What is the proper response if you suspect swine flu?

[Pink Fairy]

How long do you keep a child or yourself home if you have a suspected case of swine flu? Are you still contagious if your other symptoms have gone except for coughing and tiredness? Are there any guidelines out for when it's safe to go out and about our regular business without infecting everyone?

 

BTW, I'm asking for future reference in case we do get it.

[Melinda in VT]

Here is the Exclusion period section of the Swine Flu handout my kids' school sent home on the first day:

 

"Those with flu-like illness should stay home for 24 hours after they no longer have a fever without the use of fever-reducing medicines and regardless of whether or not they are using antiviral drugs. Data from the spring of 2009 H1N1 outbreak showed that most people had fevers for 2-4 days, which would require an isolation period of 3-5 days.

 

• People with more severe illness are likely to have a fever for longer.
  
• About 90 percent of cases transmitted within a household occurred within 5 days of the first case.
  
• Those who are sick should stay home during this period, except to seek necessary medical care and should avoid contact with others.
  

"

 

Hope that helps.

[wulfbourne]

Here is the Exclusion period section of the Swine Flu handout my kids' school sent home on the first day:

 

"Those with flu-like illness should stay home for 24 hours after they no longer have a fever without the use of fever-reducing medicines and regardless of whether or not they are using antiviral drugs. Data from the spring of 2009 H1N1 outbreak showed that most people had fevers for 2-4 days, which would require an isolation period of 3-5 days.

 

• People with more severe illness are likely to have a fever for longer.

• About 90 percent of cases transmitted within a household occurred within 5 days of the first case.

• Those who are sick should stay home during this period, except to seek necessary medical care and should avoid contact with others.

"

 

Hope that helps.

 

This is great advice. Also, from what I've read it's most contagious 24 hours BEFORE symptoms even show up, so by the time you get sick you've likely spread it around anyway. We just stay home whenever we're sick in general, cause really, who wants to be out doing stuff when they feel like crap.

[Surfside Academy]

My quesiton is how do you distinguish swine from the regular flu? The symptoms are basically the same, correct? I understand the protocol and staying at home, etc. but if you suspect the flu, should you immediately go to the doctor to make sure it isn't swine? That would put a tremendous strain on the medical system...

[wulfbourne]

My quesiton is how do you distinguish swine from the regular flu? The symptoms are basically the same, correct? I understand the protocol and staying at home, etc. but if you suspect the flu, should you immediately go to the doctor to make sure it isn't swine? That would put a tremendous strain on the medical system...

 

Treatment is the same for both swine flu and regular flu from my understanding. Rest, fluids, anti-fever medication if you have a fever or are uncomfortable, any other medication to treat symptoms you wish to take. The same guidelines for when to call the doctor would apply as well:

Call your doctor if you have these cold and flu symptoms:

 

In children:

High fever(above 103 degrees), or a fever that lasts for more than 3 days

Symptoms that last for more than 10 days

Trouble breathing, fast breathing or wheezing

Bluish skin color

Earache or drainage from the ear

Changes in mental state (such as not waking up, irritability or seizures)

Flu-like symptoms that improve, but return with a fever and a worse cough

Worsening of a chronic medical condition (such as diabetes or heart disease)

Vomiting or abdominal pain

 

In adults:

A high, prolonged fever (above 102 degrees) with fatigue and achiness

Symptoms that last for more than 10 days or get worse instead of better

Trouble breathing or shortness of breath

Pain or pressure in the chest

Fainting or feeling like you are about to faint

Confusion or disorientation

Severe or persistent vomiting

Severe sinus pain in your face or forehead

Very swollen glands in the neck or jaw

 

 

Basically, treat it like the regular flu. If you would normally call the doctor, call the doctor. If it's manageable at home, treat it at home.

 

ETA: I forgot to say, the differences between swine flu and regular flu are, I believe, that swine flu also causes diarrhea and vomiting in some cases.

[Perry]

This is great advice. Also, from what I've read it's most contagious 24 hours BEFORE symptoms even show up, so by the time you get sick you've likely spread it around anyway. We just stay home whenever we're sick in general, cause really, who wants to be out doing stuff when they feel like crap.

