Bengaluru: The rising incidence of H1N1 among children in the city has prompted paediatricians to urge parents to keep sick children away from school and follow appropriate hygiene practices.H1N1 cases among children have been rising in the city over the past few weeks, with doctors reporting influenza A as the predominant infection. Some cases have progressed to pneumonia, respiratory distress and other serious complications.Doctors said common symptoms include a sudden onset of high-grade fever, generalised myalgia and body aches, severe dehydration, respiratory distress, and gastrointestinal symptoms such as loose stools, vomiting and abdominal pain.“H1N1 has been the most predominant infection we have seen among children in the last couple of months. It usually causes high-grade fever and, in some cases, can trigger acute necrotising encephalopathy of childhood (ANEC), a rare brain disorder that can result in long-term disability. I have seen at least four such cases in the past few weeks,” said Dr Rakshay Shetty, clinical director and head of paediatric services and paediatric intensive care services, Rainbow Children’s Hospital. He added that some children were also developing necrotising pneumonia.The infection is being seen predominantly among children aged three to five years, while older children with underlying health conditions are also vulnerable.““Children with asthma, hyperreactive airway disease, cardiac conditions, allergies and compromised immunity are at higher risk. In such cases, the virus can rapidly progress to complications such as secondary bacterial pneumonia and severe dehydration. Some children require hospitalisation, respiratory support and intravenous fluids,” said Dr Santhosh Kumar, senior consultant and lead paediatrician and neonatologist, Motherhood Hospitals, Banashankari.Paediatricians said the current rise in cases is unusual for this time of year and significantly higher than the levels recorded during the corresponding period last year.“Last year, cases peaked in June and July and had settled by August. We typically see two peaks, in October-November and around December. This year, however, cases have risen significantly, with entire classes affected in some schools. Most of our admissions are due to influenza A,” said Dr Sujatha Thyagarajan, lead and HOD, paediatric intensive care and paediatric emergency, Aster Women & Children.Doctors attributed the rise to several factors. “Schools are high-density environments where close contact facilitates transmission. During the monsoon, children spend more time indoors in poorly ventilated spaces, while viral mutations may also be contributing to the rise in cases,” said Dr Kumar.Low severityDespite the rise, doctors said most children in Bengaluru recover within a few days with anti-flu medication, with overall severity lower than in some other cities.“Delhi and some other cities have reported more severe cases, including multi-organ failure requiring ECMO. With Bengaluru’s large migrant population, travel could drive further transmission and lead to more severe cases in the coming weeks,” Dr Thyagarajan said.Doctors, however, urged parents not to panic, stressing that basic precautions can help curb the spread. Clarence High School recently suspended offline classes after hundreds of students and staff reported flu-like symptoms, with two H1N1 cases confirmed.“In a school with thousands of children, a few hundred cases of flu, or even a smaller number of H1N1 cases, is no cause for alarm. It is seasonal, and children should stay home until they recover,” said Dr Sampath Kumar Shettigar, senior consultant, paediatrician and neonatologist, Kinder Hospitals.Doctors also stressed annual flu vaccination, particularly for children below five and those in high-risk groups.Inset: STEPS TO FOLLOWKeep children with fever or active flu symptoms at home and away from school.Ensure regular handwashing and good respiratory hygiene.Avoid close contact with people showing flu symptoms.Consider annual flu vaccination, especially for children under five and those in high-risk groups.Seek medical care if the child develops breathing difficulty, severe fatigue, dehydration or persistent high fever.
