Kids under the age of 5 and those with inflammatory diseases such as juvenile idiopathic arthritis (JIA) have a higher risk of getting an infection, including the flu, according to the Centers for Disease Control and Prevention (CDC). And when they get the flu, they often have more severe disease and may require hospitalization.
“The younger the child, the more significant the concern because of the potential for severe illness,” says Michael Gutzeit, MD, chief medical officer and vice president of Quality, Childrens Hospital of Wisconsin. “Young patients with arthritis are at greater risk for seasonal flu and H1N1 if they are taking medications that suppress their immune system,” adds Paul Rosen, MD, MPH, clinical director of the division of Pediatric Rheumatology at Childrens Hospital of Pittsburgh.
Teach the Basics
How do you protect your child against these potentially dangerous seasonal illnesses? The CDC offers these steps:
Make sure your child’s hands are washed often. Sing along to a verse of “Happy Birthday” while helping younger children wash their hands a minimum of 20 seconds with soap and water. Alcohol-based hand cleaners are acceptable. However, these instant sanitizers can be toxic if swallowed, and should be kept out of the reach of small children.
Avoid touching eyes, nose, or mouth. Germs spread this way.
Clean surfaces and objects frequently. Bathrooms and kitchens, toys and the like should be wiped down with a household disinfectant during routine cleaning.
Teach your child good cough and sneeze practices. He or she should use an elbow or turn toward a shoulder. A tissue can be used but make certain that your child discards tissues right away and washes her hands.
Keep your child away from sick people. Sporting events, school activities and public gatherings may need to be avoided when there is an outbreak.
Practice good health habits. Get plenty of sleep and exercise, manage your stress, drink plenty of fluids, and eat healthy food.
Create a flu plan. Consult with your child’s doctor, school or early childhood program to develop a plan to handle his special needs to avoid likelihood of infection.
To Vaccinate or Not?
Consensus from the CDC, the Arthritis Foundation and other leading medical organizations confirm the importance of annual seasonal flu vaccinations for children over the age of 6 months.
“The seasonal flu vaccination is the best way to prevent the flu and is highly recommended for young children with chronic health conditions and those at high risk of complications,” says Jennifer M. Hoorman, PhD, an epidemiologist with the Arthritis Program at CDC.
The CDC recommends that with the H1N1 flu shot in nasal spray form should not be given to children. Why? The nasal spray (sold as FluMist) contains live, but weakened, flu viruses, and is not recommended for people who take medications that suppress the immune system or anyone younger than age 2. Regular flu shots, on the other hand, contain flu viruses that have been killed, so they are safer for children who have less immune function, according to researchers.
“Hopefully, pediatricians and family physicians will recognize this increased susceptibility and will encourage these patients to receive the H1N1 vaccine,” says Herb Lazarus, MD, division of Pediatric Rheumatology at New York University. “And, remember too, that siblings are also a risk group that should be vaccinated.”
Cold or Flu?
Young children may not be able to verbalize their symptoms, which can result in a parent’s delay in responding. Watch carefully for the symptoms of seasonal illnesses or unusual behavior that may be a sign that your child is ill: sore throat, stuffy nose, cough, chills, sweats, increased fatigue. A fever, measured by mouth, equal or greater to 100 degrees Fahrenheit is an early indication of a more serious bout.
Severe symptoms, especially high fevers that last three to four days, extreme fatigue, headaches, weakness and coughs, and sometimes vomiting and diarrhea, are associated with the flu.
“We’re especially concerned about persistently high fever that’s unrelenting, fever that is causing other significant signs, such as confusion, disorientation, irritability that’s not consolable and significant variations from the usual behavior pattern of a child,” says Dr. Gutzeit.
Contact your child’s doctor immediately if you think he or she has the flu. Anti viral medicines work best when started within the first two days of getting sick. Keep your child at home for at least 24-hours after your child no longer has a fever or signs of fever. This important to the health of your child and others. Make sure your child gets plenty of rest and drinks clear fluids. Water, broth, sports drinks and juices will prevent dehydration. For infants, electrolyte drinks such as Pedialyte are recommended.
According to the CDC, the timing of flu is unpredictable and can vary from season to season. Seasonal flu activity can begin as early as October and continue to occur as late as May. Flu activity most commonly peaks in the United States in January or February. Develop a “flu preparedness plan” that addresses any potential work or childcare issues should a family member get the flu.
But parents shouldn’t forget to take care of themselves. Flu vaccines are highly recommended for adults as well. If are exposed to the flu virus, see your doctor immediately. He or she may prescribe medication to help prevent you from getting the flu or shorten the duration of your illness. Antiviral medications are prescription pills, syrups or inhalers used to prevent or treat flu viruses. There are four antiviral drugs approved for treating the flu in the United States — oseltamivir (Tamiflu), zanamivir (Relenza), amantadine (Symmetrel), and rimantadine (Flumadine). The sooner you are treated with an antiviral, the more likely it will prevent the flu.