 

Depends on the virus, but for flu and colds, you are most contagious in the first few days after developing symptoms. You might shed some virus for about 24 hours before getting symptoms, but not that much. People probably shed virus for about 5-10 days, children up to 3 weeks.

 

There is evidence that chicken pox is highly contagious before the rash appears.

[Pink Fairy]

Here is the Exclusion period section of the Swine Flu handout my kids' school sent home on the first day:

 

 

"Those with flu-like illness should stay home for 24 hours after they no longer have a fever without the use of fever-reducing medicines and regardless of whether or not they are using antiviral drugs. Data from the spring of 2009 H1N1 outbreak showed that most people had fevers for 2-4 days, which would require an isolation period of 3-5 days.

 

• People with more severe illness are likely to have a fever for longer.

• About 90 percent of cases transmitted within a household occurred within 5 days of the first case.

• Those who are sick should stay home during this period, except to seek necessary medical care and should avoid contact with others.

"

 

Hope that helps.

 

That does help. :001_smile: So if you have a sick family member, and it's fewer than 5 days but you aren't showing symptoms, should you stay home? I know it doesn't say that, but is it implied when they mention the 5 days?

[hornblower]

There is hardly any other influenza virus presenting. There are a few influenza B isolates identified but quite rare. Essentially all true flu now is the novel A/ H1N1.

 

There are other viruses - coronavirus, parainfluenza, adenovirus etc. Public health surveillance monitors all these as well. These results are usually publicly available on state health/medical serveillance websites. Doctors for sure have this info because they need to know what is 'out there' in the community. It's usually updated weekly during peak viral seasons.

 

It does get confusing that people call 'flu' all kinds of other things.....

[wulfbourne]

http://www.cdc.gov/H1N1flu/qa.htm

 

This is the official word from the CDC:

How long can an infected person spread this virus to others?

People infected with seasonal and novel H1N1 flu shed virus and may be able to infect others from 1 day before getting sick to 5 to 7 days after. This can be longer in some people, especially children and people with weakened immune systems and in people infected with the new H1N1 virus.

 

What should I do if I get sick?

If you live in areas where people have been identified with novel H1N1 flu and become ill with influenza-like symptoms, including fever, body aches, runny or stuffy nose, sore throat, nausea, or vomiting or diarrhea, you should stay home and avoid contact with other people. CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.) Stay away from others as much as possible to keep from making others sick.Staying at home means that you should not leave your home except to seek medical care. This means avoiding normal activities, including work, school, travel, shopping, social events, and public gatherings.

 

If you have severe illness or you are at high risk for flu complications, contact your health care provider or seek medical care. Your health care provider will determine whether flu testing or treatment is needed.

 

If you become ill and experience any of the following warning signs, seek emergency medical care.

 

In children, emergency warning signs that need urgent medical attention include:

 

Fast breathing or trouble breathing

Bluish or gray skin color

Not drinking enough fluids

Severe or persistent vomiting

Not waking up or not interacting

Being so irritable that the child does not want to be held

Flu-like symptoms improve but then return with fever and worse cough

In adults, emergency warning signs that need urgent medical attention include:

 

Difficulty breathing or shortness of breath

Pain or pressure in the chest or abdomen

Sudden dizziness

Confusion

Severe or persistent vomiting

Flu-like symptoms improve but then return with fever and worse cough

[wulfbourne]

There is hardly any other influenza virus presenting. There are a few influenza B isolates identified but quite rare. Essentially all true flu now is the novel A/ H1N1.

 

There are other viruses - coronavirus, parainfluenza, adenovirus etc. Public health surveillance monitors all these as well. These results are usually publicly available on state health/medical serveillance websites. Doctors for sure have this info because they need to know what is 'out there' in the community. It's usually updated weekly during peak viral seasons.

 

It does get confusing that people call 'flu' all kinds of other things.....

 

Do you still have any links or references I can read? I hadn't heard this stuff yet, and it sounds interesting.

[Perry]

Do you still have any links or references I can read? I hadn't heard this stuff yet, and it sounds interesting.

 

More hereCDC

 

[hornblower]

Well, I can give you links to the federal Canadian surveillance reports. I know on the flutrackers website I've seen similar reports from the CDC & individual states.

