Monday after a very ill weekend, I was presented with 4 doctors' notes from students diagnosed with the flu (a few more students with symptoms don't have health care insurance so they didn't visit doctors!) So at least I know WHERE I got it. The thing I thought was interesting was the antibiotic I was given for my chest to help prevent pneumonia ( I guess this is a secondary infection that has been showing with the flu). My doctor said they have been seeing TONS of cases, so "batten down the hatches"—it's going to be a doozy of a winter!!!

Um, we all know that swine flu is currently killing fewer people than normal types of flu, right? Maybe just stop the hand-wringing and do whatever it is your family has done during all the years we've had regular flu outbreaks, because that's all this is too.

You're so fortunate to have a place to go. What a minority you are. Most working parents, I'm sure, neither have enough vacation to take a week off to care for a sick child, or a separate residence to care for the child, or childcare for any other children who might be exposed. I know if one of mine came down sick, though it would break my heart to do it, I would not have the option to isolate my other children from the illness or stay out of work long enough to nurse all of them through the rounds of illness. Perhaps your situation would allow you to provide some insight as to what the rest of us less well-set-up will be able to do.

Joey,

Thanks for your comment. While I appreciate that swine flu is milder than other strains, the point of the blog is that our family was faced with the dilemma of protecting the highly vulnerable population—the elderly—that we're visiting (had we been at home, the risks to our typically healthy immediate family wouldn't be as high, though we would still follow the precautions recommended by our daughter's program and the CDC). I can assure you that the skilled nursing facility where my frail 93-year-old father lives, and the day camp my son is attending while we visit him and my mother, 84, are both extremely grateful that we're taking such precautions.

Some good Web sites to check for which populations are at risk--the elderly, infants, anyone with an autoimmune disease or taking immune-suppressing drugs, such as cancer patients or people with organ transplants--include this from WebMD (http://www.webmd.com/cold-and-flu/flu-guide/fact-sheet-elderly-people) and this page from the CDC (http://www.cdc.gov/h1n1flu/qa.htm). According to WebMD: "Of all age groups, individuals older than age 84 have the highest risk of dying from seasonal flu complications." That includes my parents. My son, normally robust, has a history of asthma, which puts him at a higher risk, too. According to the CDC: "The flu can make chronic health problems worse. For example, people with asthma may experience asthma attacks while they have the flu, and people with chronic congestive heart failure may have worsening of this condition that is triggered by the flu."

From living in isolation with my daughter for the last five days, I can say this might be a milder flu, but it's certainly no cakewalk. She's fever-free now, but still fatigues easily and has a lingering cough. It's quite likely my father, who has a heart condition, wouldn't survive the swine flu.

Jean,

Actually, I've been working while caring for my daughter, but am fortunate to be able to work remotely for BusinessWeek (I'm a part-timer). And yes, we were extremely fortunate to have the use of my brother's guest house--otherwise, we'd all be cooped up together in our split level in New Jersey--and to have my brother and his wife available to care for my son. It was a rare convergence of opportunities. But under normal conditions--at home, no one to help with child care--I would be following the CDC recommendations as closely as possible, being diligent about using facemasks, and keeping my daughter as isolated as possible. One recommendation, if you have the option: keep the child isolated in a room with an adjacent bathroom. It seems to me that you can take a page from Sharon Gantt (above) and her daughter: "She uses Lysol spray every time she coughs and tries to cough only in a mask which is quickly disposed of. She uses hand sanitizer before touching anything and does not reuse tissue, cups, etc..."

And of course you should follow the advice of your pediatrician.

When I read your blog, I thought: "There but for the grace of God go I." That's because my high school daughter left for camp on a Sunday early this month, and the following Tuesday, I and other parents got an e-mail from camp. It informed us that two high school girls had been diagnosed with the H1N1 virus, and that there was a higher incidence of kids with flu-like symptoms overall.

I've been keeping my fingers crossed in the two weeks since. So far, no more communication from camp, and apparently the two girls who had it recovered and went back to camp.

My other worry is this: I’m a single mom, and I have a chronic disease that has compromised my immune system. If my daughter were to get sick, how would I take care of her?

When I talked to my daughter, she was blase about it, although she said a lot more people were sniffling and coughing than last year. She says: "If I've been exposed to it, maybe that'll mean I won't catch it when it really hits this fall."

My reaction swings from nonchalance to anxiety. After all, I'm in New York, and my daughter is in Michigan. And she's scheduled to fly home by herself next week. Yet it's telling that in the online parent group, the chatter did not touch on swine flu at all.

Anne,
Good luck! I think you are doing the right things in protecting yourself and your family. Keep the hand sanitizer handy and use it often, especially before touching your face at all. Not only that, if your daughter is still sick, and seven days after she is ill, don't get close enough to let her breath on you unless you have a mask on. Don't let her visit anyone until the seven days is up with no signs and symptoms. I know it is torture for the young to stay cooped up after they feel better, but that is what professionals recommend. As a Registered Nurse myself, I feel that not enough is being done about the cases they are seeing, and not enough education is being provided. There are way too many people not taking this seriously. Yes, 36,000 people do pass away from a normal flu season, but they are the elderly and the immunocompromised. During this time we are not only having to worry about the elderly and immunocompromised individuals, but also and especially the young, who we have seen most of the deaths from. This fall and winter, I fear we are going to see full hospitals having to turn away severely ill individuals. I hope you and your family get through this fine. Good luck again!

