What is influenza?

Influenza ("the flu") is a viral illness that typically hits Tennessee in the late fall and winter. Symptoms include:

• fever (often very high, up to 106.5 degrees)
• fatigue and exhaustion (can last 2-3 weeks)
• headache and muscle aches
• red, watery eyes
• cough (usually dry)
• runny nose
• sore throat

Although people may refer to bad colds or other viruses as "a touch of the flu," true influenza is much more severe. In fact, it doesn't usually just touch you -- it feels more like a hammer! The two major influenza strains referred to as A and B.

Influenza A (about 90% of all cases) is the cause of the major pandemics (worldwide epidemics) of influenza that have occurred.

Influenza B (about 10% of cases) is less common and less severe than Type A, but is often associated with specific outbreaks, such as in nursing homes or daycares.

Rapid tests are now available for diagnosing influenza in our office. We can use a cotton swab to get a mucus sample from one nostril; results can be back in as soon as 5 minutes.

In cases of community epidemics, or when it is known that a family member is positive for influenza, we will sometimes not test a child if he or she is showing classic influenza symptoms.

Fortunately, most healthy kids recover from influenza without complications. However, influenza can cause lots of problems:

• About 1% of people who get the flu end up in the hospital.
• In the winter, as many as 30% of all children in the hospital are there for complications of influenza. In children, this is usually related to dehydration; less commonly, influenza pneumonia can occur.
• During the 2003-2004 flu epidemic in the US, about 150 children died from influenza. Half of these children were previously healthy youngsters.
• Even a relatively mild case of influenza can cause lots of time in missed school, missed work, and lots of money spent on doctor's visits, medicine, etc.

• Good handwashing. Ordinary soap is sufficient. Alcohol-based hand gels are useful if soap and water are not handy.
• Breastfeeding your baby. Women who breastfeed reduce the risk of respiratory infections in their children.
• Annual flu shots. Studies are finding that the more people that are vaccinated, the healthier the community at large. Some points to remember:
  • Flu shots do not give you the flu.
  • Even if your child gets a strain of influenza not covered by the flu shot, his or her symptoms will be much milder.
  • We recommend influenza shots in all children over 6 months old, especially those who are at risk: daycare attenders, children with asthma or other lung conditions, children prone to febrile seizures, etc.
  • If you are pregnant or nursing, you can still get the flu shot.

Tylenol and ibuprofen work well for fever and achiness.

Prescription antiviral medicines. Because influenza is a virus, antibiotics are not helpful against it. However, there are some medications which can shorten the course of influenza a little and make people less contagious if they are started within 48 hours of showing symptoms. The two most common medications pediatricians use are amantadine (Symmetrel) and oseltamivir (Tamiflu). Both are approved for children over age 1 year. Unfortunately, many strains of influenza are now resistant to these medications, and they can cause nausea and vomiting in many children.

Do not use aspirin in children or teenagers who have influenza. There is a small chance of getting Reye's syndrome (liver failure and coma), a rare but sometimes fatal disease.