Flu Season is Coming!
Keira was a 9-month-old baby girl when she came to my office last November. I walked in the room, took one look at her and felt my pulse quicken. This baby was sick. She had a fever of 103, was lying weak in her mother’s arms, was extremely congested and coughing frequently. She had classic influenza.
I placed Keira on oseltamivir (Tamiflu) and saw her every day that week as her parents and I carefully monitored her breathing and hydration. After five days of high fever, during which her parents anxiously pushed fluids and fever reducers, her temperature finally broke and her energy returned. We had kept her out of the hospital and she was a happy, healthy baby again. But it took her exhausted parents another week to recover!
Colds, many with fevers, affect kids all the time. While most viral upper respiratory infections are mild and self-limited, influenza, or the real “flu”, is another story.
Influenza is a serious illness. Affected people get high fever, muscle and headaches, sore throat, congestion and cough. Fever can last five to seven days and affected patients feel much more sick than with most viral infections. Some groups are at greater risk of more serious illness, hospitalization or even death.
The elderly, those with chronic disease like asthma, diabetes or immunosuppression, and young children less than five, but particularly those less than two, are at highest risk. People in these groups are more likely to develop a serious, and potentially life-threatening infection.
Every year in the United States, about 100-120 children die from influenza. 80% of pediatric deaths occur in unvaccinated children over six months. Between 2010-2014, half of pediatric deaths occurred in children with at least one high-risk medical condition like asthma, but only one third of these children had been vaccinated. In 2016, 104 children died, half of whom had no high-risk medical condition.
The flu shot is the best way to prevent the flu. The shot is reformulated every year to cover the strains that are expected to circulate in the upcoming year. How well the shot works varies due to the unpredictable nature of influenza each season. Generally, the shot cuts medical visits for flu by 50-75%.
The only shot available today is the injection, as the nasal spray was found to be ineffective against current strains of the virus. It is given to children over six months of age, and kids less than nine years old need two doses separated by four weeks the first year it is given. The shot should be given as soon as it becomes available, ideally before the end of October.
The shot is safe for pregnant woman at any time during pregnancy. It also can be safely given to people with a history egg allergy, even those who have a severe reaction to eggs.
The most common side effects to the shot are pain and swelling at the injection site. Some children will feel drowsy, have muscle or headache or loss of appetite. It is important to remember that the flu shot does not contain live influenza virus. It cannot, therefore, cause influenza. People who have had a previous severe allergic reaction requiring use of epinephrine following a flu shot should not receive the shot again.
When I talk to parents about vaccinating their children for influenza, I think of Keira, and how sick she was that November. The shot may not be 100% effective, but 50-75% protection is a whole lot better than none!