H1N1 and your child

Since H1N1 is a relatively new virus, the extent to which it will spread and infect during the back-to-school season remains unknown. Like the seasonal flu we know and dread, H1N1 spreads via coughs, sneezes, and touching the nose or mouth after touching objects that have been touched by others with the virus.

And like the seasonal flu, the H1N1 virus can cause fever, cough, sore throat, muscle aches, and weakness. In some cases, it may trigger gastrointestinal symptoms such as diarrhea and vomiting. Once infected, a person can be contagious from 1 day before symptoms appear to about 7 days after. Most schools allow children to return to class once fevers have been gone for 24 hours.

Schools (and universities) will have plans in place for handling H1N1, but the best way to protect your children from illness is to teach them the importance of prevention.

Tell your child to do the following:

Sneeze smart and cough cautiously. When you sense a sneeze or cough coming, you need to protect other people from your germs. Always sneeze and cough into your elbow, your sleeve, or a tissue. Don't use your hands, though, because the germs will then be all over your fingers and you might spread them to the things you touch – like your classroom doorknob or the crayons and pencils you share with classmates. If you accidentally cough or sneeze into your hands, be sure to wash your hands right away! If you can't make it to a sink with soap and water, you can squeeze a couple of drops of hand sanitizer into your hands.

Keep your hands to yourself – and off yourself. Kids touch lots of things all day – like doors, school desks, pencils, crayons – and each other! And when you touch things, you get germs all over your fingers. Then when you touch your fingers or hands to your face, you put the germs on your own skin. Those germs can make you sick. That's why it is so important to wash your hands well. Oh, and did you notice that kids touch their faces more often than adults do? Not to mention the nose-picking, eye-rubbing, and finger-chewing that goes on! Eww! So try your best to not touch your face – especially your nose, eyes, and mouth. Also, don't share foods, drinks, or straws with friends, because that's another way that germs can spread.

Tell someone if you're not feeling well. You may want to be tough and not miss out on any school. But if you're feeling sick, you might get other people sick, including your friends, your teacher, and your family. So, if you notice that your throat hurts, if you're coughing a lot, or if you feel hot or achy, tell your teacher or your family as soon as you can. You may have to miss some school, but you will get better faster at home, and you won't spread your germs to others.

If your child does come down with the H1N1 flu, don't panic. Most illness from H1N1 has been mild and children have recovered quickly. Those children with underlying medical conditions may be at higher risk for complications or more severe symptoms. Keep children home from school and have these home care tips in mind.


  • Teach your children the steps to a thorough hand-washing.
  • Show your children how to properly and safely use hand sanitizer.
  • Consider having your child immunized against the different flu viruses.

A guide to good hand-washing hygiene

The act of washing your hands seems so simple. In fact, many take it for granted until cold and flu season strikes or a new infectious threat emerges. But this simple act has proven to be a valuable weapon against the spread of germs and infectious diseases.

Our hands may look clean, but they pick up germs all over the place. During cold and flu season, or during infectious outbreaks, we may come into contact with the tiny, germ-filled droplets from other people's coughs and sneezes. Handling food exposes us to microbes, and we touch so many shared objects throughout the day – elevator buttons, stair rails, doorknobs, subway poles, grocery carts, telephones, keyboards. And it's not for nothing that we're taught to wash our hands well after using the restroom.

Combine our germ exposure with our human tendency to touch our face, shake hands, give hugs, and otherwise be social, and we end up spreading and sharing our germs.

Effective hand-washing or use of an alcohol-based hand sanitizer will rid our hands of most germs and reduce our risk to ourselves and others. What does a proper hand-washing look like?

  • First remove any rings or jewellery, since they can trap or hide germs.
  • Wet your hands and wrists with warm water.
  • Rub regular soap into your hands. Intertwine your fingers and rub in between them. Rub the back of each hand with the opposite palm, paying attention to the knuckles and nails. Rub each thumb by gripping it with the opposite hand. Do the same with your wrists. Lather all surfaces of your hands for 15 seconds – or long enough to sing through the song "Happy Birthday."
  • Rinse your hands and wrists thoroughly, rubbing them under warm running water.
  • Gently wipe and dry your hands with a clean towel, paper towel, or air drier.
  • Use a paper towel to turn off the tap. The same towel can be reused to open the door so you don't pick up any bacteria or viruses from the door handle.

Hand sanitizer tips

Look around and you're bound to see an alcohol-based hand sanitizer somewhere nearby. They're everywhere these days – in washrooms, in kitchens, dangling from cords attached to kids' backpacks and emerging from women's purses, perched on the walls of school cafeterias and along the halls of hospitals and nursing homes.

