* 9/23/09 Update – We continue to experience long wait times in our Emergency Department due to a large number of children with flu-like symptoms. Pediatricians and family physicians should be your first line of defense. They can direct you to the appropriate care whether in their office or at another facility. If your child has severe symptoms, difficulty breathing, is an infant or has other underlying health issues, the Emergency Department may be the best place for medical care. If you do not have a pediatrician or need medical care after office hours, consider visiting a Le Bonheur Urgent Care. We have five locations in Memphis, Cordova and Olive Branch.
Flu season has started early this year. As children have returned to school from summer break, pediatricians are seeing an increased number of children with flu-like symptoms in their offices. To help explain how this flu season is different than previous years, Dr. Keith English, director of Infectious Diseases at Le Bonheur Children’s Medical Center, answers parents’ questions.
Below our chief medical officer Dr. Bill May, director of emergency services Crile Crisler, director of infectious diseases Dr. Keith English and the Centers for Disease Control and Prevention answer common questions about the flu.
Why are we hearing about the flu so early this year? The flu is a contagious respiratory illness caused by influenza viruses. There are two different types of influenza (flu) that will affect children this fall – the seasonal flu and the novel H1N1 (swine) flu. Flu season usually runs from late fall through mid-winter, but this year is different. A H1N1 flu virus has been circulating in this area since early May. Because this new H1N1 virus came late, it continued to circulate during summer months. When school started back this fall, we anticipated an increase in the number of cases as children begin spending time together in close proximity. Illnesses caused by this H1N1 virus are very similar to those caused by the usual fall-and-winter “seasonal flu.” Symptoms usually hit hard and fast, and typically last 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 this year there will be two different flu vaccines. The usual vaccine (for seasonal influenza) will be available during the next few weeks and is recommended for children age 6 months and older and all household contacts of infants younger than 6 months of age. The new vaccine (for the novel H1N1 flu virus) is expected to become available in mid-October and also will be recommended for children 6 months and older (and household contacts of infants younger than 6 months of age)
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.
Visit the CDC Web site (http://www.cdc.gov/h1n1flu/) to find out what to do if you get sick with the flu and how to care for someone at home who is sick with the flu.
What are the flu symptoms? Both the H1N1 and seasonal flu have similar symptoms. These symptoms include:
Fever (usually high)
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?
Parents should use the same judgment and common sense they would have used last flu season to decide when to seek treatment for their children. If you suspect your child has the flu, call your pediatrician. The Tennessee Department of Health suggests 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 are most effective when given early in the course of illness. The criteria for prescribing anti-viral therapy for children with suspected or confirmed infection caused by the H1N1 influenza virus are essentially the same as those that should be used for the treatment of seasonal influenza. Treatment is recommended for patients with severe symptoms and for patients at high-risk for complications of the flu. This includes children younger than 5 years of age, especially those younger than 2 years, and children with chronic underlying medical conditions.
*From the CDC: Children at “high-risk” of developing complications of influenza include the following:
children less than 5 years of age – especially those less than 2 years of age
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
pregnant patients
According to the CDC, illness caused by the H1N1 virus has ranged from mild to severe. While most people who have been sick have recovered without needing medical treatment, hospitalizations and deaths from infection have occurred. In most cases, 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.
