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A Flu Season Primer

Influenza is caused by a variety of different viruses. For the past three seasons, 39 percent of influenza-related hospitalizations have occurred in children and adolescents younger than 18 years of age—most caused by the A/H1N1 virus. Flu season is at its peak between January and April, so parents should be on the lookout for signs and symptoms and keep a child at home if they think he or she is infected. Children who are young, severely ill, or have worsening symptoms should be treated with an antiviral agent (e.g. Tamiflu) as soon as possible. Ideally, treatment should begin within two days of symptom onset, though treatment benefits will occur for up to five days after onset.

How is the virus spread? One can catch the Influenza viruses by breathing in droplets expressed when an infected person coughs or sneezes nearby (within a meter) or by touching surfaces contaminated by the virus. Once exposed it can take several days before flu symptoms appear. This period is known as the incubation period. Infected adults can spread viruses one day before symptoms appear to about three to five days after showing symptoms. Children may infect other children several days before they have symptoms to more than 10 days after symptoms appear. It's important to remember that infants (less than 6 months of age) may not show fever or cough with a flu infection.


The most common virus for the 2014 flu season is the A/H1N1 virus. Vaccines, which are readily available and given yearly, remain the best way to prevent disease, however, some vaccinated children may still contract the flu. Check with your physician to know which vaccine is the best for your child. Usually, a flu vaccine is not given if your child has a fever or is otherwise ill.

Other ways to prevent infection include:
  1. Avoid sharing cups and utensils with friends.
  2. Use portable hand sanitizers when it is not possible to wash your hands with soap and water. 
As the season progresses, here are some basic facts every parent should know: 

The best way to prevent your child or baby 6 months or older from getting the flu is to ask his or her doctor about obtaining a vaccine. Advise your child of prevention strategies. Remind children of the importance of not sharing cups and eating utensils with friends, and provide them with portable hand sanitizers. Remind them that one of the most important strategies is washing their hands with soap and water.

What if your child begins showing symptoms?
Contain the illness: If your child has a fever or other symptoms, be sure to keep him or her at home. Take his or her temperature, and keep siblings and other family members separated from the child as much as possible. Be sure to wash your hands after every visit to the child’s room, and wash all items the child touches. Keep your child home until he or she has been symptomfree for 24 hours.
Manage symptoms
If your child’s fever is high, work to control it through use of medications such as acetaminophen, ibuprofen or naprosyn (ask your physician to choose which is best). After administering the proper dose for age and weight, you may provide baths at room temperature and cool compresses. Offer oral hydrating solutions such as Pedialyte if the child is vomiting. It is important to offer frequent small meals and avoid over bundling a feverish child.
When to see a doctor
Be sure to see your doctor right away if the fever persists for more than three days or in the event of frequent night awakenings due to headaches or vomiting. Remember, you know your child better than anyone, so if you are worried, visit your doctor immediately.

Dr. Gloria Riefkohl is a pediatrician with Nicklaus Children's Hospital, formerly Miami Children's Hospital’s Pediatric Care Center and the Division of Preventive Medicine.

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