There are lots of good, scientifically-proven reasons why alcohol-based hand sanitizers are everywhere:

  • When you're not able to wash your hands, hand sanitizers offer a safe and effective substitute for a soap-and-water scrub.
  • Gels containing at least 60% germ-killing alcohol can protect you and your family from the bugs that cause colds and gastrointestinal infections.
  • Health care workers in hospitals and other health care settings use the alcohol-based hand gels. When their hands are not visibly soiled, the alcohol-based sanitizers are more effective than normal hand-washing or cleansing with antibacterial soap.

But before you go toss out all the bars of soap in the house, consider these hand sanitizer truths:

  • Hand sanitizers do not clean off visible dirt. They're meant to kill germs, but if you can see dirt, grime, blood, or anything else, you need to wash with soap and water.
  • Not all sanitizers effectively kill germs. Inspect the label carefully. Make certain that the sanitizer contains a concentration of 60% to 95% ethanol (ethyl alcohol) or isopropanol (isopropyl alcohol). Anything less than 60% will not effectively kill germs. Watch for these sub-par formulations in the bargain bin or at dollar stores.
  • Sanitizers can be poisonous. These products contain high levels of alcohol, and some come in tantalizingly scented varieties. Children can be tempted to taste the gel. A tiny lick at their sanitized skin shouldn't hurt, but ingesting too much can cause alcohol poisoning. For the sake of cleanliness and convenience, many parents are sending mini-bottles of sanitizer to school with their young children. Some newer backpack models even come with an attachment for them! Kids may consider it a toy – or a treat – and share it with friends. Teach your children sanitizer safety and encourage them to use the product properly and only when absolutely necessary.
  • The ingredients can irritate. Alcohol is drying to the skin, and added fragrances may trigger allergic reactions and irritations. Many hand sanitizers contain moisturizers to counterbalance the drying effect.
  • Sanitizers must be used properly to work effectively. To properly apply hand sanitizers, you need to first remove any rings. Use a dime-sized drop of the gel and rub your hands together, palm to palm. Then, use the palm of one hand to rub gel into the back of the other hand and between fingers, and vice versa. Don't forget to rub around the thumbs, as well. Continue to rub the gel into your hands until they feel dry, usually for at least 15 to 30 seconds. You shouldn't need a towel to dry off.

Should my child get a flu shot?

You may be thinking about getting vaccinated against the flu this year. Considering that 10% to 20% of Canadians will be affected by the influenza virus each year, that's not a bad idea.

Canada's National Advisory Committee on Immunization advises all Canadians over age 6 months to get a flu shot. That's because vaccination is one of the most effective preventive measures you could take. And with the "shot in the arm" that a vaccine can give, you're less likely to be one of the 20,000 hospitalizations or 4,000 deaths blamed on the flu each year.

Still, you may be unsure. Perhaps answers to a few questions might make your decision easier:

Should I be vaccinated against the flu this year? Probably yes – unless you happen to be 6 months of age or younger, are severely allergic to chicken eggs (the vaccine is grown in eggs), or have had severe reactions to the vaccination in the past. If none of those apply to you, you should definitely be vaccinated if you fall into particular risk categories:

  • young children between 6 and 59 months of age
  • people who are 65 or older
  • pregnant women
  • people with chronic diseases such as heart or lung disease, kidney disease, diabetes, anemia, cancer, or HIV or other immune-suppression diseases
  • people who are morbidly obese (BMI greater than 40)
  • those who live in a nursing home or care facility
  • caregivers and health care workers
  • those at high risk of complications who travel to areas where flu virus is circulating
  • People of First Nations descent

Does the flu vaccine really work? About 60 to 80% of healthy people who get a flu shot will be protected from the virus. How well the vaccine protects you depends on whether the viruses covered by the vaccine, which is predicted by researchers ahead of time, matches the viruses causing the flu that season. The effectiveness of the vaccine also depends on individual factors such as age. Those who still get the flu usually get milder symptoms. After being injected with the vaccine, it can take a couple of weeks to take effect. If you catch a flu virus during that wait period you won't be protected.

When should I get vaccinated? You could get a flu shot at any time during flu season between November and April. But because of the time needed for the vaccine to take effect, you should get the vaccination early before the peak infection time.

How much will I have to pay for a flu shot? Most Canadian provinces and territories offer all their residents aged 6 months or older free vaccines. Check with your doctor to determine whether you are eligible for a free flu shot. In most doctors' offices and clinics, flu shots will cost about $10 to $15. Currently, influenza vaccinations eligible under provincial health benefits may also be administered by trained pharmacists in certain provinces.

