Influenza (Flu) – Seasonal Type

Definition

Influenza is a viral infection of the nose, throat, windpipe, and bronchi.  The main symptoms are a cough, sore throat and runny nose.  Usually there’s more muscle pain, headache, fever, and chills than seen with the common cold.

Cause

Flu is caused by influenza viruses.  Flu viruses change yearly, which is why people can get the flu every year.  It spreads rapidly because the incubation period is only 2 days.

Diagnosis:  How to know that your child has influenza

If influenza is widespread in your community and your child has flu symptoms, then he or she probably has flu.  You don’t need to get any special tests.  You don’t need to call or see your child’s doctor, unless your child is HIGH-RISK (see #6) or develops a possible complication of the flu.

How to treat Seasonal Flu

The treatment of flu depends on your child's main symptoms.  It’s no different from treating symptoms of the common cold.  Bed rest is not necessary, but it is important to avoid other people to decrease the spread of disease.  Antibiotics are not helpful.

1.      Fever or aches

Give acetaminophen (Tylenol) or ibuprofen (Advil or Motrin if over 6 months of age) for fever over 102°F (39°C) or for any pain.  Children and adolescents should never take aspirin unless prescribed by a physican/nurse practitioner.

2.     Cough

For children over age 6 years, give cough drops.  If your child is over 1 year of age, give honey (1/2 to 1 teaspoon as needed).  Never give honey to babies.  If honey is not available, you can use corn syrup.  Drugstore cough medicines are not as helpful as honey and they are not approved for children under 4 years old.

3.      Sore throat

Tylenol or ibuprofen (over 6 months of age) is very helpful for throat pain.  Children over 6 years old can suck on hard candy.  Children over 1 year old can sip warm chicken broth or other warm fluids.

4.      Stuffy or blocked nose

Saline (or warm-water) nose drops followed by suction (or nose blowing) will open most blocked noses.  Use these “nasal washes” whenever your child can't breathe through the nose.  You can buy saline spray without a prescription.  Saline nose drops can also be made with this recipe.

5.      Antiviral medicine (such as Tamiflu)

The American Academy of Pediatrics and the CDC recommend antiviral medicines be prescribed for all HIGH-RISK children (see #6) who come down with flu.  Most children with influenza do not need antiviral medicine unless they develop serious symptoms (such as pneumonia).  Antiviral medicines must be started within 48 hours of the start of flu symptoms to have an effect.  They usually reduce the time your child is sick by 1 or 2 days.  They improve the symptoms but do not eliminate them.

We at Pediatric Partners are fearful that overuse of Tamiflu will cause resistance of the influenza virus to virus fighting medications, therefore lending them ineffective to the most sick people.  We will only use Tamiflu for the sickest and most at risk patients.

6.      HIGH-RISK children for complications

The following children are at higher risk for complications from flu:  lung disease (such as uncontrolled asthma), heart disease (such as a congenital heart disease), weak immune system (such as cancer), diabetes, sickle cell disease, kidney disease, diseases requiring long-term aspirin therapy, other chronic diseases, pregnant teens.

7.      Expected course

The fever lasts 2 to 3 days, the runny or stuffy nose 1 to 2 weeks, and the cough 2 to 3 weeks.

Prevention of Seasonal Flu

• Flu shots:  Yearly flu shots are the best way to prevent influenza and are recommended for all children over 6 months of age.

• Preventing spread to others:
• The virus is spread by sneezing, coughing and hand contact.  Cover the nose and mouth with a tissue when coughing or sneezing.
• Wash the hands frequently.
• Stay home when sick.  This includes avoiding the doctor's office unless severly sick or high risk, as stated below.
• Your child may return to child care or school after the fever is gone for at least 24 hours. 

Call your child's doctor or go to a local pediatric urgent care center or emergency department NOW (night or day) if:

• Your child looks or acts very sick
• Breathing becomes difficult or fast
• Dehydration occurs (no urine in 12 hours, dry mouth, no tears)

Call your child's doctor during the day if:

• Your think your child needs to be seen
• Your child is in the HIGH RISK group
• Earache or sinus pain occurs
• Fever lasts more than 3 days
• Cough lasts more than 3 weeks
• Your child becomes worse