It’s that time of year again: Our children come home from school with fever and it seems like the entire class is sick. Flu testing is positive, and now you wonder what exactly does this mean?
Influenza is a virus that is spread through tiny respiratory droplets. You may become infected if someone coughs or sneezes near you. Alternatively, you may pick up the virus by coming in contact with fomites, which are objects that act transmitters (e.g. doorknob, remote control, cellphone). If you come in contact with these fomites after a contagious person has and then you touch your eyes, nose or mouth, you have placed yourself at risk for influenza. Typical viruses may “live” on fomites for a few hours.
Annually, we expect about 5 percent to 20 percent of the U.S. population to be infected with the flu, and about 200,000 people will be hospitalized due to complications. In the 2016-17 year, there were 109 pediatric deaths from the flu, and the CDC has already reported one pediatric mortality this flu season. Influenza can be extremely dangerous.
Anyone infected with influenza can develop complications, but those at highest risk are babies and children, pregnant women, adults over 65, and people with illnesses including asthma, heart disease, diabetes, and immune deficiency.
How can I protect myself and my family?
The single most important measure in flu prevention is annual vaccination. The Advisory Committee on Immunization Practice recommends influenza vaccination for all people 6 months of age and older. There are few contraindications to flu vaccination. These include significant medical illness, a history of Guillain-Barre, and allergies to any component of the vaccine. However, in September 2017 the American Academy of Pediatrics released a statement that all individuals, regardless of severity of egg allergy, can receive the influenza vaccination without any additional precautions. And pregnant women can safely receive the immunization. Please speak with your physician regarding your individual circumstance.
The flu vaccine does not protect you immediately. It will take about two weeks to build protective antibodies, so early vaccination is best. Aim for October, but remember that it’s never too late.
The next best method to protect yourself from contracting the flu is through good handwashing practices. Use soap and water, scrub fronts and backs of hands as well as in between fingers, and lather for at least 20 seconds. Sing “Happy Birthday” twice and you will meet the time criteria. Alternately, an alcohol-based sanitizer with at least 60 percent alcohol can be effective.
Let’s talk myths:
▪ A commonly held belief is that the flu shot can give you the flu. FALSE. The flu vaccine is manufactured from killed viruses. The vaccine may cause mild symptoms such as fatigue, nausea, headache, muscle aches, and chills. Up to 30 percent of children under age 2 may get a fever in the first 24 hours, but this is rare in older children. You simply cannot get the flu from the flu vaccine.
▪ It is unsafe to take the flu vaccine along with other vaccines. FALSE. It is absolutely safe to co-administer vaccines at the same time. However, if you have received a live virus vaccine in the prior four weeks you will need to wait to take any vaccination including the flu shot.
▪ Flu vaccine can cause autism. FALSE. There is an extensive amount of research showing that the flu vaccine is safe and not associated with any developmental delays.
▪ Flu season only occurs during the winter. FALSE. Flu season starts in early fall and ends in late spring. However, in my office I have confirmed influenza cases extending into May and June every year. Again, it’s never too late to get your flu shot.
Symptoms of the flu: Influenza is a virus, but symptoms can be more severe than other viruses. Fever usually comes on suddenly and may be accompanied by body aches, sore throat, nasal congestion, cough, nausea and headaches. Younger children may also have vomiting or diarrhea. Once the initial fever resolves, you may experience cough and congestion for an additional week or two.
Most cases of influenza can be managed at home. If detected early, your doctor may prescribe Tamiflu, which may help you recover sooner. Optimal effects of Tamiflu occur when given within the first 48 hours of illness. However, Tamiflu may not be for everyone and can cause side effects, especially in children, such as gastrointestinal upset and neurologic symptoms such as behavioral changes.
Once diagnosed with the flu, you should remain home from school or work until you are free of fever for 24 hours. You are most contagious at this time. Drink plenty of fluids and consider acetaminophen or ibuprofen for fever and symptom relief. Symptoms that the flu may be more severe and warrant physician/emergency room attention include: rapid/fast breathing, stiff neck, persistent vomiting, dehydration/reduced urine output, and lethargy.
Once your initial fever resolves, signs of secondary bacterial infections include ear pain, sinus pressure or persistent coughing. At this time, your primary care physician should re-evaluate you to determine if you have an ear infection, sinus infection, or pneumonia. If in doubt, get checked out!
Andrea M. Assantes, M.D., is assistant professor of clinical pediatrics at the University of Miami Health System. For more information, visit UHealthSystem.com/patients/pediatrics.