What is flu?
Influenza is a disease caused by an RNA virus that infects the respiratory tract of many animals, birds and humans. In most people, the infection leads to a fever, cough, headache and malaise (tiredness, lack of energy). Some people also experience sore throat, nausea, vomiting, and diarrhea. Most people who get sick have symptoms for about one to two weeks and then the person recovers without problems. However, compared to most other viral respiratory illnesses, influenza can lead to more serious illness and death.
The above is the standard situation for annual "regular" or "seasonal" influenza strains. But there are times when a flu surge is serious. These violent outbreaks occur when a portion of the population is exposed to a strain of influenza against which the population has little or no immunity because the virus has changed significantly. These outbreaks are commonly referred to as epidemics. Unusually severe outbreaks around the world (pandemics) have occurred several times over the past hundred years.
After examining the preserved tissue, scientists found that the worst influenza pandemic (also called "Spanish flu") was in 1918, when the virus caused 40-100 million deaths worldwide, with a death rate ranging from 2 to 20%.
In April 2009, a new strain of influenza was isolated in Mexico, against which the world's population has virtually no immunity. It spread around the world so quickly that the WHO announced this new flu strain. It was first named the novel H1N1 swine flu, influenza A, and was often shortened to H1N1, or swine flu. The first influenza pandemic in 41 years has been declared. But countermeasures in the form of vaccine production, good hygiene (especially hand washing) have led to a decrease in the expected incidence.
In 2011, a new flu strain, H3N2, was discovered, but this strain only caused about 330 infections, with one death in the United States.
Another strain of the avian influenza virus, H5N1, has been identified since 2003 and has caused about 650 human cases; this virus is now known to spread easily among humans, unlike other strains. Unfortunately, people infected with H5N1 have a high mortality rate (about 60% of infected people die).
What was previously considered the flu? Haemophilus influenzae is a bacterium that was misunderstood as causing the flu until the virus was identified as the true cause in 1933. This bacterium can cause lung infections in infants and children, ear, eye, axillary, joint inflammation, but not the flu. Another confusing term is stomach flu. This term refers to a gut infection, not a respiratory infection. Stomach influenza (gastroenteritis) is not caused by influenza viruses.
Causes
There are three types of viruses that cause disease: A, B and C.
Influenza A and Influenza B are responsible for the respiratory epidemics that occur every winter and are often associated with increased hospital admissions and deaths. Type C flu is different from types A and B. The type C strain usually results in either very mild respiratory illness or no symptoms at all. It does not lead to epidemics and does not have a strong impact on public health. Efforts to control exposure to influenza are targeting types A and B.
Influenza viruses are constantly changing. As a rule, by mutation, changes in viral RNA. This regular change often presents the virus with the opportunity to evade the host's immune system (humans, birds, and other animals) so that the host is susceptible to changes in influenza virus infections throughout its life. This process is as follows: a host infected with a virus develops antibodies to the latter; as the virus changes, the primary antibody no longer recognizes the altered pathogen, and disease can occur again because the body has not recognized the new influenza virus as a problem. The original antibody may, in some cases, provide some protection against infection with the new influenza strain. In 2009, almost all people did not have antibodies that could immediately recognize the new H1N1 virus.
When spread by droplets or direct contact, the virus (if not killed by the host's immune system) multiplies in the respiratory tract and damages the host cells. In young children, due to immature immunity, the virus can cause viral pneumonia or suppress the child's immune system. This will make him more susceptible to bacterial infections, especially bacterial pneumonia. Both types of pneumonia, viral and bacterial, can lead to serious complications and sometimes death.
The flu virus can affect anyone at any time of the year, but most people are prone to illness during the flu season, which starts in October and lasts until May. The disease peaks between December and March.
Who is most at risk of getting the flu?
Children under 5 years of age are most susceptible to influenza.
Children are at greater risk than adults because the child's immune system is still developing and weaker than that of adults.
Children who have the following conditions are at greater risk of infection:
- asthma;
- blood diseases;
- kidney disease;
- liver pathology;
- neurological diseases;
- extreme obesity;
- chronic obstructive pulmonary disease;
- a weakened immune system;
- endocrine disorders;
- congenital heart disease;
- metabolic disorders.
Persons under the age of 19 undergoing long-term therapy with Aspirin also fall into the high-risk category.
Contagiousness
The flu is highly contagious. The virus spreads when someone either inhales infected droplets in the air after an infected person coughs or sneezes, or when someone comes into direct contact with the secretions of an infected person and then inadvertently touches their nose or mouth, carrying viral particles. Droplets that carry the flu virus from sneezing or coughing usually travel up to 2 m and can spread infection if inhaled.
