Wednesday, October 1, 2008

Health Care and the Flu

Flu season is upon us. Pediatrician Vincent Ianelli says that the CDC recommends that children and teens should start getting their flu vaccine in September, or as soon as the flu vaccine becomes available, so many kids have started getting flu shots already. That's great as we prepare for this year's flu season, but parents should remember that they do have more options this year, even as experts recommend that all children get vaccinated against the flu. That option is between a flu shot and FluMist - the nasal spray flu vaccine. FluMist isn't for every child, but it is a good option to consider in getting your child vaccinated against the flu if he is older than age 2 and doesn't have any health problems. And in recent years, the recommended ages for getting a flu vaccine has greatly expanded, from just high-risk kids a few years ago to all kids between the ages of 6 months and 2 years (2004), from all kids 6 months to age 5 (2006) to the current recommendations that all children older than ages 6 months to 18 years should get a flu vaccine (2008 and 2009 flu seasons).

The New York Times reports that the flu usually begins abruptly, with a fever between 102 and 106 °F. (An adult typically has a lower fever than a child.) Other common symptoms include a flushed face, body aches, chills, headache, nausea, and lack of energy. Some people have dizziness or vomiting. The fever usually lasts for a day or two, but can last 5 days. Somewhere between day 2 and day 4 of the illness, the "whole body" symptoms begin to subside, and respiratory symptoms begin to increase. The flu virus can settle anywhere in the respiratory tract, producing symptoms of a cold, croup, sore throat, bronchiolitis, ear infection, or pneumonia. The most prominent of the respiratory symptoms is usually a dry, hacking cough. Most people also develop a sore throat and headache. Nasal discharge (runny nose) and sneezing are common. These symptoms (except the cough) usually disappear within 4 - 7 days. And, sometimes, the fever returns. Cough and tiredness usually last for weeks after the rest of the illness is over.

According to the NY Times, Influenza A usually arrives in the late winter or early spring. Influenza B can appear at any time of the year. The most common way to catch the flu is by breathing in droplets from coughs or sneezes. Less often, it is spread when you touch a surface such as a faucet handle or phone that has the virus on it, and then touch your own mouth, nose, or eyes. Symptoms appear 1 - 7 days later (usually within 2 - 3 days). Because the flu spreads through the air and is very contagious, it often strikes a community all at once. This creates a cluster of school and work absences. Many students become sick within 2 or 3 weeks of the flu's arrival in a school. Tens of millions of people in the United States get the flu each year. Most get better within a week or two, but thousands become sick enough to be hospitalized. About 36,000 people die each year from complications of the flu.

One alternative to the traditional flu shot is to use Flumist. However, Dr. Ianelli also indicates that for one thing, Flumist can't be given to everyone, including:
--children younger than age 2.
--adults older than 50 years old.
--children with medical conditions, such as asthma or reactive airway disease, diabetes, chronic heart disease, chronic lung disease or a weakened immune system.
--children younger than age 5 who have had problems with recurrent wheezing.
--children who are taking aspirin.
--teens who are pregnant.
So, basically, that means it should mostly be given to healthy children, which leaves out most high-risk children who need a flu vaccine.

Also, according to the NY Times, if you have mild illness and are not at high risk, take these steps:
--Rest.
--Take medicines that relieve symptoms and help you rest.
--Drink plenty of liquids.
--Avoid aspirin (especially teens and children).
--Avoid alcohol and tobacco.
--Avoid antibiotics (unless necessary for another illness).

If the flu is diagnosed within 48 hours of when symptoms begin, especially if you are at high risk for complications, antiviral medications may help shorten the length of symptoms by about one day. The U.S. Centers for Disease Control and Prevention (CDC) recommends using oseltamivir (Tamiflu) or zanamivir (Relenza), which are active against both influenza A and B for patients who need to be treated. These medicines affect different viruses. Each of these medicines has different routes of administration and different side effects. Talk to your doctor about whether one of these drugs is right for you. Treatment is usually not necessary for children, but if the illness is diagnosed early and the patient is at risk of developing a severe case, it can be started. Oseltamivir (Tamiflu) is the best choice for children age 12 and older. Zanamivir (Relenza) is not FDA-approved for children under age 7. Treatment will only help if started early and only if the illness is actually influenza. It will not help treat a regular cold. A yearly flu vaccine is currently recommended for many people. Possible complications if you catch the flu, especially for those at high risk, include:
--Pneumonia.
--Encephalitis (infection of the brain).
--Bronchitis.
--Sinus infections.
--Ear infections.

According to the CDC, the single best way to prevent seasonal flu is to get vaccinated each year, but good health habits like covering your cough and washing your hands often can help prevent respiratory illnesses like the flu. There also are flu antiviral drugs that can be used to treat and prevent the flu. If you are not considered to be an individual in one of the high risk groups, it makes sense to get a flu shot or use the Flumist to prevent feeling really sick if you happen to catch the illness. Use common sense about personal hygiene, especially during flu season. Avoid close contact with anyone who may have the flu and practice good health habits. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.

Until next time. Let me know what you think.

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