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Preventing the flu: 2013
last updated:
Fri, 1/04/2013 4:22 PM

The Emergency Department (ED) at Le Bonheur Children’s Hospital is seeing a large number of patients with flu-like symptoms. Le Bonheur wants to help you protect your child. Jon McCullers, MD, Le Bonheur’s pediatrician in chief and chair of Pediatrics for The University of Tennessee Health Science Center, answered some common questions parents might have about the flu.

What is seasonal flu?

According to the American Academy of Pediatrics, seasonal flu is a contagious respiratory illness caused by flu viruses. It spreads between people and can cause mild to severe illness.

What can I do to protect my children?

The flu vaccine is the best protection against the flu. Proper hand hygiene and good cough etiquette are also critical. Encourage your children to wash and sanitize their hands frequently. Cover all coughs and cough into your sleeve.

How can I treat flu symptoms at home?

If you suspect your child has the flu, call your pediatrician. There are anti-viral medications that can be prescribed by your doctor, but these medications are most effective when given early in the course of illness. To relieve your child’s pain and symptoms, first, administer fluids and make sure your child is getting plenty of rest. Acetaminophen helps with the aches, pains and fever reduction.  To protect others, keep your child home for 24 hours after the fever goes away.    

Is it too late to get the flu vaccine?

No. The shot can protect children to some effect as early as seven days after the vaccine, although full protection takes two to three weeks. Thus, a flu shot now can protect during this outbreak.

Should my child receive the shot (injection) form or the nasal spray form of the flu vaccine? 

In general, healthy children and adults ages 2-49 years of age may receive either the injection or the aerosolized (nasal spray) version of the vaccine.  Children ages 6 months to 2 years (and adults 50 years of age or older) should receive the injectable vaccine, as should children and adults with underlying medical conditions.

Is my child protected from this flu outbreak if he/she received a flu vaccine last fall?

Yes. The vaccine offered now and protects against approximately 95 percent of all flu viruses.

When should I seek emergency medical treatment for my child?

Uncomplicated flu (fever, cough, sore throat, muscle aches, generally feeling sick) can and should be diagnosed by your child’s pediatrician, rather than the ED. The ED can help deal with complications of the flu, including severe dehydration, febrile seizures from the flu, and infections of the brain or lungs. Pneumonia, when the disease moves to the lungs, can either be viral or result from bacteria complicating the flu infection.

How much longer could this flu outbreak continue?

It varies from year to year. Eight to 12 weeks would be typical, and of course a second wave from a different strain could occur later or even overlap this outbreak.

Germs Galore!
last updated:
Thu, 12/13/2012 5:06 PM

Le Bonheur’s very own molecular lab just got a bit more famous. Nationally recognized experts Anami Patel, Ph.D. and John DeVincenzo, M.D. lead the lab, and recently talked with Fox13 Health Reporter Sarah Blue about the germs and viruses circulating in our community and testing them in our lab.

Le Bonheur’s Molecular Lab currently conducts tests for all leading causes of childhood illnesses, including RSV and Influenza A and B. In the fall of 2009, we also tested specifically for H1N1 influenza, ensuring Mid-South children received timely and appropriate care. The Le Bonheur Molecular Lab also serves as a reference lab for several Mid-South hospitals and physicians – offering its cutting-edge molecular technology to the entire community - not just children. Take a minute to see what germs are floating throughout our community.

Flu is Here - Not too late for vaccine
last updated:
Tue, 12/04/2012 5:52 PM

This year's flu is in full swing sending lots of kids to the hospital. We talked to Dr. Jon McCullers, pediatrician in chief at Le Bonheur Children's Hospital. Here's what he had to say.

We are seeing an influx of children with the flu in our Emergency Department. Symptoms are cough, sore throat, fever and body aches. The onset of this year’s flu is mostly concentrated in Tennessee and throughout Texas.

The strains are covered by the vaccine, and it is not too late to get vaccinated. The vaccine is your most important weapon as we enter flu season. It’s quick and easy, as well as safe and effective. In general, healthy children and adults ages 2-49 years of age may receive either the injection or the nasal spray version of the vaccine.  Typically, the nasal spray seems to work best in the younger population from around the ages of 2 to 7. That’s because those kids haven’t typically been exposed to the flu yet, and the spray seems to benefit that particular age group’s immunities.