Lia,

Thanks so much for your comment. All of our precautions seem to have worked. We struck out for the 700-mile trip home on the seventh day of my daughter's isolation, more than a day after she was symptom-free. We kept my son away from her for 6 days, and didn't visit the nursing home. My daughter, son, and I are all fine, no flu symptoms among any of us. Back home with my husband, we were all able to attend a glorious family wedding, and plan to return shortly to visit my elderly parents for what we hope is a disease-free vacation.

In conversations with people since our return, those who take the risks of H1N1 most seriously are people with family members who are immunocompromised, pregnant, or elderly. Meanwhile, we have a large supply of masks, latex gloves, and wipes at the ready to loan friends or neighbors.

Get a humidifier too. I just read that a study a couple of years ago determined why flu virus always seems to hit more in the winter. I've always thought it was because people stayed couped up indoors more, but they did tests on guinea pigs and found that the virus is more stable in the cold and dry air, but heat and humidity make the air pockets with virus too heavy with water to stay airborne. The virus passed among the guinea pigs when it was 41 degrees, but was never transmitted when the heat and humidity got high.

You can read about the study here:

http://www.nytimes.com/2007/12/05/health/research/05flu.html

I contracted type-A influenza, and have done a good job keeping it away from the family. I am on day five and still running a fever (off and on).

What I have done, COVER ALL caughs - this is the #1 way it spreads. Using anti-bac. lotion is for bacteria & will do nothing to help you unless while you are drying it off, you remove the virus... much better to WASH YOUR HANDS.

Second, I constantly sprayed and washed all of the common things that I was touching (knobs, handles, ect).

So far so good.

Remember, it is the coughing / sneezing (although sneezing was not a symptom for me)that will spread this thing.

swine flu can kill anyone who doesn't wash their hands and keep them away from their mouth so please help to not put anything in your mouth that is dirty then if the swine flue if coming to where you live you can prevent from getting it by putting on a mask to prevent gerns just think of what the swine flue can do to you if you don't follow these instructions!!!! ooohhh nnnooo!!!

October 2nd, last Friday, my sister-in-law called and was obviously very, very weak and needed to go to the ER. They put her through immediately, she had a fever of 101.1, they gave her 2 IV's, she had not been able to keep anything down for 3 days prior to calling us. I have been quaranteened with her, taking care of her since Friday. Taken by surprise by this thing and the enormity of it, I was really tired Friday night, went in the bathroom, and YES, picked up the wrong toothbrush in the low-lit bathroom, did not realize it until I was putting it down. Now I have chills, cough, achy - and she still cannot eat anything. ER said she had a virus - flu is a virus. She has all the symptoms of H1N1.

Last night I looked on the CDC sight, Googled it, and totally realized the severity of it. I live with my 17 y.o. daughter, 15 y.o. son and frail 78 y.o. mother. No one except my sister-in-law and myself seems to realize that this is a serious condition and that those under 25 and over 65 are the most susceptible to it. I feel I must stay the course with my sister-in-law in order to, of course, help her, but also not to run the risk of infecting the members of my family at home, even though they do not realize just how serious this flu can be. We talked to an internist friend who told us that this has all the components of the swine flu, -

Here is my ? - what do you do as a mother, when taking care of a family member in an isolated situation, to protect others from infection, when you are needed as a mother in your "normal" capacity? I do not feel that well as I type this out - rather dizzy. I believe I should keep doing what I am doing until both my sister-in-law and myself are symptom free for at least 24 hours. Regardless of pressure from family to ignore this. How can one ignore, brush aside a visit to the ER, all the symptoms of this thing? It is nuts.

Susan,

You definitely should not ignore or brush off signs of the H1N1 virus in your household. The Centers for Disease Control & Prevention has very good guidelines about how to care for someone with swine flu in your home (http://www.cdc.gov/h1n1flu/guidance_homecare.htm). I've pasted them below, and when my daughter was sick we followed them pretty diligently. What to do first? Check with your health-care provider. All the doctors we consulted in her case (her pediatrician, the doctors at the summer program where she got swine flu, my internist, and doctors for my very frail 93-year-old father; we were visiting his retirement community at the time, but stayed away until she was fever free for 24 hours) gave us advice consistent with the CDC's. It seems our precautions paid off: My daughter has been the only one in the family to come down with the virus so far. Here's the CDC advice. Good Luck!

People with 2009 H1N1 flu who are cared for at home should:

* check with their health-care provider about any special care they might need if they are pregnant or have a health condition such as diabetes, heart disease, asthma, or emphysema

* check with their health-care provider about whether they should take antiviral medications

* keep away from others as much as possible. This is to keep from making others sick. Do not go to work or school while ill

* stay home for at least 24 hours after fever is gone, except to seek medical care or for other necessities. (Fever should be gone without the use of a fever-reducing medicine.)

* get plenty of rest

* drink clear fluids (such as water, broth, sports drinks, electrolyte beverages for infants) to keep from being dehydrated

* cover coughs and sneezes. Wash hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.*

* wear a facemask – if available and tolerable – when sharing common spaces with other household members to help prevent spreading the virus to others. This is especially important if other household members are at high risk for complications from influenza. For more information, see the Interim Recommendations for Facemask and Respirator Use

* be watchful for emergency warning signs (see below) that might indicate you need to seek medical attention.

Get medical care right away if the sick person at home:

* has difficulty breathing or chest pain

* has purple or blue discoloration of the lips

* is vomiting and unable to keep liquids down

* has signs of dehydration such as dizziness when standing, absence of urination, or in infants, a lack of tears when they cry

* has seizures (for example, uncontrolled convulsions)
is less responsive than normal or becomes confused