Flu Questions and Answers
October 2005Dr. Kathleen Gutierrez, a pediatric infectious disease expert and director of the integrated infectious disease program at Lucile Packard Children’s Hospital, answers the most commonly asked questions about the flu.
Dr. Gutierrez and her colleagues are also available to the nation's media to provide comment on this season's flu stories.
How many kids get the flu each year?
The number of children who get the flu each year is variable and depends on the types of influenza virus circulating each season. In general, it is estimated that 15% of preschool children and approximately 10-40% of school age children get the flu each season.
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Why is the flu vaccine recommended for children 6-23 months? Is the flu really that dangerous?
Influenza vaccine is recommended for all children 6-23 months age, even if they are healthy. Recent studies have shown that even previously healthy children in this age group are more likely than older children to end up in the hospital if they get the flu. The reasons for hospitalization include complications of flu infections such as pneumonia, dehydration or worsening of underlying medical problems. Deaths from complications of influenza are very rare but can occur.
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I've heard that the flu vaccine can actually cause the flu. Is this true? I don't want to run the risk that the vaccine will make my healthy child sick.
Flu vaccine cannot cause the flu. There are two types of flu vaccine that are licensed for use in children. The first vaccine (and the only one licensed for children younger than 5 years) is the trivalent inactivated influenza vaccine (TIV). This vaccine is an inactivated vaccine containing killed virus and is given as a shot. It is approved for use in healthy people older than 6 months and for people with chronic medical conditions. The second type of flu vaccine is given by nasal spray. It is made with a live weakened form of the flu virus. It is only approved for use in healthy people 5 to 49 years of age who have a normal immune system and who are not pregnant.
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How can I tell if my child has the flu? Maybe it’s just a cold.
The symptoms of the flu and other respiratory viruses can be similar, especially in young children. However, in general, the flu tends to make children sicker. They may have sudden fever (higher than 101), have chills with the fever, be very tired and not want to play, complain of headache and sore throat and have a dry cough. Some children with flu will have a stomach ache and vomiting or severe muscle pain. Children with colds usually have lower fever, more of a runny nose and are more likely to have more energy and want to play.
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So my child has the flu. How can I help him or her feel better and recover more quickly? What are some danger signs that might signal the need for additional medical attention?
Most children who have the flu get better without specific medical intervention. Supportive therapy including rest and plenty of fluids is important. Keep your child home from school to rest and also to prevent spread of infection to other children. It is important to remember NOT to give your child aspirin, since giving aspirin to children with influenza is associated with a serious illness called Reye's syndrome.
You should talk to your child's doctor if your child's fever persists beyond three or four days. Other signs that your child might need additional medical attention include refusing to drink, persistent cough or difficulty breathing, excessive sleepiness, persistent vomiting or diarrhea or complaints of ear pain.
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What about antiviral medications? Are they useful in children?
There are antiviral medications that are useful for treatment of influenza infections in children over one year of age. They are generally used for children with severe illness or who are at high risk for complications of flu. If given early in the course of illness, antiviral medications will decrease the duration of symptoms and the number of days your child is contagious. Your child's doctor will decide if an antiviral, or in the case of a bacterial complication of the flu, an antibiotic, is needed, and which is the best drug for your child. You must receive a prescription for these medications from your child’s doctor.
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I have a child under the age of two in my house. Should the whole family get immunized? What if my child is under the age of six months?
Since children under the age of six months cannot receive influenza vaccine, it is recommended that all household contacts and out-of-home caregivers of these babies receive influenza vaccine. In fact, members of these groups are currently identified as a priority group by the Santa Clara County Public Health Department and can receive influenza vaccine early (before October 24). In addition to immunizing children ages 6-23 months, their household contacts of children in this age group should also be immunized.
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We have an elderly or immuno-compromised person living with us in our household. Should I get my school-aged or day-care attending children immunized?
Yes. The American Academy of Pediatrics recommends that close contacts of family members who are at high risk for complications for influenza infection be immunized with flu vaccine.
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When does the flu season start? Why?
Influenza season in the United States usually occurs between December and March. The exact timing changes from year to year depending on the type of influenza virus that is circulating. At Lucile Packard Children's Hospital, we usually start looking for flu in patients with respiratory symptoms as early as October.
Influenza spreads more efficiently during the colder months of the year when people are indoors in close contact with each other. The flu virus spreads in respiratory droplets that are propelled through the air from coughing and sneezing. The virus can easily infect someone standing nearby or someone who touches the infected secretions. Remember that if you are sick with a respiratory illness to cover your mouth and nose with a tissue when you sneeze or cough and to wash your hands with soap and water frequently. Don't share eating utensils or towels.
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How worried should I be about the threat of avian influenza and my child?
So far, the cases of avian influenza that have occurred have primarily been the result of contact with infected poultry. The flu virus that has been causing avian influenza has not yet developed into a strain that is easily spread from person to person.
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