It looks like Seasonal Flu has returned this winter and there are a significant number of children with moderate to severe Flu like illnesses being treated at this time at home as well as in hospital. This is the usual situation at this time of year, irrespective of the Flu strains in circulation.

Swine Flu is the common name given to a relatively new strain of influenza (Flu) that caused a Flu pandemic in 2009-2010. It is also referred to as H1N1 influenza. However as in previous years, there are at least 3 strains of Influenza virus causing Flu like illnesses this winter. These include Swine Flu - officially called H1N1, Influenza A type H3N2 and Influenza B.

It is important to realise that H1N1 is no different from other strains of Flu as regards the principles of creating a vaccine to protect against it. Its inclusion in this year's Seasonal Flu jab poses no additional risk. It is included simply because it is one of the major Flu strains circulating in Britain this winter.

The 2009 pandemic was not as severe as originally predicted, although pregnant women and children were more likely to become severely ill compared with symptoms caused by usual seasonal Flu.

Seasonal Flu is a highly infectious respiratory illness caused by a variety of different Flu viruses. It spreads rapidly through droplets dispersed by the coughs and sneezes of infected people.

Each year, a vaccine is developed to protect against the strains of Flu virus that are expected to be most prevalent that winter. This 'Flu jab' is used not just in the UK, but throughout the Northern hemisphere. It gives good protection (70-80% reliability) against all strains of Flu included in the vaccination and lasts for a year. The entire process of developing the Seasonal Flu vaccine is led, organised and overseen by the World Health Organization (WHO).

The H1N1 Flu virus has been included in the 2010-11 Seasonal Flu vaccine which this year contains at least 3 different strains of Flu virus. The vaccines are all killed virus, and all the available vaccines are grown on egg, there is no egg free Seasonal Flu vaccine. However there is an egg free H1N1 vaccine, as used in 2009.

Vaccination is recommended for all children from 6 months old. There are no specific groups of children thought to be more at risk, as the majority of the sickest children in 2009 had no other previous illness or medical conditions. Children who have received their first vaccine at age less then 13 years are recommended to receive a second dose 3-4 weeks after the first dose. It seems that the vaccine only becomes fully protective 2 weeks after the vaccination has been given.

If you or your child have a severe egg allergy, then this year there is no product containing Seasonal Flu viruses specifically for egg allergic children. In this situation the product which is not manufactured using eggs only contains the H1N1 strain - but only covers one of the three circulating viruses.

All pregnant women (not just those in high risk groups) are advised to take the Seasonal Flu jab, which protects against H1N1 Flu. This is because there is good evidence that all pregnant women are at increased risk from complications if they catch H1N1 Flu. In pregnancy, the immune system is naturally suppressed. This means that pregnant women are more likely to catch Flu and if they do catch it, they are more likely to develop complications. However, your immune system still functions and the risk of complications is very small. Most pregnant women will only have mild symptoms.

What are the symptoms of H1N1 flu?
There are many different symptoms of H1N1, and not all will present themselves at the same time. If you or a member of your family has a fever or high temperature (over 38C/100.4F) and two or more of the following symptoms, you may have any type of Flu:

• unusual tiredness
• headache
• runny nose
• sore throat
• shortness of breath or cough
• loss of appetite
• aching muscles
• diarrhoea or vomiting

If you are suffering from any of the symptoms above, the advice is NOT to go to your GP surgery or A&E department, but phone your surgery and describe your symptoms or phone NHS Direct on (0845) 46 47

What can you do to protect yourself and your family from any types of the flu?

• Always carry tissues with you to use if you sneeze or cough (or if your children sneeze or cough)
• Always try to cover your mouth and nose when you sneeze or cough
• Throw the tissue away after you have used it on yourself or your children
• Wash your hands often with soap and hot water and encourage your children to do the same

H1N1 flu and pregnancy
If you have questions or concerns about H1N1 Flu or the Seasonal Flu vaccination please contact your GP or Midwife direct.

H1N1 flu and children According to the NHS Direct website, young children under five are considered to be at risk from the H1N1 virus. If you are worried about your child or your child has any of the symptoms above, call your GP for more advice. The use of oral antiviral drugs - the best known is TamiFlu , is debateable as to whether the drugs improve the outcome for those who take them, compared to those who do not. Generally, in a previously well child, these drugs have limited value if started 48 hrs or more after the onset of the illness, and for the children who receive the medicine, tummy aches and diarrhoea are frequent effects of the medicine.

If your GP confirms your child has H1N1 Flu, they should stay at home and you should treat their symptoms like any other cold or Flu. So, plenty of liquids, plenty of rest and medicine to bring their fever down. Vaccine is not effective in the treatment of the Flu, whatever the strain causing it. However vaccination after a 'dose' of the Flu, at any age carries no increased risks.

To find out more about H1N1 Flu, and its symptoms and treatments, visit the NHS Direct website.