Taking on Flu Season with Kids

Do you remember last year’s flu season? As a pediatrician and a mom, it will be hard for me to forget. I feel like everyone I knew was reeling from either getting sick themselves, or having someone close to them get sick - really sick. I also heard stories from my fellow pediatricians about how their patients were ending up in the hospital for the flu. And some even reporting that their patient had been one of the 179 children who had died from complications of the flu. It was one of the worst flu seasons on record and hopefully we won’t see a repeat of it any time soon.

Preventing the flu

The good news is that we don’t need to just sit back and hope that the flu doesn’t hit as hard. And actually, there are a lot of proactive steps that each of us can take to help prevent the spread of the flu:

1. Get the flu vaccine - The American Academy of Pediatrics (AAP) just released their recommendations for prevention and control of influenza in children for the upcoming 2018-2019 winter. On the top of the list is getting a flu vaccine for every child over the age of 6 months, as early as it’s available in your pediatrician’s office, or by the end of October at the latest. The flu vaccine comes in either a shot or a nasal spray, and both can be used to help prevent the flu.
2. Or get the flu nasal spray - You may have heard that the flu spray isn’t being offered anymore, and it’s true that the AAP stopped recommending the nasal spray for the last couple of years because it wasn’t as effective as the shot. But this year the spray manufacturer has changed the formulation, so that it should be more effective. The AAP still recommends the flu shot as the better option, but if your child is over the age of 2, is otherwise healthy, and is refusing the flu shot, then the nasal spray could be a good option. However, if you’re totally set on the nasal spray, I’d call the office before you come in. Some offices decided not to order the nasal spray this year, so it’s best to check if they have it in stock. Finally, if your child has an egg allergy, don’t worry! The flu vaccine doesn’t contain eggs and is safe for kids that have egg allergies.
3. Hand-washing - Hand washing is key to prevent the spread of the flu. Teach your children to wash their hands before they go into school, before and after eating, and as soon as they get home. A person with the flu can start to spread the virus to other people up to two days before they start feeling sick themselves. It’s best to assume that there are flu viruses passed around in school, and to always keep your hands clean!
4. Stay home when sick- If your child has sign of the flu (fever, aches, runny nose), it’s best for everyone to keep them home until they feel better. A good rule of thumb is that a child has to be without fever for at least 24 hours (without Tylenol or ibuprofen) before they can come back to school.

Treating the flu

The flu is a virus, which means that antibiotics don’t help to cure it. So, if you think your child has the flu, what can you do?

Check in with a doctor - Since colds and the flu are often difficult to tell apart, if your child has had a cough and runny nose with a fever (temperature of 100.4 or above), get an appointment with a doctor to go over how your child is feeling. This appointment can be in-person, or it can be done with telemedicine over a video visit, saving you a trip into the doctor’s office and reducing the risk of spreading the flu virus to other kids.

Ask about anti-viral medicines - It’s important that you set up this appointment to occur within 24 hours of the first flu symptom. Your doctor may want to give your child an anti-viral medication that can help treat the flu and this should happen as soon as possible. If you’re having trouble getting an in-person visit, this is another scenario where seeing your doctor over video may be the way to go. It’s especially important to talk to a doctor if your child:

• Has an underlying health problem like asthma, diabetes, sickle cell disease, or cerebral palsy;
• Is younger than a 6-month old;
• Is younger than 5 years old, especially if less than 2 years old.

Give lots of love - Having the flu isn’t fun for anyone, and it’s often particularly hard for kids to be sick and down for the count over the 5-7 days that it takes for them to fully recover. Give your child lots of love, time to rest, and frequent options for things to drink (like water) to keep them hydrated.

No one looks forward to the flu season, but with these guidelines, we can make it easier for everyone. I’ll be right there on the front lines with you, trying to keep my patients, and my kids, healthy, happy, and safe! Reach out with any questions in the comments below or privately contact me so we can set up a telehealth visit.

Sylvia Romm, MD, MPH, is a pediatrician and VP of Medical Affairs at American Well. She lives with her family in New York City.