Unfortunately, this year we have been hit with another significant flu season. This year we are seeing both influenza type A and type B. The typical symptoms include high fever (103-104 degrees), headache, muscle aches, congestion, cough, and vomiting. The flu vaccine this year was partially effective and we are finding that people who did get the vaccine may be more mildly affected than those who were unvaccinated.
If you think you or your child have the flu, you are probably right! The treatment for flu includes rest, fever control, and hydration! You can find weight-based dosing guidelines for Tylenol (acetaminophen) and Motrin (ibuprofen) on our website or in the acute illness guide.
In general we do not need to see patients at the office for basic flu symptoms. Our recommendations for typical flu-related symptoms will be as for any typical viral illness. HOWEVER, we DO want to see patients who have persistent or worsening fever (lasting longer than 4-5 days), patients with rapid breathing or respiratory distress, difficulty staying hydrated, children and adolescents with acute change in mental status, or any other severe, worsening, or unexpected symptoms.
The only treatment (other than supportive care) for the influenza virus is Tamiflu. Tamiflu initiation within 24 hours of symptom onset is indicated for the following people:
- Patients hospitalized for acute Flu symptoms
- Severe, complicated, or progressive illness
- At high risk for influenza complications. These include:
- Children younger than 2 years of age
- People who are chronically immunosuppressed
- People with chronic pulmonary (including asthma), cardiovascular (except hypertension alone), renal, hepatic, hematological (including sickle cell disease), and metabolic disorders (including diabetes mellitus), or neurologic and neurodevelopment conditions (including disorders of the brain, spinal cord, peripheral nerve, and muscle, such as cerebral palsy, epilepsy [seizure disorders], stroke, intellectual disability, moderate to severe developmental delay, muscular dystrophy, or spinal cord injury)
- Children and adolescents who are on chronic daily aspirin therapy (not motrin or tylenol)
Tamiflu is known to reduce the duration of flu symptoms by about 12-24 hours. The side effects include headache, muscle aches, nausea, vomiting, diarrhea, dizziness, nosebleeds, insomnia (difficulty sleeping), and psychosis.
At CMO, we believe that Tamiflu is indicated, as above, for our high risk infants and children. However, we think that the risks of Tamiflu for otherwise healthy patients far outweighs any potential benefits.
What does this mean for your child? If your child fits into one of the high risk categories above, we want to see him/her for evaluation, flu testing, and management. However, if your child is low risk and otherwise previously healthy, we strongly recommend that you treat the flu at home with supportive care and see us only if other worsening or specific symptoms appear.
Thank you for helping us keep all our children healthy and safe through flu season.
The providers at Children’s Medical Office