It is that time of year again, flu season. We are reprinting our blog about influenza in order to refresh your memory on what influenza is all about.

Influenza is an extremely common illness during the winter months, and is more commonly known as “the flu.” (Not to be confused with the stomach flu, which is also referred to as the flu by many people – the stomach flu is a separate illness). Influenza illness usually peaks in the winter months of January and February, but this can vary and there can also be more than one peak as different strains “come and go.” As of time of this blog, influenza has not yet peaked in our area. Symptoms of influenza most commonly include fever, cough, nasal congestion, sore throat, generalized achiness, fatigue, and headaches. Less commonly, nausea, vomiting, and diarrhea can occur. In addition, influenza can be a cause of croup and wheezing as well as pneumonia. Everyone is different and the combination and severity of the symptoms individuals get can vary significantly.

The majority of children will recover without any complications within 4-7 days. However, complications are not rare and can vary from mild (ear infections) to severe (brain inflammation and death). Although severe complications tend to happen more frequently in children who have various underlying medical issues, healthy children can also be affected. Contagiousness is highest during fever, but can continue even after the fever is resolved. However, most children are no longer contagious after 7 days from the beginning of the illness. Influenza is spread from person to person, most commonly by respiratory droplets from coughing or sneezing. However, influenza can also be transmitted by contact with contaminated surface. Illness usually will occur 1-4 days after exposure. Return to school is not recommended until your child is fever free for 24 hours.

For most children, treatment consists of what parents provide best, TLC! Fever reducers (acetaminophen or ibuprofen) can be used as needed. However, fever is the mechanism that helps your body fight off an infection, so reserve the use of fever reducers for “symptomatic” fever – when your child is significantly uncomfortable from the fever. In addition, do NOT use a combination of fever reducers. Use either acetaminophen OR ibuprofen, do NOT alternate these drugs every few hours as this can lead to serious side effects. Over the counter cough/cold medicines are not needed. In other words, they do NOT aid in the resolution of the infection. However, at times, they may provide some symptom relief, but should only be used in children 6 years of age and older. Diet can be as tolerated, but do not be surprised if your child does not want to eat. Do your best to encourage fluids in order to prevent dehydration. Although rest is encouraged, being up and about the house is perfectly fine as long as your child is feeling up to it. And, do not forget the most important thing – lots of hugs and kisses! (Yes, this will increase your exposure, but that’s what we get for being moms and dads!)

There are prescription medicines that can be used to treat Influenza. The most common one is Tamiflu. These medicines can reduce the duration of illness by 1-2 days and may reduce secondary complications. For these medicines to be effective, they should be started within 48 hours after the onset of symptoms. These medications are recommended for use in children that are at higher risk for developing complications. These types of children include all children less than 2 years of age and children with underlying medical issues (asthma, heart disease, diabetes, etc.). Although there is no contraindication to use these medicines in otherwise healthy children 2 years of age and older, in general they are not needed. The majority of children with Influenza do not need prescription medicines for the treatment of Influenza. If you think your child would benefit from these medicines, please discuss it with your physician.

As far as when your child should be seen in the office, here are a few guidelines:
1. Fever for more than 48 hours
2. Persistent sore throat for more than 2-3 days
3. Child is not drinking and urinating well
4. Any time that you feel your child should be seen or if you feel there may be a secondary complication

An emergency phone call is warranted under the following conditions:
1. Breathing difficulty
2. Severe headache and/or stiff neck
3. Altered mental status beyond general fatigue and not feeling good

Like any illness, prevention is the best form of treatment. The most effective way of preventing Influenza is the Influenza vaccine. Vaccination can be started as early as 6 months of age. There are two forms of the Influenza vaccine. The most common vaccine is injectable (a “shot”). The other type of Influenza vaccine is called “Flumist,” which is given intranasally. Flumist can only be used in children 2 years of age and older and cannot be used in children with certain underlying medical conditions (including asthma and immune deficiencies). Both vaccines are effective in preventing Influenza. Please discuss with your physician which vaccine is most appropriate for your child. Vaccination with Influenza vaccine is recommended in all children 6 months of age and older, unless there is a medical contraindication to it.

The injectable form of the vaccine is composed of “dead” Influenza virus particles. The main side effects are pain, redness, induration (hardness), swelling, and itching at the site of injection. Some people may experience fevers, headaches, and fatigue for a couple of days after injection. Although serious side effects have been reported, they are exceedingly rare – so rare that the risk of serious complications from the disease Influenza is far greater. You CANNOT get Influenza disease from the injectable Influenza vaccine.

The intranasal form of the vaccine is composed of “live” Influenza virus. However, this “live” virus is in an attenuated (weakened) state. The main side effects are mild sore throat, cough, and runny nose for a few days following vaccine. Although it is theoretically possible that this form of the vaccine can cause active Influenza disease, this risk is estimated to be so low that it should never happen.

Unlike most other vaccines that your children receive, the Influenza vaccine usually changes each year. The reason for this is that there are multiple strains of Influenza and these strains also can change year to year. As a result, experts predict which strains will cause problems for the next season and the vaccine that is made will provide protection from these strains. This prediction is not always 100% correct. The current Influenza season is one of these years as the strain that was hitting this area hard before the holidays was not the exact strain as in the vaccine. However, even in years when the strains do not match 100%, the vaccine can still provide some protection. In addition, most Influenza seasons have more than one circulating strain of virus, and while the vaccine may not match all of the strains, it may very well match other strains that are actively causing disease.

In addition to vaccine, general hygiene precautions can decrease the spread of Influenza. The main component of this is good hand washing. Also encourage your children to cover their nose and mouth when they sneeze and cough. Keeping your children away from other children until they are fever free for at least 24 hours will also limit transmission.

We hope this information is helpful. If you have any questions, please do not hesitate to call our office during regular business hours Monday – Friday. In addition, we encourage you to visit our website where there is a lot of helpful information on a variety of topics.

As always - be healthy!!




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