• Fever of 100.4 degrees or more in a child less than 3 months old
• Fever for 3 or more days, or a return of a fever later in an illness
• Rapidly worsening illness
• Bad sore throat or severe cough
• Chest pain
• Lethargy or unable to get out of bed
• Unable to take fluids (offer small sips frequently via cup, spoon, dropper)

If you have severe symptoms or are at high risk for flu complications, seek medical care and your doctor will determine if testing or treatment is needed.  Because we have many infants and pregnant women who visit our clinic, we will be scheduling influenza illness visits towards the end of the day, to prevent exposure to healthy patients and to minimize the spread of this contagious virus.

Treatment
Most people who have been sick with this virus in the U.S. have recovered at home without medical treatment.  To prevent the spread to other people, please keep your child home for 7 days, or 24 hours after symptoms resolve, unless given instructions by your doctor or their staff.  It is important that your child not be exposed to other children who are sick, and that if your child has a flu-like illness, that he or she does not expose other people in order to keep from spreading illness.

Supportive care at home

• Oscillococcinum homeopathic: 3-5 pellets in mouth three times per day
• Elderberry Syrup has been shown to have potent antiviral activity. 
• Probiotics (acidophilus): 8-10 billion organisms per day for children; 10-20 billion organisms per day for adults.  A recent study showed dramatic decreases in incidences of fever, runny nose and other flu-like symptoms in children supplemented with probiotics.
• For coughs or sore throats:
  • Steam showers, cool mist humidifier
  • Cough drops such as Ricola or Cold-Eeze
  • Frequent sips of warm fluids
  • Salt water gargles (~1/8-1/4 tsp salt per cup of warm water; gargle three times in a row, 3-4 times per day)
  • Throat Coat tea by Traditional Medicinals: 3-4 cups per day; sweeten with plenty of honey for everybody over the age of 1.  In a recently published study, honey was shown to be more effective than over-the-counter cough medicines.  Honey is soothing and has antiviral and antimicrobial properties. 
• For nasal congestion: Neti pot rinses 2-3 times per day.  For instructions on how to use a neti pot, visit: http://www.nasopure.com/t-Videos.aspx 
• For body aches: Epsom salt baths: use 1-2 cups of Epsom salt and add to warm bath
• For fever: In our patient population, Tylenol appears to be more effective in managing the fever from H1N1.

   

  For more information:
  
  King County's H1N1 page
  CDC's H1N1 resource page for parents