Is there any risk involved in getting a flu shot? The benefits of prevention outweigh the risks with a flu shot. Rarely, people will experience allergic reaction. More often, they will experience no side effects or perhaps some soreness, redness, or swelling at the spot where the shot was given. Contrary to myth, a flu shot cannot cause the flu, since most of them do not contain any live virus. Those that do contain a small amount of weakened virus to stimulate your immune system for protection against the virus, but cannot cause the flu itself.

Will I need to be vaccinated against new strains of flu, like the H1N1 virus? Flu shot requirements change every year. To help protect yourself against new flu strains, it is important to get re-vaccinated every year. For example, during the flu season of 2009, Canadians faced a double or even triple shot of protection (one or two shots to combat the new H1N1 flu virus and one to address the usual strains of seasonal flu).

How to care for someone with H1N1

During an infectious disease outbreak or pandemic, hospitals can quickly become overwhelmed with patients, many of whom could probably be cared for in their home. It is possible that you may be called upon to take care of a member of your family who becomes ill.

Like other types of flu, swine influenza (or influenza A (H1N1)) spreads from person to person via droplets of fluid that become airborne when a person coughs or sneezes. The virus may also fall on surfaces – doorknobs, cupboard handles, keyboards – and live for a period of time (some viruses and bacteria can live more than 2 hours), possibly infecting others who touch them and then touch their own nose, mouth, or eyes. That is why it is vital that home caregivers understand and follow hygiene and safety guidelines.

If someone in your home becomes ill, they will need to stay home for at least 7 days after onset of illness and after fever has gone down. Choose one person to be the primary caregiver to minimize the risk of spreading the virus to others.

As a caregiver, you will need to consider these home-care basics:

  • Get a doctor's advice. If someone shows flu symptoms, it's important for them to stay at home. But you will also need to ask a doctor a few home-care questions: Will this person need an antiviral medication? Will I and my other family members need to take any medication? Are there any special considerations for the sick person's pre-existing condition? Are there medications that children can or cannot take?
  • Become a hygiene expert. The simple act of hand-washing significantly cuts the risk of viral transmission. All members of the household should wash their hands often using soap and water for at least 15 seconds. If soap and water are not available, an alcohol-based hand sanitizer can be used. Use paper towels to dry hands, or else assign everyone their own towel. Within the home, too, you will need to be diligent about cleaning and disinfecting areas in which the sick person stays. Take caution when handling laundry, and tumble-dry clothing and linens in a hot dryer. Wash your hands immediately after.
  • Give a sick person their space. Keep the sick person in a room of their own. Choose a room that is as far from common areas as possible, and keep the door closed. A separate bathroom would be best, too. No visitors allowed, either, though providing the sick person with a phone or computer could help ease feelings of isolation and loneliness. Should the sick person need to be in common areas or travel outside of the home for medical care, they should wear a properly-fitted, government-approved mask or respirator or cover their mouth when coughing or sneezing.
  • Be medication smart. Follow any instructions from your doctor or pharmacist. Read medication labels carefully. Don't give children or teenagers acetylsalicylic acid (also called ASA or Aspirin®) for pain. Opt instead for medications like acetaminophen and ibuprofen. Fever and pain may respond to either type of medication. Speak to your health care provider before giving over-the-counter cough and cold medications to any child under the age of 6, and always follow the directions of how to give the medication as stated by your health care provider or as written on the medication box.
  • Take care of yourself. When caring for a sick person, wear a properly-fitted, government-approved face mask or respirator. Avoid face-to-face contact with the person as much as possible. If caring for a small child, hold them as little as possible. To hold them safely, place their chin on your shoulder so any coughs or sneezes will move away from you. And, naturally, strictly follow the described hygiene guidelines.
  • Use masks safely. For facemasks and respirators to be effective, they must be used properly. Masks should be fitted to the nose and mouth without gapping. Do not reuse disposable facemasks. Launder and tumble-dry reusable masks. Whenever you remove a facemask or respirator, wash your hands with soap and water, or use an alcohol-based hand sanitizer if soap and water are not available.
  • Remind the sick person of hygienic habits. A sick person may have a hard time staying on top of hygiene. As a care-giver you can give gentle reminders:
    • Cover coughs and sneezes.
    • Wash hands thoroughly in soap and water, especially after coughing or sneezing, or use an alcohol-based hand sanitizer.
    • Throw used tissues away into a trash can lined with a disposable plastic bag.
    • Get plenty of rest and drink lots of clear fluids to prevent dehydration.
  • Know the signs of emergency. Understand the red-flag warnings that illness has become serious enough to need emergency medical care. In swine flu, watch out for breathing difficulty, chest pain, vomiting, dehydration, seizures, confusion or unresponsiveness, or a discolouration of the lips.