The best means of prevention is good hand hygiene – wash hands or use hand sanitizer, cough into your sleeve and stay away from sick people and crowds. There are good antiviral treatments available from your pediatrician, and it is particularly important for children with underlying illnesses such as asthma, seizures, lung heart or kidney disease, diabetes and others to get to the doctor early to prevent the infection from getting worse.

Flu Spray or Flu Shot?
last updated:
Thu, 10/25/2012 5:04 PM

We've had many inquiries from parents recently about whether they should have their child vaccinated with the flu shot or the flu mist. Because the key component to flu prevention is getting your child vaccinated, we talked to Dr. Jon McCullers, chief of Pediatrics at Le Bonheur Children’s Hospital. Here’s what he had to say.

“First off, the thing parents have to remember is that vaccination is their most important weapon as we enter flu season. It’s quick and easy, as well as safe and effective. I get asked quite often which one is better, although there is not one that is technically 'better' than the other.

In general, healthy children and adults ages 2-49 years of age may receive either the injection or the nasal spray version of the vaccine.  Typically, the nasal spray seems to work best in the younger population from around the ages of 2 to 7. That’s because those kids haven’t typically been exposed to the flu yet, and the spray seems to benefit that particular age group’s immunities.

The main message I want to relay to parents is just get vaccinated;the flu is preventable. Whether you decide to do the spray or the shot, you and your family will be protected from getting an illness that causes a lot of discomfort and can lead to other things if not treated. Both forms of the vaccine are available at your pediatrician’s office or local drug store. If you've got other questions or concerns, talking to your pediatrician is best."

Get The Flu Shot
last updated:
Thu, 10/11/2012 2:46 PM

For many kids, getting a flu shot might be a source of anxiety. We talked to pediatrician Dr. Katie Alvord about what parents can do to ease those fears. Here’s what she had to say:

“Vaccines and injections can cause a great deal of anxiety in children.  However, parents can play an important role in decreasing the anxiety and anticipation of pain that accompanies the idea of receiving a shot.

Be honest with your children if they are asking about why they have an appointment and if there will be shots. Furthermore, never threaten your child with a shot or use it as a punishment for not behaving. Your child might not be at an age to understand that vaccines are one of the greatest advancements of modern medicine. Explain that you love and care for them and, as a result, want to protect them from this disease.

Usually the anticipation and anxiety are far worse than the actual injection.  Be at their side, and comfort them after the injection.  If you can provide distraction, try that.  If you are breastfeeding your child, nurse him or her immediately afterward or during administration of the shot. The good news is that it's over quickly. 

For some kids, a nasal influenza vaccine is available. Ask your doctor if your child is eligible to receive it.  Although there may be some discomfort in the short term by vaccinating your child, you are providing long-term protection from serious disease.” 

Flu Vaccine: 2012 Guidelines
last updated:
Fri, 9/21/2012 11:15 AM

Recommendations for this year’s flu season urge parents to get all children ages 6 months and older vaccinated against the flu. Updated guidelines were published Sept. 10 in Pediatrics, the journal of the American Academy of Pediatrics (AAP).

Those who regularly care for a young child are especially encouraged to be immunized, the guidelines state. Children ages 2 years and younger are considered at high-risk for influenza-associated hospitalization. Other high risk groups include:

  • Children who have medical issues like asthma, diabetes, suppressed immune systems or neurologic disorders
  • Women who are pregnant, have just delivered or are breastfeeding

Here’s what you need to know about the flu vaccine this year, as outlined by the AAP:

  • For children 6 months or older, the vaccine can still be delivered via an injection.
  • Kids 2 years old or older can receive the nasal spray version.
  • If your child is between the ages of 6 months and 8 years and has received at least two does of the fly vaccine since July 1, 2010, he or she only needs done dose of the vaccine this season.
  • Children in that age group (6 months-8 years) who have not received two or more doses in that time frame need two doses of this year’s vaccine.

For more information about the flu vaccine, visit the AAP’s website or consult your child's pediatrician.

