Is it the flu?: Here’s What to Do

Influenza, or flu, is a virus that we see primarily in the winter months. It’s classified as either A or B, and within those classifications we see more specific strains; think H1N1. The sneaky little booger actually changes from year to year by switching out proteins on the outside of the virus. That’s why we keep getting it and getting it and getting it….bummer.

 

People get the flu from respiratory droplets (flying spit) and contaminated surfaces (doorknobs and the like). The incubation period is about 2 days, so it’s contagious, and hits you quickly. Fun fact: flu A is most contagious for the first 24-48 hours, but flu B is most contagious at 24-48 before symptoms and then AGAIN 24-48 hours after.

What is it?

The flu is a respiratory virus. It’s not “the stomach flu.” The most common symptoms are fever, headache, body aches, and malaise (one of those medical words we use that means you feel like poo). Younger kids tend to have higher fevers, and more GI symptoms like diarrhea and vomiting. It’s not because they have the “stomach flu,” I promise I’m not contradicting myself here. It’s because all that snot they’re making is draining into their bellies, and making problems all the way through. In my experience, kids with flu also have eye redness, and kids with Flu B tend to have sore throats.

 

In otherwise healthy kids, the symptoms get better in about a week, with or without medicine. But, just like other viruses, the cough and malaise (poo feeling) may last longer as your body bounces back. All normal.

 

Testing and Treatment:

 

The CDC, Infectious Disease Society of America, and the American Academy of Pediatrics all recommend testing for the flu in all patients with the right symptoms, during the right season. I tend to recommend testing in patients who look “flu-y,” especially when I can’t find another problem to fix, such as an ear infection or chest infection.

 

The rapid test we use at KidMed is a nose swab, and gives results in about 15 minutes. It’s very sensitive and specific, and eliminates the “human interpretation” component of rapid testing. That means if you test positive, yes, you have it. But, even with our better rapid testing devices, if you test negative, you may still have the flu. That’s why a positive test isn’t necessary before starting antiviral medication.

 

My point is that “The Flu” is not a black and white issue. It’s really important to take each child’s background and presentation into consideration when deciding who to test, and what to do next.

 

Like all other viruses, there is virtually nothing we can do to make the flu “go away.” We have to buckle down, treat the symptoms, and wait it out. Thankfully (or not so thankfully, depending on which side of the debate you’re on), there are antiviral medicines that can at least shorten the length of the flu. They can also, SOMETIMES, prevent illness after you’ve been exposed.

 

The most recognized flu antiviral is Tamiflu. These drugs, made by someone much smarter than me, work by preventing virus release from infected cells. The main side effects of Tamiflu are nausea, vomiting, and diarrhea. Rarely, particularly in kids, Tamiflu can cause things like hallucinations, behavior changes, and severe skin reactions. Research shows, that Tamiflu can reduce the length of illness by about 1-2 days as long as it’s started within the first 48 hours of being sick. So, we take a 5-7 day illness and make it last 3-5 days instead. BUT, in those 3-5 days, you will still feel crummy. So, it’s really important that you still treat your symptoms.

 

On October 24, 2018, the FDA approved a new, one dose antiviral medication called Xofluza. It is for the treatment of acute uncomplicated influenza (flu) in patients 12 years of age and older who have been symptomatic for no more than 48 hours.

What next?

If you think your child has the flu:

  1. Come to KidMed, and request testing. Particularly if it’s within the first day or two of symptoms.
  2. Talk to our pediatric providers to find the best plan for your kid, and get tips and tricks for treating flu symptoms.

 

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