Concerns About H1N1 in a 12-Year-Old: When to Seek Further Care

Child suspected of H1N1?

Hello Doctor: My child is currently 12 years old and in the fifth grade.
Since October 17th (Saturday), he has been experiencing a fever of 38-39 degrees Celsius, along with a sore throat and cough with yellow phlegm.
We visited a pediatric clinic, and every medication prescribed contains antipyretic components.
As of now, October 19th (Monday) morning, he still has a fever of 38.3 degrees Celsius.
After taking medication, his fever subsided.
We took him to an ENT specialist, but since he had taken antipyretics half an hour prior, his temperature did not reach 38 degrees during the visit, and he was unable to undergo H1N1 screening.
He does not have any muscle pain symptoms.
I would like to ask if we should go to a major hospital for further evaluation or continue to observe him, considering he has had a fever for three days and it has been above 38 degrees Celsius.
I am worried about missing the critical 48-hour treatment window.
If we go to a major hospital, which department should we visit? I would greatly appreciate your help! A worried mother.

Luya, 40~49 year old female. Ask Date: 2009/10/19

Dr. Xiao Kaiwen reply Pediatrics

With symptoms similar to influenza and a fever above 38 degrees Celsius, you meet the criteria for a rapid influenza test.
Additionally, it is necessary to check for pneumonia (via chest X-ray) and to conduct blood tests to assess the level of inflammation and determine if there is a more severe infection (by checking white blood cell count and inflammatory markers).
Given the number of tests required and the need for timely results, it is advisable to go directly to a pediatric emergency department at a major hospital for quicker evaluation.

Reply Date: 2009/10/19

More Info

When it comes to concerns about H1N1 in a 12-year-old child, it is essential to approach the situation with caution and awareness of the symptoms and potential risks involved. Given the child's persistent fever of 38-39 degrees Celsius, sore throat, and cough with yellow phlegm, it is understandable that you are anxious about the possibility of H1N1 or another viral infection.

Firstly, it is important to note that H1N1, like other strains of influenza, can present with symptoms such as high fever, cough, sore throat, body aches, and fatigue. The fact that your child has been experiencing these symptoms for three days is significant, especially since the fever has remained elevated despite the administration of antipyretics. While the absence of muscle aches may be a positive sign, it does not rule out the possibility of influenza or other viral infections.

In terms of seeking further care, it is advisable to consider the following factors:
1. Duration and Severity of Symptoms: Since your child has had a fever for three days, it is crucial to monitor the situation closely. If the fever persists or worsens, or if new symptoms develop (such as difficulty breathing, chest pain, or severe dehydration), it is essential to seek medical attention promptly.

2. Testing for H1N1: If your child is still experiencing fever and other symptoms, it may be beneficial to return to a healthcare provider for further evaluation. While the child may not have had a fever at the time of the ENT visit due to the antipyretic medication, it is still possible to assess the overall clinical picture and consider testing for H1N1 or other respiratory viruses.

3. Where to Seek Care: If you decide to visit a larger hospital, it would be appropriate to consult the pediatric emergency department or the pediatric infectious disease department. These specialists are equipped to handle cases of suspected influenza and can provide the necessary testing and treatment options.

4. Importance of Early Treatment: You mentioned the concern about missing the "golden 48 hours" for antiviral treatment. While it is true that antiviral medications are most effective when administered early in the course of the illness, they can still be beneficial even after this window, especially in children with significant symptoms or underlying health conditions.

5. Monitoring for Complications: Keep an eye out for any signs of complications, such as difficulty breathing, persistent vomiting, or lethargy. If any of these symptoms occur, seek immediate medical attention.

In conclusion, while it is understandable to feel anxious about your child's health, it is essential to remain vigilant and proactive. If symptoms persist or worsen, do not hesitate to seek further medical evaluation. Early intervention can make a significant difference in the management of influenza and its potential complications. Remember to keep your child hydrated and comfortable, and monitor their symptoms closely. Your child's health and well-being are the top priority, and seeking appropriate care is a responsible step in ensuring they receive the best possible treatment.

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