The staff and providers at After Hours Pediatrics would like to remind you that influenza (flu) season has arrived!
We are seeing increasing numbers of children with both Influenza A and Influenza B.
Although the flu vaccine is only about 70% effective (on average), it can help prevent complications such as pneumonia and reduce the seriousness of symptoms in those who were vaccinated but still get the flu. Last year 100 children with influenza in the US died. Eighty per cent of those children had not been vaccinated for the flu.
Getting the flu vaccine not only helps prevent flu in the child getting it, but also helps keep those around the child from catching the flu. The American Academy of Pediatrics recommends that all children 6 months and older get the flu vaccine annually. All adults should also get the vaccine.
New recommendations state that patients with egg allergies should get the flu vaccine but it should be administered in a doctor’s office setting where the child can be watched for at least 30 minutes and be treated immediately for any allergic reaction. The first time a child gets the vaccine, two shots are given one month apart. The vaccine, which is slightly different every year, is recommended once every year just before the flu season starts and may also be given during the season. The nasal flu mist vaccine is NOT recommended, as the effectiveness in recent years has been unacceptably low. It takes about two weeks for the vaccine to become effective.
The symptoms of influenza may include fever that’s difficult to control and which can last for up to about seven days, fever, cold symptoms and cough, sore throat, red eyes, headache and muscle aches. Influenza B in particular can cause stomach pain, nausea, vomiting and diarrhea. There are many other viral infections that can cause similar symptoms, but not usually all at once.
The flu is very contagious and is particularly dangerous to the very young and very old, anyone with a chronic disease such as asthma/reactive airways disease and anyone with a weakened immune system. People with the flu can be contagious for up to about a week, meaning that children may miss a lot of school or daycare and parents may not be able to work in order to stay home with their children while they’re sick.
A flu test is NOT necessary for your child to be diagnosed with influenza. Physicians and other providers have been encouraged by the Centers for Disease Control to make the diagnosis and treat based on the child’s history of illness and physical exam. The influenza test has a history of being negative in significant numbers of patients who had the flu, as diagnosed by other, more sophisticated, tests. A negative flu test does NOT mean your child doesn’t have the flu. On the other hand, if the test is positive, your child DOES have the flu. If your child has flu-like symptoms, discuss with your provider whether or not he or she should be treated with oseltamivir for the diagnosis of “influenza-like illness”.
Oseltamivir (Tamiflu), a medication given by mouth, is sometimes helpful in reducing the amount of sick time, the length of the contagious period, and the intensity of some of the symptoms; however, it is most effective when given within the first 48 hours of symptoms. In some people with the flu, oseltamivir significantly reduces sick time. In others, it may seem to have no effect at all. Stomach pain and vomiting are frequent side effects.
Because there’s no guarantee that oseltamivir will work, because it’s expensive and because it can have significant side effects, your provider may not recommend the medication unless your child is at risk of complications of the flu or if there are others in your household who are at risk of complications if they catch the flu from your child.
At its worst, influenza can be a fatal disease, especially for the very young, the very old and people with chronic health problems. At best, it causes days-worth of misery and school and work absences. Please consider vaccinating your entire family on a yearly basis, not only for their health but also for the health of those around them. If you have questions or concerns, please talk to your primary care provider (PCP). Although AHP does not offer flu vaccinations, we will be happy to see your child if you think they may have the flu and you can’t get in to see your PCP.
Dr. Lou Romig, Medical Director, After Hours Pediatrics Urgent Care