Parents, Don't Dismiss the Flu Yet
last updated:
Wed, 2/29/2012 12:16 PM

As spring is fast approaching, so is a round of influenza. The Emergency Department (ED) at Le Bonheur Children’s Hospital has been extremely busy, seeing more than 300 patients a day with flu-like symptoms. We talked to Dr. Jon McCullers who was recently appointed as Le Bonheur’s pediatrician in chief and chair of Pediatrics for The University of Tennessee Health Science Center. He answered some common questions parents have about the flu.

Is it too late to get the flu vaccine?
No. The shot can protect children to some effect as early as seven days after the vaccine, although full protection takes two to three weeks. Thus, a flu shot now can protect during this outbreak.

Is my child protected from this flu outbreak if he/she received a flu vaccine last fall?
Yes. The vaccine offered now is the same as last year's and protects against approximately 95 percent of all flu viruses. 
 
When should I seek emergency medical treatment for child?
Uncomplicated flu (fever, cough, sore throat, muscle aches, generally feeling sick) can and should be diagnosed in outpatient settings, such as pediatric offices. Treatment and advice on care for the flu are also most appropriately delivered by primary care physicians. The ED can help deal with complications of the flu, including severe dehydration, febrile seizures fom the flu and infections of the brain or lungs. Pneumonia, when the disease moves to the lungs, can either be viral or result from bacteria complicatings the flu infection.

What can parents do to protect their kids?
The flu vaccine is the best protection against the flu. Proper hand hygiene and good cough etiquette are also critical. Encourage your children to wash and sanitize their hands frequently. Cover all coughs and cough into your sleeve.

How much longer could this flu outbreak last?
It varies from year to year. Six to eight weeks would be typical, and of course a second wave from a different strain could occur later or even overlap.

Vaccines: New Changes Released
last updated:
Thu, 2/02/2012 5:46 PM

All 11- or 12-year-old boys should now receive the HPV vaccine in a three-dose series, America’s pediatricians said this week.

The recommendations are part of new vaccine guidelines released by the American Academy of Pediatrics (AAP) and include three major changes to your child’s previous vaccine schedule.

  • The HPV guidelines were extended to include boys. The AAP already recommends girls receive the vaccine, which protects against human papilloma virus. The HPV-virus can cause cervical cancer in women.
  • Children as young as 9 months old should receive the meningococcal vaccine if they live in or travel to countries with epidemic disease or are at an increased risk of developing meningococcal disease. Routine meningococcal vaccination should begin at 11 or 12 years. Sixteen-year-olds should be given a booster dose.
  • Children ages 6 months to 8 years of age should get two doses of the flu vaccine this season (2011-2012) if they did not receive at least one dose of the flu vaccine last season (2010-2011). Those who did receive a dose last season only need one dose this year.

Read the full vaccine recommendations from the AAP.

Antibiotics: When to Use
last updated:
Thu, 12/22/2011 12:41 PM

We asked Le Bonheur Pharmacist Kelley Lee, PharmD, to talk about a popular subject this time of year: antibiotics. See what she says about this type of drug below.

All parents hate to see their children suffer during a sore throat, cold or flu.  We’d all like a drug we could use to quickly make our child feel better.  Antibiotics are too often used to provide this relief.  Most minor infections such as colds, flu, coughs, runny nose, most sore throats (excluding strep throat) and some ear infections are caused by viruses.  Although bacteria and viruses are both types of germs that cause diseases in children, antibiotics only work when used for infections caused by bacteria.

Shouldn’t I use an antibiotic “just in case?” There’s no harm in using an antibiotic, is there?

While antibiotics are truly “wonder drugs,” they should only be used when an infection is likely caused by bacteria.  Antibiotics can cause serious side effects.  While most common side effects are mild such as nausea, vomiting, diarrhea and headache, these effects can cause discomfort in all children and may lead to more serious problems in certain children. Not all side effects from antibiotics are mild.  Antibiotics can cause severe diarrhea, blistering rashes, liver and kidney problems and other serious illnesses. 

