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Maggie Tremblay and daughter Hannah, 4, came prepared for a long wait at a Winnipeg flu vaccination clinic on Thursday Oct. 29, 2009.Mike Aporius

With the swine flu taking its toll on an anxious nation's psyche, children are proving to be an at-risk group in more ways than one.

Parents and health professionals hear it from children confronting the new realities of absent classmates, cancelled hockey games and daily doses of H1N1 warnings. Ontario psychologist Marian Boer was talking to an eight-year-old recently who was upset about a classmate stricken with the flu.

"All the kids think he's going to die," the third-grader told her.

The spread of H1N1 has touched communities across Canada and exposed a generation of kids to a seemingly amorphous new threat. In the 1950s, schoolchildren had to do duck-and-cover drills in case of a nuclear weapons attack. Now, parents and public officials teach kids to shield themselves from danger with orders to cough-and-cover - or at least, to sneeze into their elbows.

The new health regime of dos and don'ts can be confusing. One 13-year-old in Montreal was yelled at by his teacher this week because he coughed in class and said he didn't feel well. "Why didn't you stay home?" she demanded.

The Canadian Psychological Association warns that the threat of illness can be especially upsetting to children and teenagers. And endless reports of vaccine queues, death tallies and worried parents have become hard to escape.

"If kids are exposed to it all the time, it's going to make them more anxious," said Dr. Boer, chief psychologist for the York Region District School Board. "Sometimes you've got to tune it out."

Still, tuning out becomes tough when the flu reaches into kids' lives. The Midget CC hockey league in Quebec's Eastern Townships instituted strict rules to fight the flu, ordering individual water bottles for the 15- to 17-year-old players and eliminating post-game handshakes.

But when one player missed 12 days of practices and games due to the flu, his teammates were shaken up.

"They're tough guys. But some of them are afraid of it," coach Claude Paré said. "Everyone's talking about the flu and it's starting to get them really nervous. The kids are under stress and asking a lot of questions … as coaches, we're trying to control any panic."

When the sick player returned, he told teammates he'd been quarantined in his room at home, his parents allowed to enter only with face masks and gloves. "Everyone was listening," the coach said.

In the Ontario community of Goderich, Monique Sykes's nine-year-old son became ill recently, rising from his sleep vomiting and with a fever of over 101 Fahrenheit. A severe asthma sufferer, he was at high risk of severe illness if he caught the flu.

"With his asthma, the flu represented a huge danger for us," Ms. Sykes said. "It was terrifying. We were extremely concerned."

The Globe on H1N1

Ms. Sykes and her husband took turns through the night keeping vigil over their son, and whisked him to hospital in the morning; although he'd received a flu shot, it had yet to take effect. He caught the flu and had to be prescribed Tamiflu and antibiotics.

The boy, an avid hockey and soccer player, recovered. But the flu's swift and merciless grip took an emotional toll on the family. The boy's 10-year-old brother was upset to see his younger brother ill. He, too, asked the mortality question.

"Is he going to die?" he asked his parents, his mother recalled.

Psychologists say most kids will cope fine with the flu outbreak, but others may be more affected by sick schoolmates and the recent flu-related deaths of two Ontario children. In extreme cases, some kids may even avoid going to school altogether.

The best solution, psychologists say, is cues from Mom and Dad.

"I would caution parents to be calm. If they are overanxious, children will pick up on that and they too will become overanxious," said Douglas Agar, president of the British Columbia Association of School Psychologists.

"Kids may not understand all the working of the flu virus," he said, "but they do understand that Mummy is a little nervous."

HELPING KIDS COPE

The Canadian Psychological Association urges parents to discuss the H1N1 flu and give their kids the chance to talk about their concerns.

"It is important to tell them the truth, to reassure them and to let them know that they can count on you and the adults around them," it says.

Parents of children who are frightened by reports of flu-related deaths should also stress that such cases are rare, and that health officials are working hard to contain the spread of H1N1.

Health workers suggest parents review hygiene practices with their kids. They should also be honest and factual about the flu. In the absence of facts, children may imagine situations far worse than they really are. Parents should also explain that most people who get sick will get better.

Ingrid Peritz

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