As H1N1 spreads, focus on children

Matt and Amanda Blue knew something was wrong with their 6-year-old son, Zachary, on the night of Oct. 21.

'Instantly, he went from happy-go-lucky to ugh,' Matt Blue said.

As a physician at Nason Medical Center, Blue has seen about 400 people with symptoms of flu since August, so when their son started having chills, then fever and fatigue, he acted quickly. For the first time in his career, he called in a prescription for his own family, ordering enough Tamiflu for everybody, including 3-year-old son, Graham.

While Zachary was not tested for H1N1, also known as swine flu, Matt Blue said he had it.

The Blues are urging parents — many of them, they know first-hand, are skeptical, suspicious and even scared — to have their children vaccinated for H1N1 as soon as the vaccine is available.

H1N1 vaccines are expected to arrive at the first schools in Berkeley, Charleston and Dorchester counties at the end of next week, but parents can expect to see consent forms

at the end of this week.

Despite getting his first dose of Tamiflu within four hours of symptoms, Zachary was hit hard. The family braced for the storm, quarantining themselves and separating the boys.

'The hardest thing was the muscle aches,' said Amanda, who works at MUSC's pediatric endocrinology department. 'Zachary hurt down to his toes. He would say his legs don't work because they hurt so much. He'd wake up from his nap and he was shouting, ‘Mommy my legs don't work.' '

For five full days, he weathered the flu. On days six and seven, his fever broke, but he still had a cough, his legs still hurt and he was still taking a nap in the middle of the day. A week after the onset of symptoms, Zachary's heart rate was at 130 beats per minute. The Blues feared that the flu had progressed to pneumonia, as it typically does if it lasts more than a few days. An X-ray confirmed viral pneumonia and they put him on antibiotics.

Finally, last Friday, the day before Halloween, Zachary went back to kindergarten at Buist Academy and, on Halloween night, he seemed like a typical energetic, excited kid, dressing up as Darth Vader and trick-or-treating with

other kids.

'Parents are going to vaccinate if they want to,' Amanda Blue said. 'If they could be a fly on the wall and see what we've been through, they will (vaccinate their children) ... It's as safe as safe can be.'

Linda Pranger, spokeswoman for the local office of the S.C. Department of Health and Environmental Control, said tentative plans call for the first school to be in Dorchester County District 4 on Nov. 12 and the second in Charleston County on Nov. 13. The schools that will get the vaccines have yet to be determined.

'We're going to concentrate on the elementary schools first,' said Pranger, who is expecting 10,000 doses of H1N1 vaccine this week to cover injections at schools and the first two clinics this month. 'We expect to do one school per county per day and then will proceed to middle schools.'

As H1N1 is playing out this fall, it continues to generate concern among parents because it is taking a greater toll on children, rather than the elderly.

'People are nervous,' said Pranger, 'because before now, they had to worry about their parents. Now they have to worry about their children.'

Because H1N1 tends to hit children harder and because children can harbor the virus symptom-free longer than adults, some hospitals across the nation are starting to prohibit children who are not undergoing treatment from visiting. About two weeks ago, representatives from all six Charleston-area hospitals met to talk about implementing that policy uniformly if the flu situation worsens.

'Everyone agreed that we won't apply the policy community-wide right now,' said Dr. Patrick Cawley, medical director at the Medical University of South Carolina. 'We're clearly going to get more flu. Here (in South Carolina), it peaks in January and February.'

While a ban has not been set, Cawley said MUSC is limiting access by children, ages 18 and younger, to nurseries and the neonatal and pediatric intensive care units.

Last week, the university set up a tent for flu vaccinations on Wednesday and Thursday. Lines formed on Wednesday as hospital staff sought vaccines, including a limited supply of H1N1. Staff are not being required to get the vaccines because of problems with supply.

Flu information

Priority at-risk groups for flu vaccines include pregnant women, people who live with or care for infants, health care and emergency medical personnel, people ages six months to 24 and people who have medical conditions that put them at higher risk for flu-related complications.

Those who should not be vaccinated without first consulting a physician are people with a severe allergy to chicken eggs, people who have had a severe reaction to flu vaccines in the past; those who have Guillain-Barré syndrome within 6 weeks of getting an influenza vaccine previously, children younger than six months, those with a moderate to severe illness with a fever (until they recover).

Centers for Disease Control.