Influenza

Influenza or “true flu” is a viral disease common in winter months. Adults use the term as a general description for many combinations of symptoms. I always ask parents to explain the symptoms. When “flu” appears, epidemic numbers of children and adults are affected. Type A virus is the most common strain, but during some years, Type B strain will occur. A second illness can occur in the same season, giving the false impression of a relapse. When ,in fact, the second illness is caused by a different strain of virus. H1N1 (Swine Flu) a new varient arrived in 2008 and has caused infection at times not typical for seasonal flu. There have been cases described in the Sprng and Summer which is not expected for normal seasonal type A influenza.

The virus takes about 2 to 3 days to develop before your children will show any symptoms. Older children can become ill quickly with fever, flushed face, chills, headache, muscle ache and fatigue. Temperature from 102° to 105° are common. Dry cough, runny nose and eyes appear early in the illness. You will notice sore throat and teary, burning, achy, light sensitive eyes. Up to 1/3 of children will have some diarrhea.

In younger children, the symptoms can be more severe, with a high degree of secondary infections like pneumonia, sinusitis or ear infections. Flu can mimic other illnesses like croup, bronchiolitis, pneumonia or bronchitis. Severe complications like Reye’s syndrome (a rare condition leading often to death or brain injury) can develop when aspirins are used instead of Tylenol™. I do not recommend the use of aspirin during influenza season when respiratory illnesses are more common.
For mother who are suspected of having the seasonal or H1N1 influenza and nursing babies, they should use good hand washing and may need to wear a mask when nursing. See CDC report

“Flu” or influenza can be prevented by taking a series of one or two vaccine doses depending on age and history of previous vaccine, starting in early fall. I recommend flu vaccine for children between 6 months and 18 years, especially if there is a history of chronic illness like severe asthma, heart disease or diabetes.

A drug called amantadine hydrochloride or Symmetrel™ has been shown to help prevent influenza A and was also used to treat the illness. Unfortunately there is evidence that these medications are no longer very effective as a few years ago. Other medications are available like Tamiflu but have not been shown to prevent the disease, kill the virus or markedly reduce complications. Tamiflu may shorten the symptoms of the infections but often only shorten it 1-2 days. If you suspect your child has influenza and there is a worsening cough or persisting fever beyond 2-3 days, contact my office to schedule an appointment (School notes are only written when the patient is seen in the office). If your child has influenza, most will recover with home care without other medications. Antibiotics don't help unless there is evidence of a secondary infection. CDC recommendations for school return would be after 24 hours of fever free and markedly reduced cough or other symptoms.