Most people have heard from the media about “super bugs.”  “Super bugs” are bacteria that have become resistant to commonly used antibiotics.  No antibiotic will get rid of all bacteria.  Every time an antibiotic is taken the bacteria that are sensitive to that antibiotic will be killed, but bacteria that are resistant will remain. This can be a problem for several reasons.  In some people these resistant bacteria may grow and cause other problems like severe diarrhea.  Even if these resistant bacteria don’t cause a problem immediately, they can become more common in the person who has taken the antibiotic, causing the antibiotics not to work next time.  The more antibiotics a person takes, the more likely they will get an infection from resistant bacteria. Resistant bacteria can also be spread to classmates, family and friends. 

If I shouldn’t give antibiotics for these mild childhood infections, what can I do to make my child feel better?

Getting plenty of rest and drinking plenty of fluids are two of the most helpful ways to make your child feel better.  Viral infections will usually go away within seven to 10 days.  Antibiotics will not speed up the process.  Saline nasal sprays or using a humidifier in the child’s bedroom can help stuffy, congested noses.  Breathing steam from a warm shower can also help.  Cough drops (for older children only) or throat sprays can help a sore throat feel better.  Over-the-counter products such as acetaminophen can be used for mild fever or pain, but always read the package or consult with your doctor or pharmacist to be sure the correct dose is used.   The best treatment is prevention:  children older than 6 months of age should get a flu shot each year, and remind children to wash their hands.

How can I help prevent antibiotic resistance?

The best thing parents can do to prevent antibiotic-resistant infections in their children is to only use antibiotics for infections caused by bacteria.  Parents should not ask for a prescription for antibiotics for colds and flu.   When antibiotics are prescribed for an infection caused by bacteria, give your child the entire amount prescribed.  Giving doses that are too small for short lengths of time can cause bacteria to become resistant.

 

Seasonal Sniffles
last updated:
Thu, 12/08/2011 5:44 PM

We've posted about this topic before, but thought it was a good time for a reminder. At some time or another, we’re all going to come down with the sniffles, our kids included. Between the runny noses, cough and fevers, it’s tough for parents to know when their child has more than a common cold. But don’t worry. The experts at Le Bonheur Children’s Hospital have tips on identifying and preventing more serious ailments.

Bronchiolitis
Bronchiolitis is an infection caused by a virus typically seen in children 2 years of age and younger. Its symptoms include wheezing, coughing and chest congestion, vomiting and a low-grade fever (less than 101 Fahrenheit). A child may take a longer time to eat with the infection.

The most routine care for bronchiolitis is to treat the symptoms. Parents are encouraged to frequently wash their own hands and their child’s hands, keep their child’s nose cleaned out, encourage their child drink more fluids and control fever. Your child may need medicine for wheezing.

Dr. Barry Gilmore, medical director of Emergency Services at Le Bonheur Children’s, says parents should call or see a doctor if your child has difficulty breathing, is unable to eat or drink or has signs of dehydration. Dehydration signs include dry skin, dry mouth, a lack of tears, and lack of wet diapers or use of the potty.

Le Bonheur Children’s recommends parents seek emergency care if the child’s neck, chest or ribs sink deep when breathing, if the child has trouble breathing or stops breathing, turns blue around the mouth or fingernails, has less than three or four wet diapers per day, or has trouble feeding after suctioning the nose.

Bronchiolitis is caused by a number of different viruses, including respiratory syncytial virus (RSV).

Respiratory Syncytial Virus
RSV is a common winter virus that attacks the lining of the airways and lungs. Dr. John DeVincenzo, a leading investigator in the treatment of RSV, is based at the Children’s Foundation Research Center at Le Bonheur Children’s. He says the virus infects all age groups, but infants younger than 1 year of age are most severely infected. It is the most common cause of pneumonia in infants and the most common cause of hospitalization in infants. In fact, about 3 percent of all babies younger than 1 year of age are hospitalized for RSV infection.

Early signs of RSV infection are the same as a common cold – runny nose, sneezing and mild cough. However, RSV often turns into a deeper cough and causes difficulty breathing by the second or third day of runny nose.

“It is important to try to avoid RSV infections within the first few months of life and avoiding the infection during the entire first winter season of your child’s life would be best,” DeVincenzo said.

