What to do about the flu

By Janara J. Huff, MD

Janara J. Huff, MD specializes in pediatric infectious diseases at TC Thompson Children’s Hospital at Erlanger. She is also an associate professor of pediatrics with the UT College of Medicine Chattanooga. For more information, call Erlanger’s physician referral line at 423-778-LINK (5465).

It’s influenza season again, and this year we are worried not only about typical seasonal influenza, but also about the new “swine” flu, also known as novel Influenza A (H1N1).

So far the new strain of influenza A has not caused more severe disease than the usual types of influenza. However, no one knows the exact impact of the swine flu during the coming months.

Children

Children are very susceptible to influenza. Fortunately, most children recover from the flu in a few days without any treatment. Children younger than 2 years old and those with chronic medical conditions are more likely than other children to have a more severe course. Every year about 90 children in the United States die of influenza or its complications, and many more require hospitalization.

Symptoms

The symptoms of all types of influenza include fever, sore throat, runny nose, dry cough and muscle aches. Children often also experience vomiting and diarrhea. Signs of severe illness include rapid breathing, difficulty breathing, excessive tiredness or fussiness, other changes in behavior, and the inability to drink fluids because of weakness or vomiting.  Children with any signs of severe illness should receive medical help immediately.

Influenza and many other respiratory viruses are spread into the air when people cough or sneeze. Droplets from coughs and sneezes contain virus that infect other people when they breathe. Children should be taught to cover their noses and mouths with a tissue when they cough or sneeze to prevent infecting others around them. The airborne droplets from sneezes and coughs eventually fall onto surfaces where they remain infectious for several hours. Influenza virus can be picked up when you touch these surfaces and then infect you when you touch your eyes, nose or mouth.

Protection

One important way to protect yourself from influenza and other infections is to wash your hands frequently. Hand sanitizers that contain at least 60 percent alcohol are also effective for killing bacteria and viruses.

Immunization

Yearly influenza vaccination for everyone in your family is the best way to protect against the flu. The Centers for Disease Control recommends yearly influenza immunization for all children beginning at 6 months of age. Because children younger than 6 months of age cannot receive the vaccine, it is very important for everyone in their family to be immunized against influenza to protect these very young infants.

Other people for whom influenza vaccine is recommended include pregnant women and adults who live with or care for young children. Adults over 50, or those with any chronic medical conditions, also need vaccination. Influenza vaccine can be given as a shot or as a nasal spray.

This year children and adults will need to be immunized not only with the regular seasonal influenza vaccine, but also with a separate vaccine for novel influenza A. The regular flu vaccine is already in doctor’s offices and health departments. The vaccine for novel influenza A will be available in October. Like the regular flu vaccine, the novel influenza A H1N1 immunization is expected to be available both as a live vaccine in a nasal spray and as inactivated virus in a shot. It is not known yet whether children will require one or two doses of the novel influenza A vaccine.

Treatment

Your doctor will decide if your children need prescription medication to treat influenza should they become ill. The novel influenza A and most seasonal influenza types can be treated with the antiviral medications Tamiflu and Relenza.
Tamiflu comes in a liquid and tablet form and is used for children 1 year of age and older. Tamiflu is not routinely used in children younger than 12 months unless they have severe disease. Relenza is an inhaled medicine that can be given to children 7 years of age and older. Both of these medicines work best when started in the first 48 hours of illness.

Most children recover from influenza with just comfort measures such as plenty of fluids, fever control and cough syrup. Children should not be given aspirin or aspirin- containing products, but rather acetaminophen or ibuprofen for control of fever and pain.  Non-prescription cold medicines are also not recommended for children younger than 6 years old. Children who are not old enough to blow their noses can be made more comfortable by clearing their nose with a soft suction bulb.

Currently, schools plan to remain open during influenza season unless excessive absenteeism forces closure. School systems, however, have been advised by the CDC to send children and staff home immediately if they become ill during the day. It is important for children and adults who are sick with influenza to stay at home for the duration of their illness and not return to work or school until they have been fever-free at least 24 hours without the need for Tylenol or ibuprofen.

Health Department sets up flu hotline

The Chattanooga-Hamilton County Health Department has established an Influenza Public Information Hotline. Residents who have questions about vaccine, illness symptoms, medical care, prevention measures, or other issues related to both seasonal and H1N1 influenza, can call 209-8393 between 8:30 a.m. and 4 p.m. Monday through Friday.