September 9, 2009

What to Do if Your Family Gets Swine Flu

Even if you are not one of the millions expected to catch swine flu, a member of your family or a friend may. If you’re called on to help care for them, as I was my daughter and granddaughter, here are some helpful hints and guidelines you’ll want to read.

This is the fourth of a series of articles on swine flu. Other articles in this series include:

Take Care of Yourself

You’re no good to others if you’re sick. Do what you can to avoid getting sick. You may want to review our earlier article.

Talk with your doctor about taking an antiviral drug as a preventive measure. Earlier this spring, the government left the door open for anyone to use these medicines to prevent getting swine flu. On September 8, 2009, it revised those guidelines. Now it suggests that only those in a high risk group (or who are already sick) have priority in getting prescriptions. Presumably this change is more about supply than it is about demand.

Antiviral medicines are effective 70% to 90% of the time. You should start taking it as soon as you have contact with someone with swine flu. If it is Tamiflu, the prescription will probably be for a 75mg pill taken once a day until 10 days after the last known exposure. When we went to take care of our family, my wife and I asked for a 14-day prescription. Tamiflu is expensive – expect to pay about $10 a pill. Not all insurance plans pay for it.

If there are as many cases of swine flu as the media and government says there will be, those drugs may become scarce and you may not be able to get it. Those new guidelines also say that doctors need not prescribe antiviral medicines for preventative purposes even to those in high risk groups.

Side effects: As with all drugs, there are side effects including diarrhea, nausea, stomach pain and vomiting. I did have a bout of nausea and vomiting three days after starting on Tamiflu. I don’t know if it was related to the drug or not. Call your doctor immediately if you experience abnormal behavior; confusion; hallucinations; mood or mental changes; reddened, blistered, peeling, or swollen skin; seizures; severe or persistent nausea, vomiting or diarrhea; or symptoms of infections (for example fever, chills, persistent sore throat). You may also experience symptoms of an allergic reaction.

Who Should Care For Those with Swine Flu?

If possible, only one adult in the home should take care of the sick person. This should not be someone who is in a high risk group – including pregnant women. If you are in a high risk group and you’re the only one who can care for a sick person, wear a face mask or respirator. See CDC guidelines on face masks.
Sick family members should not care for infants.

Reduce risk to other family members

Ask your doctor if other family members should take antiviral medicines – especially those who may be pregnant or who are in other high risk groups. This can prevent the flu. But remember those recently new guidelines that limit who should get prescriptions for preventative care.
Everyone in the house should wash their hands often with soap and water or an alcohol-based cleaner, especially after every contact with a sick person or that person’s room, bathroom, laundry, tissues, eating utensils, etc. Children may need reminders or help keeping their hands clean.
Use paper towels for drying hands after hand washing or dedicate cloth towels to each person in the household. For example, have different colored towels for each person.
Keep the sick person away from others as much as possible – especially those in high risk groups. Put the sick person in a separate room others do not have to use – perhaps a spare bedroom with its own bathroom. Keep the door to the room closed.
If possible, maintain good ventilation in shared areas such as the kitchen and bathroom.
If you are in a high risk group, try to avoid close contact (within 6 feet) with those who are sick. If that is unavoidable, wear a face mask or respirator. CDC guidelines on face masks.
Clean their bathroom daily with a household disinfectant.
Clean surfaces of bedside tables, surfaces in the bathroom, and toys for children often by wiping them down with a household disinfectant.
Linens, eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately, but these should not be shared without washing thoroughly first.
Tumble dry linens, towels and other clothing on a hot setting. Avoid “hugging” laundry before washing it so you do not contaminate yourself. Wash your hands with soap and water or an alcohol-based hand rub after handling dirty laundry.

Reduce the risk to those outside the home

If anyone with the flu needs to go outside the home, they should wear a face mask and cover their nose and mouth when coughing or sneezing
Have the sick person wear a face mask when they are in a common area of the house near other people.
The sick person should not have visitors other than caregivers. A phone call is safer than a visit.
People with swine flu should stay home and keep away from others as much as possible for at least 24 hours after fever is gone. Fever should be gone without the use of a fever-reducing medicine. Children, especially younger children, might be contagious longer.

Medications

Treat fevers and aches with acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®, Nuprin®) or nonsteroidal anti-inflammatory drugs (NSAIDS).
Over-the-counter cold and flu medications used according to the package instructions may help lessen some symptoms such as cough and congestion. However, these medications will not reduce how infectious a person is.
The safest care for flu symptoms in children younger than 2 years old is a cool-mist humidifier and a suction bulb to help clear away mucus.

If You Are the Caregiver

The CDC has a webpage about taking care of a sick person in your home. Check it for the latest guidelines.

Talk to your doctor about taking antiviral medication to prevent the caregiver from getting the flu. Recent changes in CDC guidelines may limit those medicines to those who are in a high risk group.
If you are in a high risk group , try to find someone else to be the appointed caretaker.
If you are sick with swine flu, do not care for infants or others who are in a high risk group.
Wash your hands often with soap and water or an alcohol-based hand rub, including after every contact with a sick person or that person’s room, bathroom, laundry, tissues, eating utensils, etc.
Throw away tissues and other disposable items used by the sick person.
Remind the sick person to cover their coughs and to wash their hands with soap and water or an alcohol-based hand rub often, especially after coughing or sneezing
Avoid being face-to-face with the sick person. When holding small children who are sick, place their chin on your shoulder so they will not cough in your face.
Watch yourself and household members for flu symptoms and contact your doctor if symptoms occur.
See our earlier article for symptoms that require emergency treatment.

Final Thoughts

Notice a frequent theme of washing your hands often? That will go far in keeping yourself and others healthy. My daughter said having swine flu was like being hit by a truck. I’ve never been hit by a truck; nor do I have the desire to try it out. You may find yourself taking care of sick family members like my wife and I did in June. If so, I hope this and our earlier articles will help make it easier.

As the flu season progresses, please share your thoughts, experiences and what you learn with other readers.

Walt