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Influenza

Influenza is an illness capable of affecting the entire respiratory tract from the nose and throat down to the small airways and lungs. It is caused by a group of 3 viruses (Influenza A, B, or C), with many subtypes including the H1N1 strain. Unfortunately these viruses keep changing form year to year, forming new outer coats which our immune system can’t recognize. This means that even if you or your child had influenza in the past, this year’s virus may be different enough to infect either of you again. 
Influenza spreads very rapidly by direct contact with nasal mucus form an infected person or by inhaling droplets coughed or sneezed into the air. The virus is fragile and doesn’t survive for long in the air or on surfaces of furniture, kitchen or bathroom facilities. Illness usually begins 1 to 3 days after exposure. 

A typical case if flu in older children and teenagers consists of sudden onset of chills and fever, headache, body aches, sore throat and dry hacking cough. The worst of the illness lasts 3 to 4 days; cough and a “worn out” feeling may go on for a week or more. 
Preschool children tend to have an illness more like a severe cold, with high fever (often over 103ËšSF, 39.5ËšC), runny nose and cough, typically accompanied by irritability and poor appetite. Some infants develop a hoarse cry and a “barking” cough (croup). Diarrhea and vomiting may also occur, giving rise to “Intestinal flu”- a term often misused for any form of upset stomach. Young children usually feel better in 3-5 days, although cough may linger for another 1 to 2 weeks. Not all flu is severe. Even in the same family, one child may be very sick while another has only a mild illness with stuffy nose and cough but no fever. 

You should call our office if you feel frightened or worried about your child’s illness. Call our office immediately if your child has: difficulty breathing: a bluish tinge to the lips; vomiting that continues for several hours; severe lethargy. 
Call us during regular office hours if your child: complains of an earache or, in an infant, pulls at the ears, becomes increasingly cranky or keeps waking at night: develops a deep cough with lots of mucus; has fever (over 100ËšF, 37.8ËšC) lasting more than 4 days. 

For relief of pain and temperature of 102ËšF (38.9ËšC) or higher, acetaminophen may be given (Tylenol®, Tempra®, Panadol®, Liqiuprin®). Aspirin (acetylsalicylic acid) or any cold medicine containing aspirin, when given to children with influenza virus infection can lead to brain and liver damage (Reye syndrome) and should be avoided. Be sure to read the label on any over-the-counter remedies you purchase.
Mist form a humidifier or vaporizer may help the cough. It is best not to give strong cough medicines that can keep your child from bringing up mucus in the chest. Your doctor may recommend treatment, however, if the cough continues and is dry. 
Antibiotics are not needed for most children with influenza. They should be used only if your child develops a complication such as an ear infection, sinus infection, bronchitis or pneumonia. That is why you should with your doctor if fever hasn’t gone away after 4 days. 
An antiviral medicine called Tamiflu® (oseltamivir) is available to treat or prevent influenza in children over 1 year of age. The decision to use this medication should be made on an individual basis and discussed with your child’s doctor. 

Flu usually takes away a child’s appetite, so don’t expect him/her to eat much for the first few days. Encourage fluids, however, especially when fever is present. Any juice or soft drink your child likes is acceptable. Forcing fluids is unnecessary. 
Active play can make a cough worse. Although children generally retrain themselves quite well, quiet activities are recommended at least during the early stages of the illness. In children over 1 year of age Honey and Lemon may be given to help quiet cough. Over-the-counter cough suppressants are not recommended for children less than 4-6yrs of age. 

The flu is highly contagious and spreads so rapidly that it is difficult to stop. Older children should be encouraged to cover their mouth and nose when they cough or sneeze, use tissues for cleaning their nose and wash their hands afterwards. Sick children should be kept away from elderly persons and anyone with a chronic illness that might increase the risk of complications. 
A vaccine to prevent influenza is recommended for children with special “high risk” conditions. If your child has cancer or chronic disease of the heart, lungs, kidneys or nervous system, or if s/he has asthma, diabetes or anemia, speak with your doctor to see whether it would be advisable to start yearly influenza shots. 
In addition, if anyone in your household is 65 years or older or falls into a “high risk” category, the whole family should receive flu vaccine yearly to reduce the chance that one of you will carry the virus home. 

Children may return to their usual activities in school or day care when their temperature is normal and they feel better. A lingering cough is no reason to keep then at home. 
The use of face masks or disinfectant sprays is of little or no value in reducing the spread of influenza in the home.