In the latter part of January 2016, a young girl in Washington State died from the complications of influenza. She had not been vaccinated.

Every year children die from influenza. Influenza season in the South typically starts in early fall and extends to spring. Since 2004, the Center for Disease Control has been tracking childhood deaths from the “flu,” and every year between 100 and 150 children die from the flu or its complications. Many of these deaths occur in children who have no health problems. More children die yearly from influenza or its complications than die from whooping cough and measles put together.

A typical attack of influenza starts with high fever, chills, muscle aches, a dry cough and a distinct feeling of being ill. Soon the virus causes a sore throat, nasal congestion, runny nose, and worsening cough. In healthy adults and children, a case of influenza lasts about a week, and recovery is usually complete. Many think the illness is nothing more than a particularly severe “cold.”

A highly contagious virus, influenza primarily spreads person to person by virus-laden droplets produced by sneezing or coughing. Alternatively, the droplets land on surfaces, which then are touched, and the contaminated hand goes to the mouth or nose.

School-aged children are the main culprits involved in spreading influenza. They are exposed to the virus at school, and they bring it home to infect family members. Children are usually contagious before they even appear or feel ill. The virus continues to be present and contagious in nasal mucous and cough droplets for over a week after apparent recovery from influenza.

Other diseases often take advantage of the weakened state of the body after a case of influenza and cause what are known as secondary infections. Bacteria such as group A streptococcus, Staph aureus, and Strep pneumonia are particularly good at causing a lethal pneumonia after influenza damages the lungs. Infants and young children frequently will get ear infections just as they are trying to recover from influenza.

The influenza virus is remarkably promiscuous. The virus often “swaps” components with other influenza viruses and new “types” of influenza virus appear often. The vaccine produced yearly for influenza is not perfect due to this viral promiscuity, but a recent study shows that between 2010 and 2014, the available vaccine reduced pediatric deaths by 51% in children with underlying health conditions and 65%in healthy children. No other influenza treatment can claim that much benefit.

Influenza has a drug treatment. This treatment is oseltamivir, Tamiflu, and similar antiviral drugs, but these drugs only work if given early in the course of influenza, often before it is even apparent that one has more than just a cold. These drugs do not “cure” influenza, but they may, if used early, decrease the severity of the flu. The antibiotics used for ear infections, pneumonia, sinusitis do not affect the flu virus.

The best treatment for a disease is considered prevention. The yearly flu vaccine remains Medicine’s best approach to reducing pediatric influenza and deaths.

 Scott Clements MD, FAAP



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