Scientists around the globe have been warning about the risk of a potential pandemic influenza outbreak. Pandemic flu is caused by a new, severe strain of the flu virus capable of producing severe disease and spreading rapidly person-to-person worldwide. Unlike the seasonal flu, a pandemic flu virus poses a novel threat since humans would have no previously developed immunity against this new virus strain, putting most people at high risk for infection. This could result in a large percentage of the world's population being infected by a rapidly spreading virus in a very short period of time. Experts predict a severe pandemic flu outbreak could result in up to 1.9 million deaths in the United States, approximately 9.9 million Americans needing to be hospitalized, and an economic recession with losses of over $680 billion to the U.S. Gross Domestic Product. How to treat and care for the nation's 73.6 million children and adolescents during an influenza pandemic is a significant concern. Children are not "small adults." Special consideration needs to be given to complicated issues ranging from: (1) Child-appropriate doses of vaccine and medications; (2) Management and treatment of children who are ill; (3) Including children in strategies to slow the spread of influenza in communities; and (4) Caring for and supervising healthy children if schools and childcare facilities are closed for extended periods of time. It is difficult to predict the impact of a future influenza pandemic on children, although children are known to suffer a significant burden from seasonal flu. Statistics regarding children in past pandemics are elusive, although children certainly became sick and died. In the 1918 "Spanish flu" pandemic, healthy young adults were the hardest hit, rather than the usual high-risk groups (i.e., young infants and the elderly) seen with the seasonal flu. More recently, children have been disproportionately affected by the avian flu virus that is circulating in Asia and elsewhere. The American Academy of Pediatrics (AAP) and Trust for America's Health (TFAH) recommend specific actions to ensure that the health and welfare of the nation's children are protected in the event of an influenza pandemic. This issue brief examines strategic approaches for containing the spread of a pandemic in children and adolescents, which include limiting social interaction, developing potential medical interventions such as vaccines and anti-viral medication, the use of masks and respirators, and educating children, families, and communities on what to do and how to do it.
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