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Influenza is an illness capable of affecting the entire respiratory tract from the nose and throat down to the bronchial tubes and lungs. It is caused by a group of 3 viruses (influenza A, B or C). Unfortunately these viruses keep changing from year to year (they shuffle their genes like a deck of cards), forming new outer coats which our immune system can’t recognize. This means that even if you or your child has had influenza in the past, this year’s virus may be different enough to infect either of you again.
Influenza spreads very readily by direct contact with nasal mucus
from an infected person, or by inhaling droplets coughed or sneezed into
the air. The virus is
fragile and doesn’t survive for long in the air or on surfaces of
furniture, kitchen or bathroom facilities.
Illness usually begins 1 to 3 days after exposure. The Illness: A typical case of
influenza in older children and teenagers consists of sudden onset of
chills and fever, headache, body aches, sore throat and a dry hacking
cough. The worst of the
illness lasts from Preschool children tend to have an illness more like a severe cold with a high fever (often over 103 degrees Farenheit), runny nose and cough, typically accompanied by irritability and poor appetite. Some infants develop a hoarse cry and a “barking” cough (croup). Diarrhea and vomiting may also occur, however these are less often the major symptoms. The “stomach flu” (vomiting and diarrhea without these other symptoms) is not usually from influenza, and is a term often misused for any form of upset stomach, usually from other viruses. Young children usually feel better in 3 to 5 days although cough may linger for another 1 to 2 weeks. Not all flu is severe. Even in the same family, one child may be very sick while another has only a mild illness with stuffy nose and cough but no fever. You should call our office if you feel frightened or worried about your child’s illness. Call our office immediately if your child has: difficulty breathing (this may consist of sucking in on the chest with breathing, flaring out of the nostrils with breathing or breathing faster than normal especially when they do not have a fever); a bluish tinge to the lips; vomiting the continues for several hours; severe lethargy. Call us during regular office hours (or on weekends) if your child: complains of an earache or, in an infant, pulls at the ears, becomes increasingly cranky or keeps waking at night; develops a deep cough with lots of mucus; has a fever (over 100 degrees Farenheit) lasting for more than 4 days. For relief of pain and temperature of 102 F or higher, it is advisable to give acetaminophen (Tylenol, Tempra, Panadol, Liquiprin) or ibuprofen (Motrin, Advil). Ibuprofen lasts a little longer and may be a little stronger than acetaminophen but can upset the stomach so is best taken with at least a few crackers. Aspirin (acetylsalicylic acid) or any cold medicine containing aspirin (Excedrin, Anacin, Pepto Mismol) should be avoided in children with influenza virus. It can lean to a serious illness known as Reye syndrome and lead to brain and liver damage. Be sure to read the label on any over-the-counter remedies you purchase. Mist from a humidifier or vaporizer may help the cough (we prefer cool mist humidifiers so that they don’t spill and burn a child). It is best not to give strong cough medicines that can keep your child from bringing up mucus in the chest. Your doctor may recommend treatment, however, if the cough continues and is dry. Antibiotics are not needed for most children with influenza. They should be used only if your child develops a complication such as an ear infection, sinus infection, bronchitis or pneumonia. That is why you should check with your doctor if a fever hasn’t gone away after 4 days or if a fever had been getting better and is again much worse. Flu usually takes away a child’s appetite, so don’t expect him/her to eat much for the first few days. Encourage fluids aggressively, however, especially when fever is present. Any juice or soft drink your child likes is acceptable. Active play can make a cough worse. Although children generally restrain themselves quite well, quiet activities are recommended, at least during the early stages of the illness. Contagion: The flu is highly contagious and spreads so rapidly that it is difficult to stop. Older children should be encouraged to cover their mouth and nose when they cough or sneeze, use tissues for cleaning their nose and wash their hands afterwards. Sick children should be kept away from elderly persons and anyone with a chronic illness that might increase the risk of complications. A vaccine to prevent influenza is encouraged for all children and especially those between 6 months and 23 months old as well as those with special “high risk” conditions. If your child has cancer or chronic disease of the heart, lungs, kidneys or nervous system, or if s/he has asthma, diabetes or anemia, speak with your doctor to see whether it would be advisable to start yearly influenza shots. In addition, if anyone in your household is 65 years or older, or under 2 years old or falls into a “high risk” category, the whole family should receive the flu vaccine yearly to reduce the chance that one of you will carry the virus home. Because of the increased attention given to influenza this year by the news, there is a nationwide flu vaccine shortage currently. However, you are welcome to call our office to see if we have any vaccine currently if you are interested in having your children vaccinated. Another option for healthy people between 5 and 49 years old (i.e. without asthma or other chronic diseases) is the new Flu mist vaccine which is administered by nasal spray instead of as an injection. However, since it is a new vaccine, it is usually not covered by insurance but may be purchased for those who are interested.
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