Nurses provide flu answers for parents

By Marcia Patrick and

Susan Gustafson

For The Courier-Herald

The H1N1 virus, commonly known as swine flu, has impacted western Washington, affecting hundreds of people. Hospitals in the region are feeling the effects with patients visiting emergency departments, making inquiries and expressing a desire for the vaccine.

Marcia Patrick and Susan Gustafson, both registered nurses with Infection Prevention for MultiCare Health System, answer some frequently-asked questions.

Vaccine is on the Way

The highly sought out H1N1 vaccine has been delayed in reaching communities throughout western Washington. Local health departments are receiving the vaccine in small amounts and distributing them first to high-risk communities. Patients who are to get the first doses available are those with higher risk for infection including; pregnant women, persons who care for infants 6 months of age or younger, all persons age 6 months to 24 years, people 25 to 64 with chronic diseases and health care workers.

For the latest information on the H1N1 vaccine, contact your primary care provider or your local health department. For the Tacoma-Pierce County Health Department, call 253-798-6410 or visit For the Seattle-King County Health Department, call 877-903-5464 or visit


The symptoms of the H1N1 virus in people are similar to the symptoms of the regular seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people who have been infected with the H1N1 virus have also reported diarrhea and vomiting.

Treatment is available for the seriously ill

It is expected most people will recover without needing medical care or hospitalization.

When someone is diagnosed with H1N1, there are two medications recommended for use. They are called oseltamivir (trade name Tamiflu) and zanamivir (Relenza). As the flu spreads, these antiviral drugs may become in short supply. Therefore, the drugs may be given first to those people who have been hospitalized or are at high risk of severe illness from the flu. They are most effective when given within 48 hours of the onset of flu symptoms.

Aspirin or aspirin-containing products (e.g., bismuth subsalicylate or Pepto Bismol) should not be administered to anyone 18 and younger confirmed or suspected of having the H1N1 infection due to the risk of complications. For relief of fever, other medications are recommended like acetaminophen or non-steroidal, anti-inflammatory drugs.


Check ingredient labels on over-the-counter cold and flu medications to see if they contain aspirin.

Children 5 and older and teenagers with the flu can take medicines without aspirin, such as acetaminophen and ibuprofen to relieve symptoms.

Children younger than 4 should not be given over-the-counter cold medications without first speaking with a health care provider. 

Emergency warning signs

If you experience any of the following symptoms, seek emergency medical care.

In children:

Fast breathing or trouble breathing

Bluish or gray skin color

Not drinking enough fluids

Severe or persistent vomiting

Not waking up or not interacting

Being so irritable the child does not want to be held

Flu-like symptoms improve but then return with fever and worse cough

In adults:

Difficulty breathing or shortness of breath

Pain or pressure in the chest or abdomen

Sudden dizziness


Severe or persistent vomiting

Flu-like symptoms improve but then return with fever and worse cough

Avoid Contact With Others

If you are sick, expect to be ill for at least a week. Unless medical care is necessary, you should stay home and minimize contact with others, including avoiding travel and not going to work or school until you have been fever free for at least 24 hours while not taking fever-reducing medications.

If you leave the house to seek medical care, wear a face mask and cover your coughs and sneezes with a tissue or into your covered elbow. You should avoid contact with other people as much as possible to keep from spreading your illness. With influenza, people may be contagious from one day before they develop symptoms to up to seven days after they get sick. Children, especially younger children, might potentially be contagious for longer periods.

Hospital visitor guidelines

To protect patients, visitors and staff, hospitals are implementing visitor guidelines and restrictions to specific units.

MultiCare Health System has developed visitation guidelines to help protect those patients most vulnerable to the current flu viruses.  

It is strongly recommended children younger than 12 not visit adult hospitals. Studies have found children are more vulnerable to the H1N1 virus and are often carriers and can easily pass the virus on to others even though they may not show symptoms of the flu for several days prior.

 At MultiCare’s Mary Bridge Children’s Hospital, visitors will be limited to adults and children 12 and older.

 Marcia Patrick is director of Infection Prevention and Control for MultiCare Health System and Susan Gustafson is an infection preventionist at MultiCare Good Samaritan Hospital.

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