 

Canada respiratory virus detections/isolations - weekly reports archive: http://www.phac-aspc.gc.ca/bid-bmi/dsd-dsm/rvdi-divr/index-eng.php

 

FluWatch is Canada's summary of flu activity:

http://www.phac-aspc.gc.ca/fluwatch/index-eng.php will take you to the page where you can see the current report, which includes a summary of the serological info from the RSV reports in the first link only as they relate to influenza.

 

 

Again, this info is probably publicly available in your state - you just need to know what to look for :-)

[Twinmom]

I just got back from the doctor this morning. Apparently, my daughter, myself and my husband likely have swine flu. DD tested positive for flu...I guess that per the CDC, they aren't testing directly for H1N1 anymore because of the cost (unless you are hospitalized). However, the doctor said based on her symptoms and the time of year, they could be around 95% sure that it was H1N1. My whole house is on Tamiflu and we've been told to stay indoors until everyone has been symptom-free (no cough at all) for at least 48 hours. With six people in the house, I'm guessing we'll be in here a while! :glare: We started with mild cold-like symptoms that progressed to a deep cough that sounds a bit like croup. No high fevers, just low grade. We're still running around and feeling okay, so it's a real surprise for us!

 

Our doc says you have to take Tamiflu within 48 hours for it to be effective, so if you have a question about symptoms, go right in. I seriously thought DD might just have a touch of bronchitis and that I had just a cold!

[wulfbourne]

I just got back from the doctor this morning. Apparently, my daughter, myself and my husband likely have swine flu. DD tested positive for flu...I guess that per the CDC, they aren't testing directly for H1N1 anymore because of the cost (unless you are hospitalized). However, the doctor said based on her symptoms and the time of year, they could be around 95% sure that it was H1N1. My whole house is on Tamiflu and we've been told to stay indoors until everyone has been symptom-free (no cough at all) for at least 48 hours. With six people in the house, I'm guessing we'll be in here a while! :glare: We started with mild cold-like symptoms that progressed to a deep cough that sounds a bit like croup. No high fevers, just low grade. We're still running around and feeling okay, so it's a real surprise for us!

 

Our doc says you have to take Tamiflu within 48 hours for it to be effective, so if you have a question about symptoms, go right in. I seriously thought DD might just have a touch of bronchitis and that I had just a cold!

I don't know. I don't like the idea of everyone running out and getting Tamiflu. If used too much it will lead to more resistant viruses for everyone. It also scares the crap out of me because of it's possible psychiatric side effects.

 

http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2005/11/15/MNG29FO9K71.DTL

 

I'd much rather see people not take it unless they are in a high risk category. Most healthy adults have immune systems that can deal with the flu fine on it's own.

[cillakat]

ACE inhibitors, some antiinflammatories will help dampen down a cytokine storm. So can optimal D levels. Read on.

 

share as needed/interested. All information is mine and from evidence based sources. I didn't have time to cite......so do with it what you will.

 

http://docs.google.com/Doc?docid=0AV...ZGd3a2N3&hl=en

 

Virtually all flulike illnesses currently presenting are H1N1. It's possible that 50% of cases are presenting without a fever and very likely many more. This makes meaningless, the recommendations to "stay home from school or work until fever free for 24 hours" as many with the flu will never have had a fever. Children are unknowingly being sent to school with H1N1; adults with H1N1 will continue to go to work not realizing that they are spreading the flu.

 

Contagion is a factor from 24h prior to onset of symptoms and for 7-10 days after *onset of symptoms*.

 

It's wonderful that most people are reporting being sick for 1.5-2 days. Yay! For those at risk for respiratory complications though (including our pregnant friends and family members) it doesn't matter that 'most' are sick for 1-2 days. For them, this is not a typical flu so please stay home if you have any symptoms. Please keep your child home if they have any symptoms. If one is sick, keep them all home.

 

What can you do to prevent or treat the flu?

 

Consider:

•Anti-Virals if you think you have the flu [CDC recommendation not mine] Keep in mind that there is a 50-90% false negtive rate on the rapid flu tests. Yes, you read that right. Just b/c you have a negative rapid flu test absolutely positively does not mean you are home free.

