Children with Disabilities and H1N1 Flu

Introduction

Main Item

The H1N1 flu has been on the minds of all people in America; as of August eighth

Doctors are warning that a focus must be placed on children with special needs who exhibit flu-like symptoms. Out of the group of thirty-six children between the ages of two months and seventeen years who have died due to the flu, two-thirds of them experienced a chronic illness or a form of developmental disability that included muscular dystrophy, cerebral palsy, a developmental delay, cardiac issues, or respiratory problems.

Children, or anyone, who has an underlying condition, needs to be seen by a health care professional if they get a fever, it could make the difference between becoming severely ill or recovering. Receiving treatment within forty-eight hours has the potential to make a large difference in speeding the person's recovery. Children who have developmental disabilities will be first in consideration for the flu vaccine as it becomes available.

The flu vaccine could become available in the middle of October, which is rapidly approaching. Overall, nearly five-hundred people in America from all age groups have died from the H1N1 flu to date. It is unknown if the H1N1 flu pandemic will impact children more than a regular flu season at this time. Approximately fifty to one-hundred children die from the flu every year.

There is not a whole lot that is known about how this form of the H1N1 flu may affect children. In past pandemics and with the seasonal flu it is known that children, particularly those under the age of five and children who have high-risk medical conditions, are at an increased risk of flu-related complications. Children younger than age five have a risk of complications that is highest among children who are less than two years old. Young children are less likely to present with typical flu symptoms such as a fever and cough, while infants can present with both fever and lethargy; they may also not have a cough or additional respiratory symptoms or signs.

Flu-associated deaths among children are uncommon, but do happen with seasonal flu. Some of these deaths are associated with co-infection between the flu and Staphylococcus aureus, methicillin resistant S. aureaus (MRSA) in particular. The symptoms of severe disease can include:

Apnea
Dyspnea
Cyanosis
Tachypnea
Dehydration
Extreme irritability
Altered mental status

Some children are at a higher risk for complications from flu infection. Children with chronic neurological or neuromuscular condition are a portion of the population who are at a higher risk, as are infants younger than six months of age. Children with immune suppression, chronic kidney disease, heart disease, HIV/AIDS, asthma, diabetes, lung problems, sickle cell disease, on long-term aspirin therapy for chronic disorders are as well. Children with any condition which affects their respiratory function to include neurologic conditions such as intellectual and developmental disabilities, cerebral palsy, seizure disorders, spinal cord injuries, metabolic conditions, or neuromuscular disorders are also at a higher risk due to the H1N1 or the seasonal flu.

Children with poor nutritional and fluid intake due to prolonged vomiting and diarrhea, children with underlying metabolic disorders such as medium-chain acyl-CoA deydrogenase (MCAD) deficiency and are unable to tolerate prolonged periods of fasting are at higher risk from the flu. Children with either metabolic or neurological disabilities might not have the ability to tell others about the symptoms they are experiencing, or if their symptoms are getting worse - a delay in identifying the flu can lead to additional complications. Children who are HIV positive and are not taking anti-retroviral medication can have a more severe experience of the flu, hospitalization, as well as bacterial complications.

The CDC has stated that aspirin or aspirin-containing products such as Pepto-Bismol should not be given to children suspected of having either the seasonal or H1N1 flu because of the risk of Reye syndrome. To relieve the fever, other anti-pyretic medications like acetaminophen or NSAID's are what they are recommending. Children under the age of four years should not be given over-the-counter medications without first speaking to a health care provider.

The CDC is also saying that both parents and caretakers need to make sure that children's vaccines are up to date. Parents of children with disabilities and chronic conditions who require medications are encouraged to continue their child's medications. The CDC recommends that adults with flu-like symptoms stay at home until at least twenty-four hours after they are free of fever (100 degree F , 37.8 degrees C), or signs of a fever, without the use of fever-reducing medications.