Influenza update 11/17/09
Posted on Nov 17, 2009 This is an unusual year for influenza because we are concerned about two types of bronchial flu: H1N1(swine flu) along with the usual yearly or “seasonal” influenza. (“Stomach flu” is a completely different kind of illness, associated with vomiting and diarrhea.) Seasonal influenza usually comes during the cold months, most often January. However, we have been seeing low levels of H1N1 influenza circulating in Lincoln since spring of this year and have seen a big jump in H1N1 activity since school started. So far the symptoms have been fairly typical of flu.
Symptoms of both seasonal and H1N1 flu include: fever, muscle aches, scratchy throat, nasal congestion, cough, sometimes vomiting and loose stools. The fever usually last 1-4 days, the cough trails off after a week or so. Ear infections, sinusitis, pneumonia occasionally can be complications of the flu. Your child should not attend daycare, school or work if they are exhibiting these symptoms. They can return when they are feeling better and their fever has been gone for over 24 hours without the use of acetaminophen or ibuprofen.
Given the large number of people currently developing symptoms of flu, our office is being flooded with phone calls, many of which are aimed at getting general information about the flu, or are regarding patients who are mildly ill, and who would neither require, nor benefit from, medical evaluation. While concerns about the flu are understandable, it must be remembered that H1N1 has been typically a mild illness in most cases, with the very large majority of patients, including children, not developing severe symptoms of illness or complications. Unless your child is under two years of age, or has a chronic medical condition (such as asthma, diabetes, chronic neuromuscular conditions, metabolic disease, or heart disease) they do not necessarily need medical evaluation or antiviral treatment and would benefit most if they were kept home, rested, and treated supportively. If our office is overwhelmed with calls regarding low-risk mildly ill individuals or for general questions, then there is a very real concern that we will not be able to effectively deal with those patients truly requiring our help. We would urge parents desiring high-quality information and general guidance regarding this illness to start by going on the web to www.cdc.gov or www.aap.org for up-to-date and accurate information rather then calling our office.
FLU VACCINES
We recommend the seasonal influenza vaccine for all of our patients over 6 months of age and all family members of children under 6 months of age. FluMist nasal spray and flu “shots” can be given to children over 2 years of age. Children under 2 years can only receive flu shots. Children younger than 9 years of age who have not previously been immunized against influenza require 2 doses administered at least 1 month apart to produce a satisfactory antibody response. If your child is taking an anti-flu medication such as Tamiflu, they can receive the injectable flu vaccine at any time, but must wait a few days after finishing the medication to receive FluMist.
A flu vaccine for the H1N1 virus has been developed and the Health Department is in the process of distributing the vaccine to doctors’ offices. However, the supply is somewhat limited and delivery of the vaccine is infrequent. We are currently vaccinating children who are 6 months of age and older. Watch our web site for information about increased supply of H1N1 vaccine and how we will proceed at that point.
WAYS TO PROTECT YOURSELF AND YOUR FAMILY
Stay informed: Visit www.cdc.gov/h1n1flu/ for the latest information from the CDC. Cover your mouth and nose with a tissue when you cough or sneeze and throw the tissue away after you use it. Wash hands often with soap and water. Alcohol based hand cleaners are also effective. Avoid touching your eyes, nose or mouth. Try to avoid close contact with sick people. People may be contagious from one day before they develop symptoms to up to 7 days after they get sick (potentially longer in children). If you are sick with flu-like symptoms stay home for 7 days after your symptoms begin or until you have been fever free for 24 hours without the use of acetaminophen or ibuprofen (whichever is longer). Keep away from other household members as much as possible. If you are sick and sharing a common space with other household members or need to leave your home to seek medical care wear a mask. Antivirals which treat flu are available. They should be started within 48 hours of illness to be most effective, they are not needed for most people with mild illness who have no underlying medical issues, and there are infrequent reported side effects.
