Homeschoolers and H1N1 Swine Flu

Some homeschooled children in our area have symptoms of H1N1.

One of my sons has some symptoms right now but not a high fever so I’m honestly not sure if this is a regular old sickness or H1N1 or just a sore throat with fluid in the ear and a possible ear infection and a two degree higher than normal temperature. I’m playing it safe by keeping him away from others.

Per the federal government we should quarantine our children once they have symptoms so we do not infect others. It is contagious before the first symptom but we can’t do anything about prior exposures when our children have NO symptoms. The CDC says communities should make guildelines for their own groups, I take this to mean for example, a homeschool co-op would inform their members of the guidelines that they wish their participants to follow.

We homeschoolers are used to doing our own thing and making decisions that are best for our family. We are not in the same situation as parents of schooled kids who have school boards making decisions on when a child should leave school and when they are healthy enough to return. However when homeschoolers take part in group activities or attend paid classes the organizers of the event (co-op boards, professional art schools, music schools, etc.) should do their part to know the CDC recommendations and figure out policies to use for their participants.

Here is the CDC quote from this URL about quarantine in one's own home:

“Sick individuals should stay at home until the end of the exclusion period, to the extent possible, except when necessary to seek required medical care. Sick individuals should avoid contact with others. Keeping people with a fever at home may reduce the number of people who get infected, since elevated temperature is associated with increased shedding of influenza virus. CDC recommends this exclusion period regardless of whether or not antiviral medications are used. People on antiviral treatment may shed influenza viruses that are resistant to antiviral medications.

Many people with influenza illness will continue shedding influenza virus 24 hours after their fevers go away, but at lower levels than during their fever. Shedding of influenza virus, as detected by RT-PCR, can be detected for 10 days or more in some cases. Therefore, when people who have had influenza-like illness return to work, school, or other community settings they should continue to practice good respiratory etiquette and hand hygiene and avoid close contact with people they know to be at increased risk of influenza-related complications. Because some people may shed influenza virus before they feel ill, and because some people with influenza will not have a fever, it is important that all people cover their cough and wash hands often. To lessen the chance of spreading influenza viruses that are resistant to antiviral medications, adherence to good respiratory etiquette and hand hygiene is as important for people taking antiviral medications as it is for others.”

Since President Obama declared a national state of emergency for swine flu on October 24, 2009, every citizen should be adhering to the guidelines our government recommends.

It’s unfair for parents to intentionally expose healthy people to the virus just because we’re trying to be faithful to attend our homeschool co-op’s, homeschool group field trips, Scout events, or sport practice or a game. This all goes for parents of schooled kids too. That’s my two cents and I’m backed up by the President and the CDC so I'm not a lone voice in the wilderness!

An additional issue for our homeschool community is sometimes we interact as families and children under age 5, babies and pregnant women are in our company, those populations are at increased risk for worse outcomes if they get H1N1. If we parents are sick or our kids are we should stay home and not risk spreading the infection to others who may fare worse than us if they become ill.

Regarding the question of “to test or not” or “to treat with Tamiflu immediately or not at all”or “give Tamiflu only after the test comes back positive” the CDC says this from this source:

“When a decision is made to use antiviral treatment for influenza, treatment should be initiated as soon as possible without waiting for influenza test results. Antiviral treatment is most effective when administered as early as possible in the course of illness.”

Perhaps if someone in your family gets symptoms of H1N1, you should read & print off the CDC guidelines & take it in hand to discuss treatment with your doctor so you can have a discussion of options & to make an informed decision. I say this because two doctors I'm friends with that I spoke to yesterday do not know of these new guidelines, and neither did my friend’s child’s covering doctor, so maybe your Dr. doesn’t know them either. Specifically I am speaking about whether to prescribe the antiviral Tamiflu or not, if only certain people should ever get it, testing and so forth.

Below is a coorespondence another homeschooling mother sent me:

This is an official
CDC Health Advisory

Distributed via Health Alert Network
November 6, 2009, 13:51 EST (01:51 PM EST)
CDCHAN-00300-09-11-06-ADV-N

Key Issues for Clinicians Concerning Antiviral Treatments for 2009 H1N1

Although use of influenza antiviral drugs in the United States has increased during the 2009-2010 flu season, not all people recommended for antiviral treatment are getting treated. Listed below are important facts to consider when deciding whether a patient needs to be treated with antiviral medication.

It is critical to remember that it is not too late to treat, even if symptoms began more than 48 hours ago. Although antiviral treatment is most effective when begun within 48 hours of influenza illness onset, studies have shown that hospitalized patients still benefit when treatment with oseltamivir is started more than 48 hours after illness onset. Outpatients, particularly those with risk factors for severe illness who are not improving, might also benefit from treatment initiated more than 48 hours after illness onset.

Recommendations for Clinicians:

Many 2009 H1N1 patients can benefit from antiviral treatment, and all hospitalized patients with suspected or confirmed 2009 H1N1 should receive antiviral treatment with a neuraminidase inhibitor – either oseltamivir or zanamivir – as early as possible after illness onset. Moderately ill patients, especially those with risk factors for severe illness, and those who appear to be getting worse, can also benefit from treatment with neuraminidase inhibitors. A full listing of risk factors for severe influenza is available at: http://www.cdc.gov/h1n1flu/highrisk.htm

Although antiviral medications are recommended for treatment of 2009 H1N1 in patients with risk factors for severe disease, some people without risk factors may also benefit from antivirals. To date, 40% of children and 20% of adults hospitalized with complications of 2009 H1N1 did not have risk factors. Clinical judgment is always an essential part of treatment decisions.

When treatment of persons with suspected 2009 H1N1 influenza is indicated, it should be started empirically. If a decision is made to test for influenza, treatment should not be delayed while waiting for laboratory confirmation. The earlier antiviral treatment is given, the more effective it is for the patient. Also, rapid influenza tests often can give false negative results. If you suspect flu and feel antiviral treatment is warranted, treat even if the results of a rapid test are negative. Obtaining more accurate testing results can take more than one day, so treatment should not be delayed while waiting for these test results. For more information on influenza testing, please see: http://www.cdc.gov/h1n1flu/guidance/diagnostic_tests.htm.

Although commercially produced pediatric oseltamivir suspension is in short supply, there are ample supplies of children's oseltamivir capsules, which can be mixed with syrup at home. In addition, pharmacies can compound adult oseltamivir capsules into a suspension for treatment of ill infants and children. Additional information on compounding can be found at: http://www.cdc.gov/H1N1flu/pharmacist/.