Monday, January 14, 2013


I am seeing on the news that the flu is really bad this year. What is the best way to protect my family and what should I do if my son or daughter gets sick?
Influenza, commonly referred to as the “flu”, is a very common virus that causes respiratory symptoms most often in the winter months.  On average, there are between 250,000-500,000 cases of influenza in children every year in the United States.  Of these children, up to 200,000 will be hospitalized because of influenza or complications from a flu infection. 
There are 2 main types of influenza which affect humans (types A & B).  Both types cause typical flu-like symptoms (see below) in children and adults.
Who gets the flu?
The flu can affect any age group.  Rates of influenza infection are typically highest in school-age children.
·         Groups of children and adults most at risk:
o   Children less than 2 years old.
o   Children and adults with chronic medical conditions – including asthma or diabetes.
o   Pregnant women.
o   Adults over the age of 65.
o   People who live with or care for someone who is in a high risk group (as above).
§  This includes all health care and day care workers.
·         Even healthy children and adults can become severely ill by the flu virus.
Influenza is spread via person to person contact (i.e. coughing or sneezing) or from indirect contact with contaminated surfaces.
·         The time from exposure to the virus until time where a person will typically start to have symptoms (incubation period) is around 1 to 4 days.
What are the symptoms of the flu?
=> Fever                             => Tiredness
=> Muscle pains                => Cough
=> Headache                     => Sore throat
=> Body aches                   => Runny nose
How can I protect my family from the flu?
Since influenza is so prevalent, especially during the winter months, avoiding contact with a person who has the flu (especially for children) is sometimes impossible.  Receiving a flu vaccine every year is the best way to protect yourself and your family.
·         Ways to prevent catching the flu:
o   Hand washing frequently with soap and water or alcohol based sanitizer.
§  Especially after touching surfaces in crowded/public areas.
o   Avoid close contact with a person who is coughing or sneezing (easier said than done).
o   Avoid touching your eyes and mouth without first washing your hands.
The flu vaccine should be a top priority for all members of the family who are eligible to receive it. 
There are 2 types of flu vaccine: one which is given via a needle injection (inactivated) and one delivered via nasal spray (live-attenuated).
·         Inactivated (killed virus) vaccine can be given to:
o   All persons over 6 months of age, including pregnant women and people with certain medical conditions such as asthma or diabetes.
·         The nasal spray flu vaccine can be given to:
o   Healthy* people between 2 to 49 years old who are not pregnant.
§  *Ask your physician if you qualify for a nasal-spray flu vaccine.
There are some children and adults who cannot receive a flu vaccine regardless of age.
·         Ask your doctor or pediatrician if you have any medical condition that  makes it unsafe for you or your child to receive a flu vaccine.
***Protect the infants around you who cannot be vaccinated by getting a vaccine for yourself and encouraging other family members to also get vaccinated.***
Can the vaccine give you the flu?
·         Neither vaccine causes the flu.  Low grade fever, discomfort, or muscle aches can occur from an injection with the killed virus.  The nasal spray vaccine, while it does contain a weakened (attenuated) influenza virus, does not cause the flu.
o   The nasal spray vaccine can cause mild reactions, but does not cause the severe symptoms that are often seen with an illness due to influenza.  Some of the possible side effects of the nasal spray vaccine include: cough, runny nose, fever, headache or mild muscle aches.
If my family and I get a flu vaccine, are we protected right away?
·         No, it typically takes about 2 weeks for your immune system to make antibodies to fight off an infection caused by the influenza virus. 
o   This is why it is important to get a flu vaccine as soon as possible each flu season.
o   Even if you do get a flu vaccine, it is possible to get sick with the flu after 2 weeks have passed.  Flu vaccines, depending on the year and types/strains which are most prevalent in your community, are usually between 60-90% effective.
§  Regardless of the vaccine not being 100% effective, it still should be given to all children and adults who qualify.
Is there a treatment for the flu?
There is medication, such as Oseltamivir (Tamiflu®), that can be used to treat a documented case of the flu.  This anti-viral medication is only effective if started within 24-48 hours of symptoms first appearing.  Since symptoms are many times mild to moderate in the first 24-48 hours, most people do not seek medical attention until it is too late for the medication to be effective.
·         Taking the medication, even if in the first 48 hours, does not mean that you will be healthy and feeling 100% overnight.  Children and adults who get the medication may feel less ill and have less severe symptoms then those who do not get the medication at all.  
o   Children and adults are many times still sick (albeit less severe) for the typical 5-7 day course of illness.
·         Certain groups of children should still receive the medication even if more than 48 hours have passed.  Some children should also receive medication even if they have been exposed (prophylaxis) to someone who has been diagnosed (by laboratory test) with influenza.
o   Consult with your pediatrician to see if influenza prophylaxis is right for your child if they are exposed to someone with the flu.
What should I do if my child has the flu?
·         Children with the flu or flu-like symptoms as above should be allowed to rest.
o   Missing a day or two from school is better then infecting the entire class and teacher!
§  Kids should return to school 24 hours after their fever has ended.
·         Encourage them to drink lots of fluids and have a regular diet.
·         Acetaminophen (Tylenol®) or ibuprofen can be used for pain or as a fever reducer.
o   Aspirin should never be given to a child for pain or fever.
·         Tips for cough.
·         A multivitamin (which should be taken every day) can also help to replenish lost vitamins and minerals as well as help aid your body in fighting an infection.
·         Chicken soup or warm tea with honey and lemon may also provide some relief (grandma was right again!).
·         Avoid spreading the flu to other family members, especially to those who are unable to be vaccinated!
o   Frequent hand washing.
o   Cover your mouth with a tissue when you cough or sneeze and wash your hands. immediately afterwards.
§  Don’t have a tissue? Cough or sneeze into your elbow, then wash your hands!
o   Avoid sharing cups and utensils.
When are flu-like symptoms the most worrisome?
·         Flu-like symptoms which should evaluated by a physician are:
o   Excessive tiredness.
o   Inability to drink liquids.
o   A child who is urinating less or having less wet diapers.
o   A child who was getting better and then gets suddenly worse.
o   Continued high grade fevers.
o   Difficulty breathing.
·         Every child should be seen by a physician any time a parent feels uncomfortable or concerned!
o   Always call 911 for an emergency.
For more information on the flu vaccine or influenza and other viruses which can mimic the flu, consult with your pediatrician.
For breastfeeding mothers, tips on breastfeeding while sick.
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