| Influenza, or the flu, is a very common illness that is caused by the influenza virus, which strikes most commonly in the winter (although flu season can occur at other times in tropical climates). The reason that the flu is so common and hard to prevent is that there are three types of flu virus (A, B and C), and each of the types have different strains that can change enough from year to year so that it is not possible to develop enough immunity to prevent infections. This makes it possible to get the flu more than once, or even yearly.
Although children get more mild flu infections than adults, rates of flu are much higher among children. Flu symptoms usually develop 2-3 days (incubation period) after coming in contact with someone else who is sick with the flu.
The most common symptoms of the flu are the sudden onset of a runny nose, nasal congestion, sore throat from post nasal drip, cough, fever, which can be either low grade or very high, chills, muscle aches and pains, fatigue, headache, nausea, decreased appetite, vomiting, diarrhea and abdominal pain. Symptoms usually worsen over the next 3-5 days, and then gradually improve over the next few days without treatments.
What is the difference between a cold and the flu? While both are viral infections that can cause a runny nose, cough and fever, children with the flu are usually sicker and they typically get worse over a very short amount of time.
Although antibiotics do not work against the flu, there are some things you can do to make your child more comfortable as he recovers, including bedrest, plenty of fluids, a pain and or fever reliever, decongestants, cough suppressants, or use of a humidifier.
The flu can lead to complications, especially in young children and the elderly and in anyone with other chronic medical problems. Rarely your child may need to be hospitalized if he is having difficulty breathing or is dehydrated. Other complications can include secondary bacterial infections, such as ear infections, sinusitis or bacterial pneumonia. In patients with a secondary bacterial infection, symptoms will usually have started to improve and they then begin worsening again. With an uncomplicated case of the flu, although you may have a worsening of the symptoms over the first 3-5 days (with persistent fever), once the symptoms begin to improve, they should just continue to slowly get better. If not, see your Pediatrician.
Influenza can also cause secondary viral infections, including viral pneumonia, bronchiolitis, parotitis and croup. Other complications can include febrile seizures. More serious complications rarely occur, but do include Reye syndrome, encephalitis, Guillain-Barre syndrome, myocarditis and/or pericarditis, rhabdomyolysis and arrhythmias.
Remember that since the flu is caused by a virus, your child will not need an antibiotic as treatment to get better. Antibiotics do not kill the flu virus. There are some antiviral medicines that may help your child get better quicker if they are started within 48 hours of the first signs of illness.
Among the medications available to treat influenza A infections which usually account for about 75% of flu infections (but don't work against influenza B) in children are amantadine (symmetrel), for children over 12 months old, and rimantadine (flumadine), for children over 14 years old (and often used for younger children), both of which can also be used as prophylaxis to prevent children over 12 months old from getting the flu if they are in a high risk group. If started early, within 48 hours of the beginning of symptoms, these medications can decrease how long you are sick by about a day only. Also, they have significant side effects, especially amantadine which can cause anxiety, nervousness, and lightheadedness. These medicines are usually used in children with chronic medical conditions or they seem to have a severe case of the flu. They are not generally used on all children with flu symptoms.
Newer medications, which treat both influenza A and B infections include zanamivir (relenza), which is a dry powder inhaler used twice a day for 5 days and which is available for children over 7 years of age. Zanamivir has been associated with causing wheezing, and so should be used with caution in children with asthma. Another new medication is oseltamivir (tamiflu), which is now available in a syrup form and is approved for use in children over one year of age. These newer medications are much more expensive than amantadine (which is the least expensive) and rimantadine, but they do cover both major types of influenza.
There are tests available to see if your child does have the flu. These include rapid assays that are performed on samples obtained from a throat or nasopharyngeal swab. Also, viral cultures can also be done. Most children do not need to be tested for the flu. While some of the tests can detect both types A and B of the flu, they don't tell you which one your child has, and other tests can just check for type A.
Since the flu is spread by coming into contact with the secretions of someone who is already infected, the best way to not get the flu is to teach your children to wash their hands often, especially before eating and after using the bathroom, to not share cups or glasses, and to cover their mouth and nose when they cough or sneeze. Also wash toys and other objects and surfaces after someone with the flu (or any other infection) touches them. Children over six months can also get the flu vaccine each year, especially if they have a chronic medical problem.
Children with a high risk of getting a serious case of the flu may need to be given an antiviral medication (such as amantadine or rimantadine) as prophylaxis when they are exposed to someone with the flu to prevent them from getting sick.
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