 

Effective treatment:

 

•Anti-Viral Medication started within 24h (less helpful but still helpful if started later....though drug resistant cases are emerging)

 

•High Dose Vitamin D3 therapy aka Stoss Therapy. (reduces cytokines) Stoss Therapy is 1,000 IU D per one lb body weight per day

FOR THREE DAYS,

then back to normal dosing: 1,000 IU per 25 lbs body weight. Stoss therapy is not appropriate for those with kidney disease. Take sufficient calcium and magnesium while taking vitamin D.

Likely Helpful adjuncts effective treatment - will reduce and/or moderate cytokines or act as ACE inhibitors:

 

•Aspirin,

Adults only;

never children or adolescents

(reduces cytokines).

 

•Green tea (ACE inhibitor, reduces cytokines). Consider drinking

 

daily and/or gargling with it.

 

•High dose vitamin C therapy to bowel tolerance. Use cheap ascorbic acid unless you personally need buffered - avoid time released for this usage.

 

 

Effective Prevention:

 

•Optimal blood levels of D3 (reduces cytokines)

 

 

•50-80 ng/mL is optimal; some say 50-70 ng/mL, some say 55-80 ng/mL - it depends on who's writing and when they wrote it. Anything less than 50 ng/mL=substrate deficiency which is a Very Bad Thing. Our 50-80 ng/mL translates to 150-200 nmoL in any other place in the world

Moderate levels are correlated, by some data, with increased cytokine activity (20-40 ng/mL). We don't want moderate levels or even 'normal' levels. We want optimal levels in the middle of the 'reference range'.

 

 

 

•Remember that because of problems with Quest's test, any D result from them should be divided by 1.3 to get an accurate number.

 

 

 

•Optimal vitamin D levels are your very best defense against influenza, some researchers posit that it may be as or more effective than a vaccine.

 

 

•Green tea (ACE inhibitor, reduces cytokines).

 

Drink it or gargle.

 

•Probiotics. Take daily.

May be helpful adjuncts to effective treatment and/or prevention in addition to above measures:

 

•Black tea (ACE inhibitor, reduces cytokines)

 

•Quercetin (possible ACE inhibitor, reduces cytokines)

 

•Pomegranate (ACE inhibitor)

 

•Proanthocyandin containig foods, supplements (ACE inhibitors): grapeseed extract, pinebark extract (pycnogenol)

 

•Turmeric (reduces cytokines). 1/4 tsp powder can be placed on tongue and swallowed with water

.

 

•Black pepper (reduces cytokines)

 

•Raw crushed garlic (reduces cytokines). For easy dosing, mix with tsp raw honey.

 

•Coconut oil (reduces cytokines)

 

•Echinacea (increases some cytokine activity but overwhelmingly reduces cytokine activity)

Assess carefully:

 

•Elderberry aka Sambucol (known to increase cytokines). I am avoiding.

 

•Astragalus (reduces activity of some cytokines, increases activity of other cytokines). I am avoiding.

 

•Olive oil (may increase cytokines). I will continue to use as needed but will use coconut oil for cooking/baking.

 

•Fish oil (may increase cytokines). I will continue to take significant amounts.

 

•Chocolate (ACE inhibitor but increases cytokines). I will use moderately;p

Cannel on preventing and treating H1N1:

http://www.vitamindcouncil.org/newsl...itamin-d.shtml

 

Randomized, placebo controlled trial shows D3 prevents and treats colds and flu:

http://www.ncbi.nlm.nih.gov/pubmed/17352842

[cillakat]

"Those with flu-like illness should stay home for 24 hours after they no longer have a fever without the use of fever-reducing medicines and regardless of whether or not they are using antiviral drugs. Data from the spring of 2009 H1N1 outbreak showed that most people had fevers for 2-4 days, which would require an isolation period of 3-5 days.

 

 

The tricky thing is that 50% of ppl with H1N1 are presenting fever free.....throws off allllll sorts of things. 3-5 days is such an oddly short period of isolation considering that one infected with H1N1 is contagious for 24h prior to onset of symptoms until 7 days post onset - at least....up to 10-14 days in people with weaker immune systems or in younger kids.

 

But I stayed in for 3 days.....I was on Tamiflu for three and felt totally fine....uber minor symptoms for three days. No symptoms after that.

 

K