For premature babies and for babies with heart or lung problems, medication can help prevent RSV. For other babies, the only way to prevent RSV is to follow these precautions:

From mid-October through the end of March, DeVincenzo recommends that parents try to ensure infants 6 months or younger aren’t touched by adults and children with colds. RSV doesn’t float through the air, but can be sneezed onto your infant or physically brought to your baby by direct physical contact.

Flu
The flu’s peak season runs from late fall through mid-winter and symptoms usually hit hard and fast. Those include fever, headache, muscle aches, dry cough, sore throat and weakness and fatigue. See our recent post on the flu to learn more.

How To: Prevent the flu
last updated:
Wed, 10/12/2011 10:52 AM

To help inform our community about the flu, our infectious disease experts have compiled important information through a series of questions and answers.

What is the flu?
The flu is a contagious respiratory illness caused by influenza viruses. The seasonal flu typically runs from late fall through mid-winter, and symptoms usually hit hard and fast. Once symptoms occur, the fever and body aches typically last anywhere from three to seven days.

Is there a vaccine available?
Flu vaccine is an important way to reduce your child’s risk of developing influenza, and each year the vaccine protects against three different flu viruses.  All people ages 6 months of age and older should receive the influenza immunization this year unless they have a rare medical contra-indication such as allergy to chicken eggs or a history of allergic or severe adverse reaction to flu vaccine in previous years. Also note that individuals with a history of Guillain-Barre syndrome should consult with their physician regarding whether or not to receive the influenza vaccine.

How many doses of the vaccine will my child need?
This depends on the age of the child and whether the child received flu vaccines last year.  Children 9 years of age and older need only one dose.  Children 6 months to 8 years of age will either need one or two doses, depending on whether or not they received flu vaccines in previous years. Your pediatrician will be able to help you determine whether your child needs one or two doses of the flu vaccine this year. The American Academy of Pediatrics guidelines are available here.

Should my child receive the shot (injection) form or the nasal spray form of the flu vaccine?
In general, healthy children and adults ages 2-49 years of age may receive either the injection or the aerosolized (nasal spray) version of the vaccine.  Children ages 6 months to 2 years (and adults 50 years of age or older) should receive the injectable vaccine, as should children and adults with underlying medical conditions (a list of these conditions is available here.

How can you prevent the flu?
Children should be educated about the importance of hand hygiene and respiratory etiquette. These common-sense actions can help reduce the spread of influenza and many other infectious agents.

  • Cover your nose and mouth with a tissue when you cough or sneeze. 
  • If you don’t have a tissue, cough or sneeze into your upper sleeve, not your hands. 
  • Throw the tissue in the trash after you use it. 
  • Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective. 
  • Avoid touching your eyes, nose and mouth. 
  • Try to avoid close contact with sick people. 
  • If you get sick, stay home from work or school, and limit your contact with others to keep from infecting them. People should stay home at least 24 hours after they are free of fever (100°F), or signs of a fever without the use of fever-reducing medications.

What are the flu symptoms?
Flu symptoms include:

  • Fever (usually high, >101.5 or 102°F) 
  • Headache 
  • Extreme tiredness 
  • Dry cough 
  • Sore throat 
  • Runny or stuffy nose 
  • Muscle aches 
  • Lack of appetite 
  • Coughing 
  • Stomach symptoms, such as nausea, vomiting, and diarrhea, also can occur but are more common in children than adults

When do I need to seek medical care for my child if I think he or she has the flu?
Parents should use the same judgment and common sense they would have used last flu season to decide to seek treatment for their children. If you suspect your child has influenza, call your pediatrician. Le Bonheur agrees with the Tennessee Department of Health that, “in the majority of cases, testing is unnecessary” and that “initiation of treatment should be based on clinical presentation and should not be delayed for a confirmatory test.”

There are several anti-viral medications that can be prescribed by your doctor, but these medications are most effective when given early in the course of illness, especially within the 48 hours of the start of the symptoms.  Treatment is recommended for all patients with severe symptoms and for patients at high-risk for complications of the flu. This includes children younger than 5 years of age and especially those younger than 2 years of age and children with chronic underlying medical conditions.

What can I do for my child’s symptoms?
To relieve your child’s pain and flu symptoms, first, administer fluids, and make sure your child is getting plenty of rest. Acetaminophen (Tylenol and other brands) helps with aches, pains and fever reduction.  Aspirin should not be given to children with suspected influenza.

