Asked by Karen McCann, Juno Beach, Florida
In the emergency room recently, my 14-month-old son got a diagnosis of influenza A, but he wasn't tested for H1N1. He has recovered after nine days of fever and other symptoms, but we are unsure going forward whether to seek the regular or swine flu vaccine for him. Any suggestions?
Living Well Expert
Dr. Jennifer Shu
Children's Medical Group
Thanks for your question. I'm so glad your son has recovered from influenza. As you mentioned, he tested positive on the rapid test for Influenza A. This test can show whether a person has influenza virus, but it does not specify whether it is a seasonal flu virus or the 2009 H1N1 strain. It also can be incorrect at times and may test falsely positive, although more commonly the test will be falsely negative despite a person actually having influenza.
A more specific test called rRT-PCR (real-time reverse transcriptase polymerase chain reaction) can tell which type of influenza is present; however, it is not widely available in most doctors' offices, and the turnaround time may be a few days. The Centers for Disease Control and Prevention currently does not recommend routine rRT-PCR testing, since the outcome typically will not change a person's medical treatment.
The H1N1 vaccine is recommended for anyone over the age of 6 months who wishes to get the immunization and has not had a confirmed case of H1N1 flu. The vaccine is especially important for groups of people who are at highest risk of complications from the infection themselves or who stand to infect others who have weakened immune systems. These groups include pregnant women, health care workers, children from 6 months through 4 years of age, anyone who lives with or cares for an infant younger than 6 months (who is too young to receive the vaccine, since the flu vaccine does not produce immunity well in these young babies), and anyone with a chronic health problem such as asthma or a weakened immune system.
Since very few people are being tested specifically for the 2009 H1N1 flu virus, most people who have had the flu this year will fall into your son's situation, and they are advised to still get the vaccine. The CDC reports, however, that about 99 percent of all influenza A as of September 2009 is H1N1, so chances are good that your child did have the H1N1 infection. If a person who did have the H1N1 infection gets the H1N1 vaccine, it will simply boost his or her immune system. If the person didn't have H1N1, then the vaccine will help protect him or her.
If you have further questions, I encourage you to talk with your son's pediatrician. Good luck!
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