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What Every Parent Should Know About Influenza by Dr. Ashley Carter

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What every parent should know about Influenza
By Dr. Ashley Carter – Lake Murray Pediatrics


flupicThe facts

It is common knowledge that the influenza virus (flu) can make anyone feel terrible, but did you know that it can cause serious complications that can lead to death? Influenza is a virus that mostly affects the respiratory system, but may affect the whole body. Common signs of the flu include a sudden fever (temperature > 101⁰F), chills, body aches, headache, fatigue, sore throat, dry hacking cough, and congestion or runny nose, but vomiting and diarrhea may also occur. It is possible to get the flu more than once in the same year and many times during your life because there are multiple strains of the virus and they change from year to year.

The influenza season ranges from late summer/early fall to the spring. Flu seasons vary from year to year, but on average 20,000 children under 5 years of age are hospitalized yearly due to flu related complications. During the 2012-2013 flu season there were more than 150 flu related pediatric deaths reported. According to a report from the CDC in March of 2013, approximately 90 percent of the flu associated pediatric deaths during the 2012-2013 flu season occurred in children who had not received a flu vaccination during that season. A review of the flu associated deaths of people younger than 18 years of age from the 2012-2013 flu season showed that 60 percent occurred in the population of children who are at high risk for developing serious complications, but 40 percent occurred in children who did not have known chronic health problems.

flupic2Who is at greatest risk?

  1. Children younger than 6 months.
  2. Children between the ages of 6 months and 5 years old. In addition to the more than 20,000 hospitalizations related to the flu in children this age, children between the ages of 2 and 5 years are more likely than older children to go to the doctor, urgent care, or emergency room due to flu.
  3. American Indian and Alaskan Native children are more likely to have severe flu illness.
  4. Children with chronic health problems including:
    1. Asthma
    2. Neurological and neurodevelopmental conditions such as cerebral palsy, seizure disorder, mental retardation, stroke, moderate to severe developmental delay, muscular dystrophy, or spinal cord injury
    3. Chronic lung disease
    4. Cystic fibrosis
    5. Blood disorders such as sickle cell disease
    6. Endocrine disorders such as diabetes mellitus
    7. Kidney disorders
    8. Liver disorders
    9. Metabolic disorders such as inherited metabolic disorders or mitochondrial disorders
    10. Weakened immune system due to disease such as HIV or AIDS or cancer or medications in patients on chronic steroids
    11. Children receiving long-term aspirin therapy

Protecting your children: prevention

The CDC recommends that everyone 6 months of age and older get a seasonal flu vaccine. It is important to do this early during the season because it can take 2 weeks after vaccination for immunity to develop. If your child is younger than 6 months, you need to protect him by preventing flu in any caretaker. There are multiple different flu vaccines available for children including a trivalent and quadrivalent vaccine as well as an inactivated influenza vaccine (IIV) and a live-attentuated influenza vaccine (LAIV). The trivalent vaccine protects against 3 strains of influenza; influenza A (H1N1), influenza A (H3N2), and influenza B. The quadrivalent vaccine covers these three strains plus another influenza B strain. The inactivated influenza vaccine is given as a shot and is approved down to 6 months of age. The live-attentuated influenza vaccine is given as a mist sprayed in the nose and is recommended for healthy children 2 years of age and older.

The first time a child between the ages of 6 months and 8 years of age gets a flu vaccine, he will need a total of two doses of the vaccine at least 28 days apart. The first dose primes the immune system and the second dose provides the immune protection usually within 2 weeks. Talk to your doctor if your child who is younger than 8 years of age has never had a flu vaccine before or has not had one since the H1N1 pandemic in 2009 to determine the number of doses your child will need.

Few side effects have been reported with flu vaccines. Fever may occur in the first 24 hours after the vaccine, but this has only been reported in 10-35% of patients younger than 2 years of age and rarely in older children. The area where the flu shot was administered may be sore for 1-2 days after then injection. If your child was given the nasal mist they may have a stuffy or runny nose, mild headache, fever, or muscle aches for 1-2 days after the vaccine.

Children with history of mild egg allergy (i.e. hives) can safely receive the IIV in their pediatrician’s office. If a patient has a history of a severe egg allergy, a consultation with an allergist will be needed prior to administering the vaccine.

Flu is spread easily through the air with coughing, sneezing, or touching objects like toys or doorknobs that have been infected. Make sure that this season you protect your family with good hand washing, covering the cough with elbow or upper sleeve, and using disinfecting wipes. If your child exhibits any flu-like symptoms, you should visit his pediatrician right away for further evaluation and potential treatment.

 
Dr. Ashley Carter is a pediatrician with Lake Murray Pediatrics in Lexington. To find out more about this practice, please visit www.lakemurraypeds.com.

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1 Comment

  1. Heather

    October 14, 2013 at 10:58 am

    Cold and flu season can have an affect on more than just your general well being too. It can also affect your oral health! I recently wrote a blog about how the flu can affect your oral health, see it here: http://goodhealthstartshere.org/post/Snuff-Out-Sniffles-Colds-and-Your-Oral-Health.aspx.

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