It’s that time of year again. Pumpkin patches sprout from empty lots, the clocks are turned back, children begin to anticipate the excitement of the upcoming holidays, all while parents and pediatricians begin to brace themselves for the onslaught of winter viruses. The most famous of these, of course, is “the flu”. Despite its notoriety and its yearly presence, however, the flu remains misunderstood by much of the public. There is confusion about what exactly this term means, how the disease is spread, and how it is treated. In addition, we now have a vaccine to aid in prevention, and vaccine recommendations have recently changed. The following, therefore, addresses some common questions regarding the flu as well as updates on the vaccine--essentially a crash course in Flu 101.
This term refers to an infection caused by the influenza virus. This virus infects the respiratory tract, including the nose, throat, and lungs. While many viruses cause a similar infection, influenza infection can lead to more severe illness and complications, including even death. In fact, epidemics of influenza cause an average of 20,000 deaths per year in the United States.
The flu tends to come on abruptly. A child may experience sudden onset of fever, headache, tiredness, sore throat, cough, runny nose and muscle aches. Some children can also experience nausea, vomiting, or diarrhea, though these symptoms are uncommon in adults. The term “stomach flu”, therefore, is almost always referring to an infection caused by something other than influenza.
The flu is spread from person to person, usually through the coughing and sneezing of an infected person. This sends the flu virus into the air, which can then be inhaled by nearby victims. The virus enters its subjects and begins to replicate. It’s also possible to pick up the virus from touching a surface contaminated by the virus and then touching one’s own nose or mouth. The flu is contagious from about one day prior to the onset of symptoms to about five days after. Some children may remain contagious longer, even more than a week.
The treatment is largely supportive. This includes rest, fluids, and treating the symptoms with cough or cold medications. Antibiotics cannot speed recovery unless intended to treat a complication of the flu such as an ear infection or pneumonia. There are four antiviral drugs available that are approved for treating flu. They can be helpful, but only if started within the first 48 hours of the illness, and even then they are no “quick fix”. They can however, shorten the course of illness by about one day. They are all be prescription only and have varying potential side effects.
Any child over six months can get the flu shot as all are at risk of getting the flu. Some children, however, are more at risk for complications. This includes children with chronic heart or lung conditions, including asthma; those with other chronic illnesses, such as kidney disease or weakened immune systems; and those on daily aspirin therapy. The concern with aspirin stems from the risk of developing a serious condition called Reye syndrome if aspirin is given during an influenza infection. In addition, this year’s recommendations include giving the flu shot to children ages 6 to 23 months when possible. Of note for families, pregnant women in their second or third trimesters during the flu season should also get the flu vaccine.
The annual epidemic is caused by different influenza viruses, necessitating a new vaccine each year. Different types of influenza virus are created through changes in the surface proteins on the virus. Therefore, the body’s immune system cannot recognize the 2002 winter flu even though it may have already dealt with a 2001 strain. Each year, experts try to predict what influenza viruses might be in circulation during the coming winter season. The vaccine is based on those predictions and is designed to include the three most likely strains.
No. The flu vaccine CANNOT cause the flu. It’s made from egg-grown viruses that are inactivated, or rendered noninfectious. Occasionally, a flu shot recipient may experience temporary low-grade fever or aching, but this is not actually the flu itself. Someone who gets a high fever and runny nose after the flu shot has a coincidental infection from another virus.
Does the flu shot work? I got mine last year and still got sick!
Yes, the flu shot does work, though protection is not 100 percent. Studies have shown it to be 70 to 90 percent effective in healthy young adults. The vast majority of those getting ill in a season following their flu shot are therefore getting ill from some other virus. There are a lot of bad guys out there, and the flu shot can only protect you from influenza. Why bother then? We bother because out of all the bad guys, the influenza virus is the worst and most deadly.