Stopping the Sniffles
last updated:
Wed, 11/17/2010 2:03 PM

At some time or another, we’re all going to come down with the sniffles, our kids included. Between the runny noses, cough and fevers, it’s tough for parents to know when their child has more than a common cold. But don’t worry. The experts at Le Bonheur Children’s Hospital have tips on identifying and preventing more serious ailments.

Bronchiolitis
Bronchiolitis is an infection caused by a virus typically seen in children 2 years of age and younger. Its symptoms include wheezing, coughing and chest congestion, vomiting and a low-grade fever (less than 101 Fahrenheit). A child may take a longer time to eat with the infection.
The most routine care for bronchiolitis is to treat the symptoms. Parents are encouraged to frequently wash their own hands and their child’s hands, keep their child’s nose cleaned out, encourage their child drink more fluids and control fever. Your child may need medicine for wheezing.
Dr. Barry Gilmore, medical director of Emergency Services at Le Bonheur Children’s, says parents should call or see a doctor if your child has difficulty breathing, is unable to eat or drink or has signs of dehydration. Dehydration signs include dry skin, dry mouth, a lack of tears, and lack of wet diapers or use of the potty.
Le Bonheur Children’s recommends parents seek emergency care if the child’s neck, chest or ribs sink deep when breathing, if the child has trouble breathing or stops breathing, turns blue around the mouth or fingernails, has less than three or four wet diapers per day, or has trouble feeding after suctioning the nose.
Bronchiolitis is caused by a number of different viruses, including Respiratory Syncytial Virus.
 
Respiratory Syncytial Virus
RSV is a common winter virus that attacks the lining of the airways and lungs. Dr. John DeVincenzo, a leading investigator in the treatment of RSV, is based at the Children’s Foundation Research Center at Le Bonheur Children’s. He says the virus infects all age groups, but infants younger than 1 year of age are most severely infected. It is the most common cause of pneumonia in infants and the most common cause of hospitalization in infants. In fact, about 3 percent of all babies younger than 1 year of age are hospitalized for RSV infection.

Early signs of RSV infection are the same as a common cold – runny nose, sneezing and mild cough. However, RSV often turns into a deeper cough and causes difficulty breathing by the second or third day of runny nose.
 
“It is important to try to avoid RSV infections within the first few months of life and avoiding the infection during the entire first winter season of your child’s life would be best.” DeVincenzo said.
For premature babies and for babies with heart or lung problems, medication can help prevent RSV. For other babies, the only way to prevent RSV is to follow these precautions:
• From mid-October through the end of March, DeVincenzo recommends that parents try to ensure infants 6 months or younger aren’t touched by adults and children with colds. RSV doesn’t float through the air, but can be sneezed onto your infant or physically brought to your baby by direct physical contact.

Flu
The flu’s peak season runs from late fall through mid-winter and symptoms usually hit hard and fast. Those include fever, headache, muscle aches, dry cough, sore throat and weakness and fatigue.
Once symptoms occur, they typically last anywhere from three to seven days. To relieve your child’s pain and symptoms, first, administer fluids and make sure your child is getting plenty of rest. Tylenol helps with the aches, pains and fever reduction. There are several anti-viral medications that can be prescribed by your doctor, but your child must be seen shortly after experiencing symptoms, as they are only beneficial in reducing the severity of the illness in the beginning stages.
The first recommendation for flu prevention is the vaccine, which is available to all healthy children ages 6 months and older. There are two forms – the nasal dose and the injection.
• The nasal dose is available only to kids age 5 and older who have no underlying health issues such as asthma. It is a live virus, so there can sometimes be side effects.
• The injection form of the vaccine is the most common. First-time doses of the injection should be administered in two doses, with four weeks between. Although there is some protection from the first dose, the second dose improves immunity most. After the first year dose of two injections, only one dose per year is needed. Parents who have kids with underlying health issues are advised to talk to their doctor about getting their child the vaccine. This form of the vaccine is not a live virus and symptoms are typically minimal.
Flu prevention is easy and in some cases, life-saving. If you have any questions regarding the flu vaccine or the flu, contact your pediatrician or health care provider.

