Action Steps for Parents of Children at Higher Risk for Flu Complications

Children with chronic health problems such as asthma, diabetes, heart disease, metabolic conditions, neurologic and neuromuscular disorders, and pregnant women are at higher risk of having complications from flu. In addition, all children younger than 5 years old are at higher risk of flu complications compared to older children. If you are not sure if any of your children are at higher risk for flu complications, please check with a doctor.

Keep children at higher risk for flu complications from getting sick with the flu

• Make sure your child’s hands are washed often – or help your younger child wash them – for 20 seconds with soap and water. If soap and water are not available, use an alcohol based hand cleaner. Alcohol-based hand cleaners can be toxic if swallowed, so keep them in a place that only you can access when you need to use it.
• Have your child cough and sneeze into a tissue or into his or her elbow or shoulder if a tissue is not available. Make sure your child throws tissues away right after use and washes his or her hands.
• Keep your child away from people who are sick.
• Clean surfaces and objects that your child frequently touches. Wipe these surfaces with a household disinfectant that is usually used, following the directions on the product label. Additional disinfection of these surfaces beyond routine cleaning is not recommended.
• When there is flu in your community, consider your child’s risk of exposure if they attend public gatherings. In communities with a lot of flu, people who are at risk of complications from flu should consider staying away from public gatherings such as sporting events and concerts.
• If flu is severe in your community, talk to your doctor and child’s school or early childhood program to develop a plan on how to handle your child’s special needs.
• Get your children over the age of 6 months vaccinated for seasonal flu and 2009 H1N1 flu when vaccines are available.

Recognize if your children are sick

Some children may not be able to tell you about their symptoms, which can result in a delay in responding to their illness. It is important to watch carefully for the signs and symptoms of flu or unusual behavior that may be a sign your child is sick. Symptoms of flu include fever or chills and cough or sore throat. In addition, symptoms of flu can include runny nose, body aches, headache, tiredness, diarrhea, and vomiting. A fever is a temperature measured by mouth with a thermometer that is equal to or greater than 100 degrees Fahrenheit (37.8 degrees Celsius). If you are not able to measure a temperature, signs and symptoms that may indicate your child has a fever include chills, feeling very warm to the touch, having a flushed appearance, or sweating.

Watch for emergency warning signs that need urgent medical attention. These warning signs include one or more of the following:

• fast breathing, trouble breathing, shortness of breath, or stopping breathing;
• bluish, purplish, or gray skin color especially around the lips and the inside the mouth, or around the nails;
• not drinking enough fluids, refusing to drink;
• not urinating, decreased number of wet diapers, or no tears when crying;
• severe or persistent vomiting;
• not waking up or not interacting (i.e. unusually quiet and inactive, no interest in playing, no interest in favorite toy);
• being so irritable that the child does not want to be held, or cannot be consoled;
• pain or pressure in the chest or stomach;
• sudden dizziness;
• confusion; and
• flu-like symptoms improve but then return with fever and worse cough.

Please share this information with your child’s teacher or other caregivers, so they can tell you if they notice your child is not feeling well.

Tips for taking care of high risk children with the flu

• Contact your doctor immediately if your child is sick. This is important because the antiviral medicines used to treat flu work best when started within the first 2 days of getting sick. Your doctor will tell you what special care is needed for your child. 
• Keep your sick child at home until at least 24 hours after your child no longer has a fever or signs of a fever (without the use of a fever-reducing medicine). Keep your child home unless they need to go to the doctor. Make sure your child gets plenty of rest and drinks clear fluids (such as water, broth, sports drinks) to prevent dehydration. For infants, use electrolyte drinks such as Pedialyte^®.
• If your child has a fever, use fever-reducing medicines that your doctor recommends based on your child’s age. Aspirin (acetylsalicylic acid) should not be given to children or teenagers; this can cause a rare but serious illness called Reye’s syndrome.
• Keep your sick child in a separate room (a sick room) in the house as much as possible to limit contact with household members who are not sick. Consider designating a single person as the main caregiver for the sick child.

Additional information about caring for sick household members can be found at www.cdc.gov/h1n1flu/guidance_homecare.htm.