Influenza virus and the flu vaccine
I don't know about you guys, but when I was little I thought that "the flu" was a vomiting and diarrhea thing. It wasn't until I got to medical school that I realized that the flu vaccine wasn't going to prevent the unpleasantness of gastroenteritis.
Influenza is a respiratory disease and therefore the influenza vaccine is most beneficial to the children who suffer from respiratory illnesses.
Influenza virus is a disease that circulates this time of year and usually shows up as a fever (lasting up to 10 days), chills, headache, fatigue and muscle pain. You rarely get influenza without the headache. It can involve a non-productive cough, sore throat, runny nose and congestion. This year, the eyes seem to be more red and sore, without pus, and with gobs of tearing (a viral conjunctivitis). We can usually recognize it in kids because they look really sick and are often refusing to walk because of severe pain in their calf muscles. In addition to that good stuff, the virus can lead to pneumonia, wheezing, croup and bronchiolitis. Up to 1/3 of kids have vomiting. Diarrhea is unusual.
The influenza virus is the reason that children are not supposed to have aspirin. The use of aspirin (as a way to reduce fever) in influenza has been associated with Reye syndrome. Aspirin generically is salicylic acid , and can be found in Pepto. DON'T USE ASPIRIN ever in your children without talking to me first!!
The virus is spread from person to person through inhalation of small virus particles from somebody who just sneezed on you, by direct contact with the virus particle (so wash your hands) and by touching stuff that's been recently contaminated with the virus (so wash the toys and stay out of the ball pit at your favorite fast food joint!)
It's pretty easy to get, and you feel pretty lousy during the illness. You are most infectious within 24 hours of getting the disease, during a time period that you probably don't feel that bad. You can share the virus with others for 7 days after getting it and it's usually 1-3 days after exposure that you start to feel really bad.
How we can make you feel better
It's a virus, so there are no antibiotics to make this any better. There are some new medicines for treatment but they are only studied and indicated for children over 12 years of age.
But not with aspirin. And not because we have to keep the temperature down. We want to keep your child comfortable. See the acetaminophen and ibuprofen medicine charts here.
Treat the Cough
The AAP, and me, for that matter are not big fans of over the counter cough medications. They haven't been tested for safety in children and are not usually effective. Cough suppression in general is not a good idea. The cough reflex is a protective airway mechanism; by suppressing it, we may be suppressing a very important defense mechanism against foreign particles in the child's airway.
Coughing always gets worse at night. Try to keep the child's head elevated, keep the air moist (and I don't care about hot vs. cold vaporizers), and if you are tempted to use OTC medications, try Benadryl, as the side effect in most children is sleep.
I use a lot of albuterol this time of year. Albuterol is the same medicine we use in children with asthma. (If your child has asthma and is coughing, use the inhaler by all means.) It has been used in all age groups and is safe. It's mechanism of treating cough is to open airways, not cough suppression, so it treats the underlying problem without suppressing important airway reflexes. And just because we use the medication does not mean necessarily that your child has asthma.
Since the cough from influenza can last for weeks after the disease is done, the albuterol can be used as a cough medicine for the rest of the winter.
call us if your child
Prevent getting the disease in the first place.
Highest vaccine priority (seasonal vaccine) in the pediatric age group
Side effects of the seasonal vaccine:
My grandfather swears he didn't have asthma until he got the vaccine, but there are no infectious particles in this vaccine, so you can't (sorry grandpa) get sick from this vaccine
Seasonal Influenza Vaccine Schedule
Children 6 months to 8 years who have never had the vaccine get 2 doses given at least one month apart. Children over 8 years need only one vaccine a season. All age groups need to get a vaccine every year, as the sneaky little influenza virus changes just enough each year to make previous vaccines not work.
or your child can get FluMist
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