 

Commercial Appeal Prints Plea for Vaccine
last updated:
Wed, 11/03/2010 1:22 PM

In the Wednesday, November 3 edition of Memphis’ Commercial Appeal, Dr. Keith English, Infectious Disease Chief at Le Bonheur Children’s Hospital encouraged parents and healthcare workers to receive their flu vaccine. In the Guest Editorial piece written by English, he stresses the critical influence people can have against another dangerous flu outbreak by getting vaccinated.  Read his guest column by clicking here.

Le Bonheur Experts Talk Flu 2010
last updated:
Thu, 9/16/2010 3:16 PM

To help inform our community about the flu, our infectious disease experts have compiled important information through a series of questions and answers.

What is the flu?
Flu season usually runs from late fall through mid-winter, but as everyone knows, last year was different. A novel H1N1 influenza A virus began circulating in the Memphis area in May and caused hundreds of hospitalizations in August and September.  Symptoms caused by this virus were generally very similar to those caused by the usual “seasonal flu” that appears in fall and winter

We don’t know when flu will hit the Memphis area this year. It is likely that the H1N1 virus from last year will again affect people this fall and winter -- probably with at least one of the more common types of flu virus circulating at the same time.

The flu is a contagious respiratory illness caused by influenza viruses. Symptoms usually hit hard and fast, with fever and body aches typically lasting anywhere from three to seven days.

Is there a vaccine available?
The flu vaccine is the best way to reduce your child’s risk of developing influenza, and each year the vaccine protects against three different flu viruses.  This year, the vaccine also protects against the new strain of H1N1 influenza A virus that affected so many last year.  All people ages 6 months of age and older should receive the influenza immunization this year unless they have a rare medical contra-indication, such as an allergy to chicken eggs or a history of allergic or severe adverse reaction to flu vaccine in previous years. Also note that individuals with a history of Guillain-Barre syndrome should consult their physician before receiving the influenza vaccine.

How many doses of the vaccine will my child need?
This depends on the age of the child and whether the child received flu vaccines last year.  Children 9 years of age and older need only one dose.  Children 6 months to 8 years of age will either need one or two doses, depending on whether or not they received flu vaccines in previous years and whether or not they received the H1N1 flu vaccine last year. Your pediatrician will be able to help you determine whether your child needs one or two doses of the flu vaccine this year. The American Academy of Pediatrics guidelines are available online: 
(http://www.healthychildren.org/english/news/pages/aap-issues-flu-vaccine-recommendations.aspx)

Should my child receive the shot (injection) form or the nasal spray form of the flu vaccine?
In general, healthy children and adults ages 2-49 years of age may receive either the injection or the aerosolized (nasal spray) version of the vaccine.  Children ages 6 months to 2 years (and adults 50 years of age or older) should receive the injectable vaccine, as should children and adults with underlying medical conditions (a list of these conditions is available here: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-flulive.pdf).

How can you prevent the flu?
Children should be educated about the importance of hand hygiene and respiratory etiquette. These common-sense actions can help reduce the spread of influenza and many other infectious agents.

• Cover your nose and mouth with a tissue when you cough or sneeze.
• If you don’t have a tissue, cough or sneeze into your upper sleeve, not your hands.
• Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
• Avoid touching your eyes, nose and mouth.
• Try to avoid close contact with sick people.
• If you get sick, stay home from work or school and limit your contact with others to keep from infecting them. People should stay home at least 24 hours after they are free of fever (100°F or above) or signs of a fever without the use of fever-reducing medications.

What are the flu symptoms?
Flu symptoms include:

• Fever (usually high, >101.5 or 102°F)
• Headache
• Extreme tiredness
• Dry cough
• Sore throat
• Runny or stuffy nose
• Muscle aches
• Lack of appetite
• Coughing
• Stomach symptoms, such as nausea, vomiting, and diarrhea, also can occur but are more common in children than adults

When do I need to seek medical care for my child if I think he or she has the flu?
Parents should use the same judgment and common sense they would have used last flu season to decide to seek treatment for their children. If you suspect your child has influenza, call your pediatrician. Le Bonheur agrees with the Tennessee Department of Health that, “in the majority of cases, testing is unnecessary” and that “initiation of treatment should be based on clinical presentation and should not be delayed for a confirmatory test.”

