Every winter brings the threat of an outbreak of influenza, a viral infection of the respiratory system that, during most outbreaks, strikes up to 20 percent of the population in an affected region. Babies and children of all ages are prone to influenza, but those who attend school, or day care are most likely to be exposed.
For most of the population, the flu is only a nuisance requiring bed rest and interfering briefly with normal activities. It can, however, be a dangerous illness for some people, including the very young.
WHAT CAUSES THE FLU?
Influenza, or flu, is caused by several types of viruses that attack the upper and lower respiratory tracts—the nasal cavities, throat, windpipe and lungs. The three main types of influenza virus are classified as types A, B and C, but there are many variants within these types. Type C is usually mild, like a cold. One bout of this type of flu confers immunity for life. The viruses that cause types A and B, however, continously undergo changes so that having suffered through one years' strain of flu gives no guarantee against catching the flu again.
HOW DOES FLU SPREAD?
Influenza viruses spread easily when an infected person sneezes or coughs. Hand and other bodily contact can also spread it. Some people who are infected—known as carriers—develop no flu symptoms, but they can spread the infection to others who may develop the illness.
Of the several forms of flu, influenza A is the most severe and can last the longest. It can start suddenly with a high fever, which begins to subside after about two days. Five days later, most other symptoms should be disappearing, although respiratory problems (runny nose, cough and sputum production) may persist for seven to ten days. Influenza type B may not last as long or produce such severe symptoms.
WHEN SHOULD I SUSPECT THAT MY CHILD HAS FLU?
The first warning may be news that the child's classmates have the flu. Symptoms of the flu sometimes come on suddenly. Look out for a runny nose, cough, headache and sore throat, along with more generalized symptoms such as headache, chills, fever, appetite loss, muscle aches and weakness. Some children with the flu also develop vomiting, diarrhea or both.
IS MEDICAL ATTENTION NECESSARY?
Yes. The pediatrician will want to monitor the child's illness because influenza can potentially cause several complications. The most common complication is secondary bacterial infection of the sinuses, middle ear or lungs. In rare cases, pneumonia develops as a complication of the flu.
HOW CAN THE PEDIATRICIAN TELL IF MY CHILD HAS FLU?
If a child has flulike symptoms in the midst of community-wide flu outbreak, the diagnosis is fairly straightforward. The pediatrician will, however, perform a physical examination and throat culture to check for strep throat, a bacterial infection that may have similar symptoms.
WHAT TREATMENTS ARE AVAILABLE?
For uncomplicated influenza, treatment focuses on alleviating the symptoms. Bed rest is the most important measure. In addition, the pediatrician may recommend acetaminophen to reduce fever and aches, as well as fluids to counter the dehydrating effects of fever and vomiting or diarrhea. If necessary, the pediatrician also will prescribe a cough suppressant. Although two antiviral drugs (amantadine and rimantadine) have been proven effective against the flu, both have significant side effects and both need to be started immediately after the onset of symptoms. Therefore, these drugs are rarely used, especially in children.
When the child's fever has gone down, bed rest is no longer necessary. Even so, most children will continue to tire easily for several more days. It is probably best to wait at least a week from the onset of symptoms before resuming full activity, including school or day care.
PREVENTING INFLUENZA
Flu viruses are so easily spread that standard preventive measures such as hand washing provide only slight protection. Because flu is dangerous for certain groups, vaccines are developed each year from a combination of the type A and B viruses causing the prvious year's influenza outbreaks. If new viruses are similar to those of the previous year, these vaccines can be quite effective. Although not all children need the vaccine, your pediatrician will probably recommend it if your child has:
• Chronic heart or lung problems, including asthma
• Diabetes, kidney disease or a disorder associated with abnormal hemoglobin
• A compromised immune system
GETTING HELP
Call your doctor if:
• Your child's flu symptoms do not start improving by the fifth day of illness
• Flu symptoms begin to improve but flare up again a few days later
• Your child has the flu and develops ear pain, pain when inhaling, or facial pain and a puslike nasal discharge. These symptoms indicate the possiblity of a bacterial respiratory infection secondary to the flu.
