In late April 2009, the World Health Organisation (WHO) announced the emergence of a novel influenza A virus. This particular H1N1 strain of swine origin had not circulated previously in human to human transmission. It is also not related to previous or current human seasonal influenza viruses, and hence, the virus is entirely new. However, it has shown influenza-like symptoms (such as sore throat, cough, runny nose, fever, headache, joint/muscle pain) and has set the world in the direction of a pandemic (worldwide epidemic affecting many countries). In the history of influenza pandemics and epidemics, there had been the “Spanish flu” (H1N1) pandemic in 1918 that killed more than 20 million worldwide, “Asian flu” (H2N2) in 1957 with 2 million deaths, “Hongkong flu” (H3N2) in 1968 and “Russian flu” in 1977.
As of August 6, 2009, the cumulative total of confirmed cases worldwide is 177,457, with a death toll of 1,462. Closer to home, several schools in East and West Malaysia have already experienced temporary closures as the virus continues to spread rapidly. A total of 64 deaths were reported in the country as of Augut 17, 2009, together with 4,225 reported cases. More are expected in those with certain illnesses or obesity (co-morbidilities).
Why should we be worried?
Although WHO has considered the overall severity to be moderate, with the majority of people who contract the new virus experiencing milder illness, it does not mean that you should feel less concerned about it. Unlike the seasonal flu, influenza A(H1N1) is a new virus and one to which most have no or little immunity, while not forgetting its rapid spread within the community. You should be more concerned if your child is still very young, as their immune systems are less mature, or if they have underlying respiratory illnesses like asthma. Thus, it is important that you practise preventive measures at all times.
Can I vaccinate myself and my child against influenza A(H1N1)?
The vaccine against influenza A(H1N1) is still not available, but work is already under way to develop such a vaccine. You may not be able to protect yourself and your child with the available seasonal flu vaccine as evidence from studies suggests it will offer little or no protection against the A(H1N1) virus. Nonetheless, seasonal influenza vaccine is recommended just as pneumococcal vaccine to prevent secondary infection in the midst of a fullblown pandemic. If you or your family members have been tested positive, new antiviral agents can be given early to prevent worsening of symptoms.
Influenza A(H1N1) and Children
How do I know if my child has influenza A(H1N1)?
Without medical help, you will not be able to tell influenza A(H1N1) from the seasonal flu or even acute tonsillitis. Only medical practitioners and designated public hospitals can confirm a case of influenza A(H1N1) from throat or nasal swabs. The risk and suspicion is higher if there is a history of travel or contact with a recent traveler.
What are the emergency warning signs that I should be aware of?
- Your child has severe trouble with breathing
- Has bluish skin colour/lips
- Has fits/seizures
- Unresponsive or hard to wake up, unable to move
- Is dehydrated (in infants, no wet diaper for 12 hours)
What can I do to protect my child from influenza A(H1N1)?
- Watch out for influenza-like symptoms in your child.
- Keep your child at home for observation if he or she shows influenza-like symptoms.
- Encourage your child to practise good personal hygiene (like frequent hand washing, not mouthing common toys shared with other children, proper disposal of tissues after sneezing) and lead by example!
- Ensure a healthy and balanced diet at home and at school.
- Maintain good indoor ventilation. Always open windows and turn fans on as circulating air can dilute the concentration of airborne infectious particles.
- Wear a mask when in really crowded areas.
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