There are several anti-viral medications that can be prescribed by your doctor, but these medications are most effective when given early in the course of illness, especially within the first 48 hours of presenting symptoms.  Treatment is recommended for all patients with severe symptoms and for patients at high risk for complications of the flu. This includes children younger than 5 years of age and especially those younger than age 2 and children with chronic underlying medical conditions.

From the CDC website: “Children at ‘high risk’ of developing complications of influenza include the following: children with chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, cognitive, neurologic/neuromuscular, hematological or metabolic disorders (including diabetes mellitus); children who are immunosuppressed (including immunosuppression caused by medications or by HIV infection); children receiving long-term aspirin therapy who might be at risk for experiencing Reye syndrome after influenza virus infection; residents of long-term care facilities; and pregnant patients).
To relieve your child’s pain and symptoms, first administer fluids and make sure your child is getting plenty of rest. Acetaminophen (Tylenol? and other brands) helps with the aches, pains and fever reduction.  Aspirin should not be given to children with suspected influenza.

The first and most important step to prevent the flu is to get vaccinated. Vaccination stimulates an immune response using a killed or weakened virus that uses the body’s own defense mechanisms to prevent infection.

Does this year’s influenza vaccine protect against the novel H1N1 influenza A virus that caused the global pandemic in 2009?
Yes.  This year’s vaccine protects against three different influenza viruses, including the novel H1N1 influenza A virus that was first identified last year.

Can the influenza vaccine cause the flu?
No. The injectable form of the vaccine contains dead viruses.  The aerosolized version of the vaccine contains weakened viruses that cannot multiply at body temperature.  When people who have received the flu vaccine recently develop an acute respiratory illness, it is caused by other viruses.

Is the influenza vaccine safe?
Yes.  Millions of doses of flu vaccine are administered every year and serious side effects are extremely rare.  The risk of developing severe influenza is much higher.

Should everyone get the vaccine, or only those in high-risk groups?
Everyone 6 months of age or older should be immunized against influenza every year unless they are allergic to chicken eggs, have had a prior allergic or severe adverse reaction to influenza vaccine, or have a history of Guillain-Barre syndrome. 

CDC Flu Vaccine Information
last updated:
Wed, 8/11/2010 1:56 PM

As last year proved beyond a doubt, influenza can be unpredictable. Consequences of the 2009 H1N1 pandemic factored into CDC's Advisory Committee on Immunization Practices' (ACIP) vote earlier this year to recommend universal influenza vaccination for all persons 6 months of age and older.

How does this affect you? Because all people age 6 months and older are now recommended to receive annual influenza vaccination. Vaccination efforts should begin as soon as vaccine is available and continue throughout the influenza season.  This year's vaccine will include the 2009 H1N1 strain as part of the regular seasonal vaccine. Communication science research conducted this summer has shown us that consumers may have safety concerns about the 2009 H1N1 strain being included in the vaccine, which can be a barrier to seeking vaccination. This year's flu vaccine is made in the same way as past flu vaccines. An average of 100 million doses of influenza vaccine have been used in the United States each year and flu vaccines have an excellent safety record.

While everyone is now recommended to receive influenza vaccine, your high-risk patients—pregnant women, those with asthma, diabetes, or other chronic conditions—remain at risk for serious complications from influenza. CDC, and state and local public health agencies, will continue to reinforce efforts to emphasize the crucial importance of vaccine for these groups while simultaneously promoting annual influenza vaccination for everyone in the community.

Parents are encouraged to make sure they vaccinate themselves and their family members too, perhaps utilizing options that might be available through pharmacies, schools, workplaces or other local partners. Information on the flu vaccine is available at www.cdc.gov/flu and www.flu.gov

Vaccination continues to be the best protection against influenza and your efforts will be reflected in a healthier community—yours.

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Le Bonheur Children's Medical Center is a leading children's hospital in the Mid South, providing pediatric care to children from 95 counties in six states.
50 N. Dunlap Street, Memphis, Tennessee 38103 • (901) 287-KIDS