Heed the signs of H1N1 complications, doctors tell parents

CHICAGO (AP) — Max Gomez was a bright-eyed 5-year-old happy to have just started kindergarten when he developed sniffles and a fever. His mother figured it was only a cold.

Three days later, the Antioch, Tenn., boy was dead, apparently from the H1N1 virus.

At least 76 American children have died from the new virus, and doctors are urging parents to watch for warning signs that the flu has become life-threatening.

Ruth Gomez says Max developed dangerous symptoms — bluish fingers and extreme fatigue after seeming to get better — just one day before he died. She took him to the doctor, but it was too late.

“We were in shock,” Gomez said softly, still trying to wrap her mind around her little boy’s Aug. 31 death. “There are so many unanswered questions. What happened?”

It’s a question on other parents’ minds, too: How can they protect their kids from swine flu until the vaccine is widely available?

Swine flu has infected probably hundreds of thousands of youngsters nationwide, but deaths among children are rare. Health officials are keeping track of children’s flu deaths, but they say it’s impossible to count all flu cases. So they don’t know what percentage of children’s infections are fatal.

Many experts say the H1N1 virus does not appear to be more dangerous than other flu strains, but kids have been catching it more easily than seasonal flu.

Last week alone, there were 19 new reports of children who died, according to the federal Centers for Disease Control and Prevention. And the 76 H1N1 fatalities since April compare with 68 pediatric deaths from seasonal flu since September 2008.

Because kids seem so vulnerable to it, “every medical epidemiologist in the country” is tracking how it affects them, said Dr. Susan Gerber, an associate medical officer for the public-health department in Cook County, Ill.

Most children will recover, but “it’s still very concerning and needs to be watched very closely” Gerber said.

Dr. Kenneth Alexander, the University of Chicago’s pediatric infectious-disease chief, said there are common signs to indicate when both kinds of flu turn dangerous.

Flu viruses can damage cilia, the hairlike fibers lining the respiratory tract that move bacteria and mucous “where we can cough them out” of the lungs, he explained.

That can make people susceptible to pneumonia and other bacterial infections — a scenario blamed for many flu deaths in otherwise healthy children and adults, he said. In these cases, flu patients often appear to get better, but then fever and a cough return.

Authorities urge parents to seek immediate help if emergency warning signs develop. In children, these are:

UFast or troubled breathing.

UBluish skin color.

ULack of thirst.

UFailure to wake up easily or interact.

UIrritability so that the child does not want to be held.

UImprovement of symptoms, then a return to fever and worse cough.

UFever with a rash.

Parents also should seek medical help if flu symptoms develop in children most vulnerable to flu complications: those younger than 5 or with high-risk conditions, including asthma and other lung problems; cerebral palsy, epilepsy and other neurological diseases; heart, kidney or liver problems; and diabetes.

A recent report from the CDC found that one-third of pediatric deaths from the new H1N1 virus were in children such as Max, with no known underlying condition that would put them at risk.

Authorities are walking a fine line between making sure parents are vigilant without raising undue alarm.