The World Health Organization (WHO) has announced that children with severe or deteriorating illness, and those at risk of more severe complications from swine flu (H1N1) infection, should receive prompt antiviral treatment – this includes all children under the age of 5 years.

However, otherwise healthy children over 5 who have mild symptoms need not be given antiviral treatment, unless their condition deteriorates.

WHO said that following recent publications of two clinical reviews, some concerns have emerged about the advisability of giving antivirals to some children.

  • Shortness of breath while physically active or resting
  • Breathing difficulties
  • Face turning blue
  • Chest pain
  • Colored or bloody sputum
  • Altered mental state
  • Fever that continues for over three days
  • Hypotension (low blood pressure)
  • In children, the following are also danger signs:

    • Fast or difficult breathing
    • Lack of alertness
    • Difficulty in waking up
    • Little desire to play
    • No desire to play

Health care professionals, patients and people providing home-based care need to be aware of these signs as they can be indications of serious complications. If any of the signs appear in a person who is confirmed or suspected of H1N1 (swine flu) infection, medical help should be sought immediately because progression can be extremely fast.

There is concern in the UK about the overuse of antivirals, such as Tamiflu, as well as widespread lack of adherence – people starting the antiviral course but not completing it. If people do not complete their course of treatment the risk of resistance increases significantly.

Written by Christian Nordqvist