INFLUENZA (flu) is a viral infection characterized by the sudden onset of fever, often with chills, headache, muscle aches, and dry cough. Respiratory symptoms rapidly become more prominent including sore throat, nasal congestion, and cough. Conjunctivitis (pink eye), stomach ache, nausea, and vomiting can also occur. Fever can be quite high and last from three to five days. The cough may last one to two weeks. An individual with the "flu" usually feels very tired, aching, and "wiped out". For others it may just feel like a bad cold. Complications of influenza include ear infection, pneumonia, sinusitis, croup, and worsening of chronic diseases such as asthma or diabetes. This is not to be confused with the "stomach flu", where the main symptoms are vomiting and diarrhea, and is caused by germs other than the influenza virus.

Influenza epidemics tend to occur yearly, usually during the winter months. Different strains of Influenza type A and B tend to cause epidemics that can last for three months. An individual may become ill with more than one strain during the "flu" season. Influenza is most contagious from the day before symptoms begin through the peak of the symptoms, but usually no longer than seven days.

Most children are sick with influenza for a few days, but some children get much sicker and may need to be hospitalized. Influenza is responsible for over 20,000 deaths in the U.S. annually.

PREVENTION: Influenza is spread by direct contact and droplet infection or by articles contaminated by nasal secretions. Careful hand washing is important but small air droplets can spread infection across a room. Administration of the influenza vaccine each year is recommended for all with chronic diseases such as asthma or diabetes. It can also be given to those who desire to decrease their chance of acquiring influenza.

VACCINATION: The influenza vaccine offers good protection against disease. Since the influenza viruses change from year to year, it is necessary to get revaccinated each year to maintain protection. Although some people who received the vaccine will still get the "flu", it is usually a milder than those who do not get the vaccine. In general, those children older than six months of age who are at greater risk of getting a serious case of influenza or suffering from its complications should get the vaccine.

We recommend INFLUENZA VACCINATION for:

• Children with long-term health problems such as: heart disease, kidney disease, metabolic diseases like diabetes or blood disorders like chronic anemia.
• Children with underlying lung disorders like asthma, reactive airway disease or respiratory problems secondary to pre-maturity.
• Any child on long-term aspirin treatment such as: children with arthritis.
• Any child living in a group home.
• Any child that has a weakened immune system due to drug treatment or an underlying immune disorder.
• All children aged 6 to 59 months.
• All children who are household contacts of anyone 0-59 months and 65 years and older, or any high risk person as listed above.

Most people need only one influenza vaccination to prevent sickness. Two doses of influenza vaccine are recommended for children under 9 years of age receiving flu vaccine for the first time. One dose of vaccine is better than none, but it may not provide sufficient protection against influenza.

VACCINE CHOICES: Injectable flu vaccine is recommended for those ages 6 -59 months and those with chronic illnesses such as diabetes or asthma. If two doses are needed, they must be separated by at least four weeks. The live, inactivated nasal influenza vaccine called Flumist is recommended for those age 5 years and up who are generally healthy and without chronic illness. This vaccine is given as a nasal spray (in the nose) instead of injection. If two doses are needed, they must be separated by at least 6 weeks.

APPOINTMENTS FOR VACCINATION: We generally start giving influenza vaccine to children in the fall or when our supply arrives. Because of supply issues, we only schedule appointments one week in advance.

REACTIONS: If you have ever had a serious reaction to eggs or a previous influenza vaccine, talk with your provider before receiving the vaccine.

Serious reactions from the vaccine are extremely rare. The vaccines are made so that you cannot get influenza from the vaccine. With the injection, mild reactions include soreness, redness and swelling where the shot was given; fever and body aches. These usually last one to two days. Reactions from the nasal influenza vaccine are also generally mild such as low?grade fever, headache and body aches. If your child is a close contact with someone requiring protection from infections (they must wear a mask when going outside - like a bone marrow transplant patient), they should not receive the nasal vaccine.

If you have additional questions, please talk to your provider.

TREATMENT: If your child does come down with influenza, treatment is mainly directed at symptom relief, just like most colds or viral infections.

• Fever and aches can be treated with appropriate doses of acetaminophen (Tylenol) or ibuprofen (Motrin, Advil). Children and adolescents should never take or be given aspirin because it may cause Reye's syndrome.
• Cough and hoarseness may be treated with over-the-counter cough and cold medications in doses recommended on the label in children over three years old. Large amounts of fluids by mouth, extra humidity provided by a room humidifier or cool mist vaporizer, and sleeping with the head propped up may also provide symptomatic relief.
• Sore throat may be treated by using cough drops or hard candy for older children only and warm liquids such as broth or chicken soup for younger children.
• Stuffy nose may be treated with salt water nose drops (one-quarter teaspoon of salt in eight ounces of water), nasal suctioning or nose blowing to open blocked passages. Over-the-counter cold and cough medications may provide some symptomatic relief in children over three years old.

CALL THE OFFICE IF:

• Your child is having difficulty breathing.
• Your child shows signs of dehydration, such as lethargy, dry mouth, decreased urination, and sunken eyes.
• Your child develops complications such as earache, sinus pain or pressure, or a high fever lasting more than five days.
• Your child's cough lasts more than one week without signs of improvement or is still present after two weeks.