Flu Q&A: How concerned should I be about my child’s risk?

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Four-year-old Gabriella Diaz sits as registered nurse Charlene Luxcin, right, administers a flu shot at the Whittier Street Health Center in Boston, Mass., Wednesday, Jan. 9, 2013. Boston declared a public health emergency Wednesday as the city tried to deal with a harsh flu season and the state reported 18 flu-related deaths so far. (AP Photo/Charles Krupa)

It’s been a nasty flu season, to say the least. Starting early this winter, it’s dominated by a strain that usually makes people experience more severe symptoms. We asked blog contributor Stephen C. Aronoff, M.D., M.B.A., from Temple University Hospital and a specialist in pediatric infectious diseases, to weigh in on this year’s flu season effect on children.

What’s happening with this year’s outbreak?

On an almost annual basis, outbreaks of influenza occur in the U.S. and around the world. Because the strains of the virus that cause these annual outbreaks differ from year-to-year, new vaccines are developed annually. This year’s outbreak is mixed with two-thirds of the cases caused by Influenza A (H3N2) and one third caused by Influenza B. The vaccine for this season should cover both of these strains. At the present time, infection in Pennsylvania and nationwide is considered to be widespread.

How concerned should I be about my child’s risk?

The risk of infection in children is comparable to that in adults. To date, 18 children in the U.S. have died of influenza or its complications. Data from the 2009-2010 H1N1 outbreak suggest that children with neurological disorders, such as cerebral palsy, were at highest risk for death followed by children with chronic heart and chronic lung problems, including asthma. Both the Centers for Disease Control and the American Academy of Pediatrics recommend routine vaccination of all children over 6 months of age.

How do I know if my child has the flu and what can I do at home?

For the most part, the symptoms of influenza are indistinguishable from the symptoms of the common cold or an upper respiratory viral infection. The majority of children develop fever, cough, runny nose, headache and a sore throat.

Less commonly, diarrhea and vomiting occur. Muscle aches, a common feature of the infection in adults, occurs in less than half of infected children. For the most part, these symptoms can be managed at home by offering lots of fluids, using non-aspirin medications to keep the fever and muscle aches at bay, and by observation. Typically, the severity of the illness peaks in 3-4 days and then resolves; a residual cough may last for 1-2 weeks.

When should I seek care for my child?

Children in the high risk groups noted above as well as children with cancer on chemotherapy, HIV infected children and pregnant adolescents should be evaluated by a medical professional. Otherwise, healthy children who develop difficulty breathing, rash, high fevers late in the illness, decreased urine production or changes in behavior also should be evaluated by a healthcare professional.

Is there treatment for the flu?

Prevention is best. All children over 6 months of age are eligible for vaccination. Vaccination is best early in the season since it takes time to respond to the vaccine, but it is not too late to have your child vaccinated. Since the virus is spread by sneezing and coughing, teaching your child how to properly cover their face is important. It is currently recommend that the arm, not the hand, be used to cover the face. Since the virus can also be picked up from contaminated surfaces such as sinks and tables, frequent handwashing or sanitization is strongly recommended.

Finally, oseltamivir (Tamiflu) is effective for the treatment of influenza when given early in the course of infection. This drug is available from your health care provider by prescription.

My entire family was vaccinated last fall. How protected are we from the flu?

CDC officials said a recent study of more than 1,100 people has concluded the current flu vaccine is 62 percent effective. This means the average vaccinated person is 62 percent less likely to have to go the doctor to get treated for the flu, compared to people who don't get the vaccine.

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