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Lots of rest, fluids, chicken soup a recipe for toughing out swine flu: doctors

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Oh boy. Your throat is sore, you have the sniffles and you're starting to cough. Not only that, but you feel feverish and you're aching all over. In fact, you feel absolutely lousy.

Yes, chances are you have the dreaded swine flu.

So how do you care for yourself and family members who may also come down with the virus? And how do you avoid spreading it to others?

First and foremost, say experts, stay home and take it easy.

"One of the big things we say is give a person time to rest and to rest by themselves," says Dr. Bonnie Henry, director of Public Health Emergency Management at the B.C. Centre for Disease Control.

"When you're fighting off an infection like influenza, your body needs rest to recuperate and help get rid of the infection," she says, adding that anyone who comes down with H1N1 flu should avoid pushing themselves, particularly by exercising.

"I know it's difficult for children, but most kids who get this, they feel pretty wiped out for a couple of days, so kind of lethargic. They just want to sit in bed and maybe read a book and not run around and be active like they usually are."

Dr. Andrew Simor, an infectious disease specialist at Sunnybrook Health Sciences Centre in Toronto, says most adults who come down with swine flu - or any other flu, for that matter - won't feel up to doing much except lie in bed anyway.

"And that's probably not bad advice," Simor says. "Taking it easy, staying at home resting - especially in the first few days - drinking lots of fluids, taking (acetaminophen) to ease fever, aches, pains and muscle aches, makes good sense."

That's pretty much what Niko Politis of Moose Jaw, Sask., and his girlfriend did after getting hit with the illness. The couple had attended a wedding where some of the guests had recently been in contact with children sick with swine flu.

"We both got it at exactly the same time, maybe a week later," says Politis, 29. "My whole body felt like I'd been trampled by an elephant. I just ached from top to bottom, high fever. I felt like I was going to cough my lungs inside out, and I had severe dizziness."

"I couldn't walk around the house without supporting myself with the wall. It was not fun."

Politis said he doctored himself by slugging cough medicine and taking ibuprofen for the aches and pains.

"We drank lots of orange juice, but we were coughing so much that we just did not feel like eating at all."

Lack of appetite can be one of the symptoms of flu, explains Henry, who is a proponent of chicken soup and other soups and broths, which can provide protein and other nutrients the body needs.

"If they're feeling like eating, then they should eat normally, but also make sure they get lots of liquids," she says of people laid low by influenza. Fever can cause loss of body fluid through perspiration, and that's especially true for children, who need to be kept well hydrated, she says.

"One of the main reasons young children end up in hospital is because they're not taking enough fluids and they get dehydrated," explains Henry, who recommends giving children juice half-diluted with water to prevent an upset stomach or sports drinks that replace sodium and other electrolytes lost by sweating.

She advises that children under 16 can be treated with kid-sized doses of acetaminophen or ibuprofen, but not ASA because of a link between viral infections and a potentially fatal condition called Reye's syndrome. Decongestants and cough suppressants should not be given to children under age six because they can be harmful.

Both Henry and Simor say that if possible, an adult or child with swine flu should be isolated in a separate room, with one person designated as the caregiver, to prevent the virus spreading to others in the home.

That can be difficult to do, admits Simor. Studies suggest about a third of household contacts on average will develop influenza as a result of exposure to someone who is ill.

A sick adult or child should cough or sneeze into their sleeve or elbow to avoid spraying virus-laden droplets into the air or onto surfaces, "or if they happened to cough into their hand, to immediately wash their hands," he stresses.

"Napkins or tissues should be immediately disposed of into a garbage receptacle rather than just left lying around."

Henry says people are most infectious the first couple of days after developing symptoms (but can pass it to others for about a week), and the worst of the illness typically lasts four days for adults, three days or less for children.

But what if an adult or child with swine flu is not improving, but getting worse?

"The worrisome signs for children is their fever's not coming down, even with medication. They're lethargic and irritable and not eating," Henry points out. "You also worry if they're having difficulty breathing, especially for young children." Ditto for any blueness around the lips.

"Those are signs they need to go to the emergency department for assessment."

As for adults, Simor says it depends on the severity and duration of symptoms.

"If you're coughing and having trouble breathing - you're short of breath - that's a clue there's something else going on like a pneumonia that's complicating the influenza. That needs medical attention. Or if you've got chest pains with underlying cardiac disease (or) you've got an exacerbation of your asthma, that probably needs medical attention."

"I think in most cases you could go to your family doctor or a walk-in clinic. Obviously if someone is acutely ill, then they need to come to an emergency department."

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On the Net:

Flu self-assessment: https://h1n1.cloudapp.net/Default.aspx

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