It’s that time of year again, dreaded flu season. Hospitals, urgent cares, and primary care offices are full of sick patients, every nurse I know has chapped hands from washing a million times a day, and I think we all know some unfortunate family member or friend who has come down with it. Even I’ll admit, walking into grocery stores, pharmacies, or church events the past few weeks has felt a little bit like playing Russian Roulette with illness. Parents are worried, (we have been answering lots of flu questions in the KidNurse Community) and I understand their concerns.
What Every Parent Should Know About The Flu This Year
Every year, influenza causes serious illness and even death. It’s not an illness to be trivialized, especially this year with the trends we are seeing. These are the important updates that parents should know about the 2017-2018 flu season.
Is this year’s flu season worse than other years in the past?
Influenza typically circulates in the United States during the fall and winter months, and peaks November through March. Influenza is widespread across the entire United States right now. We are seeing more cases at this point in the flu season than we have in previous years. In fact, this is the first time in 13 years that the entire country is experiencing widespread flu at the same time (see map below). As most of the parents I work with have been asking, it’s true that this year’s flu activity is severe.
The CDC tracks information on patients with a lab-confirmed flu diagnosis and the hospitalization rates across the country from the flu. They have created a very interactive site with that information, so visit it here if you’d like to know more flu tracking specifics for your state. Unfortunately, in my state of Arizona, flu cases are up 938% this year over last year.
Do people really die from the flu?
And yes, it’s important to remember that the flu can kill people who are perfectly healthy. Like this 21 year old body builder who died a few weeks ago. Or this 17 year old. Or this precious 4 year old. I had a family friend in her 40’s who ran marathons and exercised religiously who died from influenza a few years ago. She thought she caught a cold and died 3 days later in her husband’s arms as he was rushing her into urgent care. Influenza kills both healthy and immune-compromised alike, and it is very tragic.
When parents bring up flu vaccine concerns with me, I like to remind them that out of all the diseases we vaccinate against, the flu kills more Americans every year than any other vaccine-preventable disease.
What do the different “strains” of the flu mean?
Influenza is caused by a virus. There are two main types of influenza viruses – type A and type B. This year, the most common strain making people sick is a type A strain known as H3N2. This is unfortunate because historically H3N2 causes the most hospitalizations and deaths. Because this strain is the most prevalent this season (approximately 80% of cases are H3N2 right now), we are seeing more severe cases of influenza.
Should I still get a flu shot if I haven’t already?
Yes. While it will still take about 2 weeks for your body to respond to the flu shot to build protective antibodies, it is not too late to get a flu shot. Flu activity can last well into April and sometimes even May. Dr. Jernigan at the CDC said during a press conference last week that he anticipates at least 11 to 13 more weeks of increased flu activity before it finally starts tapering off. This vaccine finder is a great resource for finding the nearest location that offers flu shots.
But I heard the flu shot isn’t very effective for this year’s flu season?
We won’t know the true efficacy of this year’s flu vaccine until mid-February. Some reports have estimated that the vaccine is about 10% effected based off of Australia’s flu season, but Australia and the US have some important differences. Many flu experts here are anticipating that the flu shot will be about 30% effective or more, but we truly don’t have the data back yet. Here is a great summary about efficacy regarding different flu strains from a Shot of Prevention:
“Last season, vaccine effectiveness in the U.S. was 39% and effectiveness against the H3N2 strain was 32%. However, if you look back beyond just last season, multi-year pooled vaccine effectiveness against the H3N2 strain has consistently been between 30 – 40%, while effectiveness against influenza B viruses has been about 54%, and against H1N1 viruses as high as 61%. That’s good news because even though this season appears to be dominated by the H3N2 strain of flu, the surveillance data is already indicating that there are H1N1 strains and B strains circulating as well, and the vaccine is known to protect against those strains as well.”
Additionally, it should be noted that when the flu season peaks early like this year, and it’s dominated mainly by type A strains, we can sometimes see an increase in type B strains in the spring. Again, we won’t know for sure until it is here, but that has happened historically. The protection provided by this year’s flu shot for type B strains is looking quite positive.
What are the most common symptoms of influenza?
First of all, we call influenza “the flu” but it should not be confused with the stomach flu (gastroenteritis). Gastroenteritis usually causes a stomach ache, vomiting, diarrhea, and sometimes fever for about 24-48 hours. Rest and plenty of hydration are will usually clear up the stomach flu in a few days.
Influenza hits fast but can last as long as 2 weeks. Most children will have consistent symptoms for an average of 5-7 days. Patients describe feeling like they have been “hit by a 2×4.” Influenza causes symptoms you can’t ignore and children will usually want to be in bed or on the couch until those symptoms finally start to improve. Common symptoms include a fever over 101 degrees, body aches, headaches, fatigue, weakness, and exhaustion. Children with the flu normally have a cough and congestion, and can sometimes have nausea and vomiting as well. Here’s a great breakdown of influenza vs the common cold if you are unsure if your child has a run-of-the-mill viral cold or influenza.
What should I do if my child starts showing symptoms of influenza?
The basic treatment for influenza is what medical professionals call supportive care: mainly, fluids and rest. The fluids are especially important as you need to make sure your child stays well hydrated.
If your child is experiencing pain or a high fever from influenza, you can give them acetaminophen or ibuprofen.
Also, if you think your child is having flu symptoms, you can call or schedule a visit with your pediatric care provider to see if an anti-viral medication known as Tamiflu would be helpful for your child. If Tamiflu is started within the first 48 hours of your child’s flu symptoms, research shows that it can lessen the length of influenza symptoms by 1 to 1 ½ days. This medication is especially recommended for children who are immune-compromised or have other medical conditions. Side effects can include GI upset like nausea, vomiting and diarrhea, and very rarely behavioral disturbances, so Tamiflu may not be right for every child with influenza. Consult your pediatric provider for whether or not Tamiflu is indicated for your child.
Monitor your child for extreme lethargy or fatigue. If your child experiences worsening symptoms, it’s time to visit your pediatric care provider or the ER. Pneumonia is a common secondary infection to influenza and can cause respiratory distress, so any changes in breathing are also a concern.
To save the rest of your family and the general public from your little one’s germs, it’s VERY important to practice good hand washing, stay away from public places while contagious, and thoroughly clean the house.
How long is someone with influenza contagious?
It can take between 24 hours and four days for symptoms to start after you are exposed to influenza. Unlike many illnesses that are only contagious when you’re experiencing symptoms, you can start spreading the flu 24 hours before your symptoms appear. After symptoms start, adults can spread the virus for 5-10 days and sometimes children can spread the virus past 10 days.
Your child may start feeling well before those 10 days have passed, but it’s important that you continue to keep them at home and away from the public while it’s possible they are still contagious. Children need to be fever-free without taking fever reducers (like acetaminophen or ibuprofen) for at least 24 hours before going back to school. Since influenza is spread through droplets, it’s also very important (especially with little children) that coughing and sneezing has resolved.
Use this time to read good books and watch a little television. Board games are also great once your child is feeling better. And, of course, you can also catch up on some of the schoolwork they need to do – the school would much rather have you teach your child at home for a few extra days than risk them sharing influenza with the whole class.
I’m hoping your family stays healthy this season, but if not and if you have flu questions I didn’t answer here, please leave them in the comments or join the KidNurse Community on Facebook!