The flu season is here and if it isn’t bad enough dealing with the threat of the seasonal flu, the H1N1 flu (aka swine flu) is also ready to add its virulence to autumn-winter sniffles. Mexico is already possibly seeing the second wave of H1N1 flu and it is only a matter of time till the bug again crosses the border to the rest of the Americas and the world.

Many parents with little children (including me) are on the verge of panic and are scrambling to find out how to best protect their families from the pandemic that’s almost here. Other than the options of moving to South Pole, to a remote tropical island or isolated cave, we can’t avoid being exposed to the flu. My physician told me she believes everybody will get it sooner or later and I tend to agree with her. So how do we live with the epidemic that’s hanging over our heads? Here are some tips aside from the usual wash-your-hands-and-cover-your-nose advice.

Be Informed About the Flu.

This may be an overused cliché but the “knowledge is power” adage still holds true. Inform yourself about the disease, the symptoms, and the treatment. There questions about the flu that can only be answered by gathering as much information as we can. Only then can we make “informed” choices.

Flu Prevention.

I will use another overused adage here. “An ounce of prevention is worth a pound of cure.” And prevention is not just about washing hands. It’s about a whole lifestyle of healthy nutrition, physical fitness, and thinking positively.

Here is a list of resources on prevention which I found useful and therefore would like to share:

• 100 Healthy Hacks to Help You Through Cold & Flu Season at Online Nursing Programs

• What You Can Do to Stay Healthy at the Center for Disease Control and Prevention (CDC)

• For those with kids in college: CDC Guidance for Responses to Influenza for Institutions of Higher Education during the 2009-2010 Academic Year

• American Academy of Pediatrics (AAP) H1N1 Flu Information.

To Vaccinate or Not to Vaccinate.

I am an advocate of immunization but I always drew the line when it came to the seasonal flu vaccine. I thought I and my family never had a need for it. But with the added threat of H1N1 flu, I have to rethink my options. To vaccinate or not to vaccinate, that’s a big question. So what do we know about the flu vaccines?

Flu Vaccination Updates:

• The US FDA approved the new batch of seasonal flu vaccines last month. It was developed from the most common strains of the previous season as well as strains isolated during the winter flu season in the southern hemisphere. It is indicated for adults and children.

• The US FDA has also approved the H1N1 flu vaccine but it is currently available for adults only. The vaccine is still being tested in children and, according to the Institute of Allergy and Infectious Diseases, is showing promise (CNN reports). If approved for pediatric use, children ages 6 months to 9 years may need 2 doses versus the single dose mean for adults and children older than 9. For those who would like to know about thimerosal, some formulations of the vaccine have it, and some not. Thimerosal is normally not present in children’s vaccines in the US.

• The AAP has recently updated it guidelines for flu vaccines. It highly recommends that children ages 6 months to 18 years old should receive the current season flu vaccine.

Know Your Family’s Susceptibility.

Children are especially susceptible because they had limited exposure to the seasonal flu. In the UK, the cases of H1N1 among children have doubled since school started a few weeks ago.

Thousands have caught the swine flu but fortunately, it is not as deadly as previously thought. There are certain sectors of the population which are more likely to develop serious symptoms and complications that can result in death.

Here are some of the latest statistics on fatal swine flu cases in children:

• As of end of August, 36 children (under 18) have died of the H1N1 flu in the US (Source: MedicalNews Today).

• The youngest victim was aged 2 months, and the oldest was 17 years.

• Five fatalities were under 2 years old and 7 were under 5 years old.

• The majority of children who died (24 out of 36) have at least one other medical condition that made them highly susceptible. These conditions include developmental delay such as cerebral palsy and chronic pulmonary problems such as asthma.

Thus, considering that there probably won’t be enough vaccines to go around, the AAP suggests that the following high-risk groups should receive the vaccine first:

• Children ages 6 months through 24 years

• Parents and caretakers of infants younger than 6 months

• Pregnant women

• Health care workers and emergency services personnel

• Adults ages 25 to 64 with chronic health conditions

Think about your family’s susceptibility. Does anybody have a serious condition that makes vaccination worth considering? Does anybody have a higher likelihood of more exposure than usual (e.g. healthcare professionals, school teachers, etc.)?

Take care of yourself.

Finally, moms, do not forget to take care of yourself. It is our jobs to look out for our families in good times and bad times and it seems that bad times may be coming. All the more reason that we should stay healthy.

The Advisory Committee on Immunization Practices met in Atlanta on Wednesday, Feb 25. The committee makes recommendations to the Centers for Disease Control and Prevention. Among the latest recommendations: the Hepatitis-A vaccine for people who come in contact with international adoptees.

Dr. Cindy Weinbaum, a medical epidemiologist with the CDC, said the recommendations cover adoptions from countries with a high or intermediate infection risk. “That includes most of the world. All that (it) excludes is North America, Western Europe, Australia, New Zealand and Japan,” she said. The disease is unfortunately common among children coming from the four top countries of origin for children being adopted by US families. Those are China, Russia, Guatemala and Ethiopia.

Formerly, only parents who were traveling to such countries were recommended for the vaccine. Now, the suggestion includes people such as grandparents and babysitters–anyone who will have close contact with an international adoptee withing 60 days of his or her arrival in the U.S. The average incubation for the disease is 28 days, but it can be longer, and young children often show only very mild symptoms, thereby increasing the risk to unsuspecting adults. And children adopted from other countries usually have not had a vaccination.

Even though these children only cause 3% (at the highest estimate) of Hep-A infections every year, federal officials state that the results can be tragic–especially since they are both foreseeable and preventable. The latest of these cases involved a 51-year old woman who became critically ill after exposure to her internationally adopted grandchildren. Weinbaum cited there were about 20 recent cases.

Hepatitis A is a highly contagious liver infection caused by a virus. It is typically spread through feces (in other words, be careful with the diapers!). Symptoms can include fever, jaundice, nausea and vomiting. It is usually more severe in adults, and can be fatal.

The vaccine is given in two doses. The first one should be administered as soon as an adoption is planned. The second would ideally be given two weeks before the child’s arrival. It is an expensive vaccine, by some standards ($140). But considering that international adoptions often cost between $20,000 and $40,000 (according to Dr. Weinbaum), it’s not a lot of money in the big scheme of things.

This recommendation follows the news last summer of many false-negative tuberculosis tests in international adoptees. For some reason, the children did not show positive results for three months. Similarly, young children with hepatitis-A don’t often show signs of jaundice, an indicator for the infection.