Tips on how to stay healthy during the flu season.
By Peter S. Waldstein, M.D.,F.A.A.P and Julia A. White, M.D.,F.A.A.P

doct1It has been an interesting year for influenza. Not only are there more types to worry about, but also more vaccines for the flu than ever before. The novel H1N1 influenza virus (also known as “swine flu”) has hit the community hard, and particularly early in the year. This article will focus on prevention of the flu.

Prevention of Influenza

Knowing how to protect yourself from illness this winter will be the most important way to keep your family healthy. People who have influenza are thought to be shedding the virus from around 1-2 days before symptoms appear to about 5-7 days after symptoms start. This can vary, however, especially in children. The H1N1 and seasonal influenza viruses spread through respiratory droplets from coughing and sneezing. Someone then comes into contact with these and touches his/her mouth, eyes, or nose before washing the hands and becomes infected. The influenza viruses are thought to be able to live on environmental objects for several hours after being deposited.


Given all of this information, washing your hands is one of the most important steps in influenza prevention. Wash them or use an alcohol-based gel every time you touch any objects before touching your eyes, mouth, or nose. Wash them every time you cough or sneeze. Teach this to your child as much as possible. You should wash for 20 seconds, about the time it takes to sing the Happy Birthday song twice. If someone is sick in your home, wash linens and utensils before they are shared, and do not share food. Also, clean counter tops, bed side tables, and other objects by wiping them down with a disinfectant.

Stay away from those who are sick. If you are around them, stay at least 6 feet away to not come into contact with respiratory droplets should they cough or sneeze. If your child is exposed to someone with the flu or H1N1 at school, there is no need for intervention. Simply monitor for symptoms such as fever, sore throat, cough, runny nose, congestion and headache, and if they develop then see your pediatrician.

If your child is sick, he or she should stay home from school and other activities to prevent other children from becoming ill. If your child is old enough, teach them to cover their mouths with a tissue every time they cough or sneeze, and throw it away in the trash. Alternatively, they should cough or sneeze into the elbow instead of hands if a tissue is not available.

Finally, vaccination is the other primary means of prevention for your child. This season, there are two types of influenza vaccines – one for the seasonal influenza, and the other for H1N1. The seasonal influenza vaccine has been around for many years and has been proven to be safe and effective over the years. Three strains of seasonal influenza are selected each year to become the influenza vaccine. It is recommended by the CDC for all children between the ages of 6 months and 18 years be vaccinated. If your child is under the age of 9 and will be having the influenza vaccine for the first time, he or she would receive 2 injections separated by 1 month. The vaccine is available in the regular injection which is an inactivated vaccine. It is also available as a nasal spray, which is a live attenuated vaccine. The live nasal vaccine is available for children ages 2 and older.

In response to the H1N1 outbreak this year, production of a vaccine for the H1N1 virus was also done. The vaccine was manufactured in the same way as the seasonal flu vaccine by the same manufacturers. The difference, however, is that the H1N1 strain was added instead of the various seasonal flu strains which are added and change from year to year. Given the problems with the swine flu vaccine in the 1970s, there has been concern regarding the new vaccine, in addition to concern over the quick production and limited testing that was done. The testing that was done shows a similar side effect profile to the seasonal influenza vaccine, however, the most common being some local tenderness, redness, or swelling. Thus far, we have not experienced any major side effects in our patients who have received the vaccine. The H1N1 vaccine is available in the inactivated injection and live nasal spray just like the seasonal flu vaccine. It is suggested that your child receive 2 vaccines separated by 1 month if under the age of 10.

Flu vaccines are not mandatory, and are a decision that many parents struggle with. You should discuss vaccination options with your pediatrician. Ask questions, and together you can determine the best decision for your child that you are both comfortable with.

We hope that this brief overview will be helpful regarding influenza. Of course, the situation with influenza is always changing. The best source of information is always your pediatrician. There are also some trusted websites such as the CDC ( and the American Academy of Pediatrics ( and By being up to date with the most trusted information, you will be prepared should your little one come down with an illness this winter.