The H1N1 influenza virus causes swine flu. Unlike previous influenza viruses, which usually affected the elderly, H1N1 has an increased prevalence among young people and children. It is spread from person to person by contact with infected respiratory droplets when a person coughs or sneezes. Early recognition of the signs and symptoms of influenza infection are important to prevent contagion and to institute appropriate treatment.
Respiratory signs
Infants with influenza H1N1 infection present with signs of upper respiratory infection like runny nose with nasal congestion. Infants primarily breathe through their noses, so if they have a lot of nasal congestion, they can have significant respiratory distress, which usually can easily relieved by loosening the mucous with a saline solution and suctioning the nose with a bulb syringe. Infants can also have lower respiratory tract symptoms, like cough, rapid breathing, respiratory distress, wheezing and retractions (pulling in of the chest wall muscles in an effort to improve air exchange). In some cases, respiratory distress can lead to respiratory failure and the need to help the infant's breathing with a ventilator.
Gastrointestinal symptoms
Infants with nasal congestion and respiratory distress have difficulty eating and drinking. Infants cannot drink and breathe at the same time, so their intake of milk and food can diminish significantly. Infants with swine flu can also have episodes of vomiting and profuse diarrhea. The combination of respiratory distress, inability to tolerate oral intake, vomiting and diarrhea predisposes these infants to severe dehydration. Infants with severe dehydration need to be managed with intravenous fluids and close monitoring of electrolyte and kidney function.
General symptoms
Infants with swine flu will also exhibit a range of nonspecific symptoms. Fever is a common symptom. Infants are at risk for serious bacterial infections, like urinary tract infections and pneumonia, so it is important to determine if an infant has a fever because of the swine flu or if there is an underlying bacterial infection. Infants with the flu can also be lethargic, restless or irritable. If any of these symptoms are present, it is necessary to seek prompt medical attention, as they could be related to a worsening of the illness.
