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Ask the Expert

The Dreaded Flu

Don't sneeze at the flu!
This year’s influenza arrived earlier than usual, resulting in widespread, even epidemic levels of influenza throughout the country. Most experts expect the flu season will last until the end of March or beginning of April. Reports about the epidemic have been discussed on the news and most of us know at least one adult or child who has been kept home ill with the infection. In the Suburban Hospital Pediatric Emergency Center, we have seen a huge increase in volume with this recent wave of influenza.  Taking the following precautions can help decrease your risk of contracting the illness. 

How do you know it is the flu? 

For most people, influenza causes a week or more of discomfort.   In children, symptoms generally include fever, chills, body aches, sore throat, cough and nasal complaints such as stuffed or runny nose.   Occasionally, kids can also have vomiting and/or diarrhea.   The main symptoms that differentiate the flu from a common cold are the presence of fever (usually over 101 degrees) and body aches.

Wash your hands, wash your hands, and wash your hands!

As reports of influenza cases continue to escalate, many people have been asking about what they can do to keep themselves healthy.   The best protection against the infection is getting a flu shot.   At the time of this writing, this year’s vaccine is still available and can be effective in preventing this season’s influenza.   While no vaccine can provide 100% protection against an illness, the influenza shot provides good protection and if someone vaccinated does contract influenza, s/he may end up with a milder case of the disease due to some partial protection of the shot.   It should be emphasized that the strains of influenza change each year and that a new vaccine is needed annually in order to confer protection against the infection. 

In addition to getting a flu shot, parents and kids can also employ strategies to minimize their chance of getting or spreading the flu.   In particular, hand washing should be performed regularly.  The actual washing with soap should last about 20 seconds.   If your access to a sink is limited, then alcohol based hand sanitizers also help to reduce spread of influenza.   Other techniques include:

                 ·         Encouraging family members to cover the coughs and sneezes (and doing so into their elbow rather than their hands)

Avoiding sharing cups, utensils etc at school

                 ·         Keeping one’s hands away from his/her face

Discarding used tissues into a garbage can

Stay Away from Aspirin if Your Child Has the Flu

Even with the best preventive practices, it is possible that a child or family member may contract the influenza illness.  If this happens, one can generally expect a week or so of fever and discomfort.  Treatment generally consists of rest, fluids and fever reducers such as ibuprofen or acetaminophen.  Remember that giving a child aspirin is contraindicated when they have the flu as it can lead to a serious illness known as Reye Syndrome.  In some instances, anti-viral medications may be employed as a way of minimizing influenza symptoms and you should call your family’s physician to ask if this is the appropriate.

While it seems that treatment for influenza generally involves rest, fluids and fever reduction, many parents may wonder when it would be appropriate to bring their child either to the pediatrician or to the emergency room.  If you notice the following signs or symptoms, an urgent medical evaluation is indicated:

·         Fever in an infant less than 3 months of age

·         Difficulty breathing

·         Looks extremely ill or lethargic

·         Cannot drink or has no urination in 8 hours

·         Is not showing any signs of improvement after 3-4 days of fever

This list is by no means exhaustive.  If you have any questions or concerns, you should call your pediatrician’s office.   In addition, if your child appears to demonstrate any other unusual symptoms such as ear pain, facial pain, strange rash, etc., you should contact your pediatrician.

When is it OK to send the kids back to school?

Of course, one of the most important questions that we get in the Pediatric Emergency Center is “When can my child go back to school?”    As opposed to the common cold (during which children frequently attend school), children with influenza must be kept out of school or day care to improve their healing and prevent spread of the infection to classmates.   A child or adult should be fever-free (without any use of ibuprofen or acetaminophen) for at least 24 hours prior to returning to school or work.

And when in doubt about the flu, consulting with your pediatrician is always recommended.   More information regarding this can be found at www.healthychildren.org.

David Reitman, M.D.
Medical Director
Suburban Hospital Pediatric Emergency Center

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