The incubation period (from infection to symptoms) of influenza is usually 2 to 4 days.
Children with the flu can infect others from the first day before they develop any symptoms. They can remain contagious for another seven days or longer. Some children can pass the flu to others, even if they themselves do not feel very sick. Because transmission can occur before the patient develops any symptoms, the flu spreads quickly.
Children play a large role in the spread of influenza in their communities as large numbers of people are exposed to viruses in schools and kindergartens. In general, up to 30% of children can become infected during the regular flu season, and in some institutions, up to 50% of children become infected.
Flu symptoms
Influenza symptoms vary in children.
Influenza in children who are already immune or have received the vaccine has milder symptoms.
The onset of the disease may start suddenly, symptoms will develop during the day, or it may progress more slowly.
Classic symptoms include 400C fever, chills, sore throat, muscle aches and headaches, dry cough, and malaise. These symptoms usually last 3 to 4 days, but the cough and fatigue may linger for one to two weeks after the fever has cleared. Other family members often have a similar course.
In young children, the flu pattern may be typical of an influenza-like illness or similar to other respiratory tract infections such as bronchitis, croup, or pneumonia. Abdominal pain, diarrhea, and vomiting are common in children. Vomiting tends to be more severe than diarrhea. Fever is usually high.
Influenza in children under one year of age is often unrecognized because the signs are not specific and may indicate a bacterial infection. Influenza is less common in children under 6 months of age, and symptoms include lethargy and decreased appetite.
Flu or cold?
Chances are you will mistake the flu symptoms for the common cold. They are similar, but there are significant differences.
Compared to other viral respiratory infections such as the common cold, influenza usually causes more severe illness, with a death rate of about 0.1% of people infected with the virus. Cold symptoms - sore throat, runny nose, cough with possible phlegm, and mild fever are similar to flu, but flu symptoms are more severe, last longer and may include vomiting, diarrhea, and dry cough.
Flu or food poisoning?
Some flu symptoms may mimic food poisoning, while others may not. Most of the signs of food poisoning include nausea, vomiting, watery diarrhea, abdominal pain, and fever.
Note that most food poisoning symptoms are gut-related, with the exception of fever. Consequently, respiratory problems such as nasal congestion, dry cough, and some breathing problems can help distinguish flu from food poisoning.
Complications
- Primary influenza pneumonia is characterized by progressive cough, shortness of breath, and cyanosis of the skin.
- Secondary bacterial pneumonia can occur from numerous pathogens (eg Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae). The most dangerous complication is staphylococcal pneumonia, which develops 2 to 3 days after the initial manifestation of viral pneumonia.
A study in Israel found an increase in S. pneumoniae bacteremia during regular periods of influenza; and during the 2009–2010 H1N1 influenza pandemic, children had higher rates of S. pneumoniae bacteremia and higher rates of S. aureus and Streptococcus pyogenes infections.
Pneumonia due to S. pneumoniae or Haemophilus influenzae (if it occurs as a complication) usually develops 2 to 3 weeks after the first symptoms of influenza.
Other complications of influenza in children include ear or sinus infections. Influenza can worsen chronic conditions such as asthma, heart failure, or diabetes.
When should you take your child to the hospital?
Call an ambulance or take your child to the hospital yourself if:
- the child has difficulty breathing or is breathing quickly and does not improve even after clearing the nose.
- the child tries to breathe strongly and has a bluish skin color.
- the child cannot react normally. For example, does not cry when expected, does not have good eye contact with the parent, or the toddler is too lethargic.
- the child does not drink well or shows signs of dehydration. Common signs of dehydration include lack of tears when crying, decreased urine output (dry diaper), dry mucous membranes (tongue, lips, tongue).
- the child has severe or persistent vomiting.
- the child cannot eat.
- the child has a fever that does not improve with paracetamol or ibuprofen.
- the child has a fever with a rash.
- the child has seizures.
Any of these manifestations indicates that a medical examination is necessary.
Some children are at increased risk of severe complications from influenza and may need medical attention earlier than usual. This includes the following groups of children:
- Children 6 months and younger. They are too small to be vaccinated. It is best that all family members and those around them are vaccinated to protect the baby.
- Small children from 6 months to 5 years old.
- Children with chronic conditions, including:
- lung problems such as asthma, COPD, and cystic fibrosis;
- neurological conditions such as epilepsy, cerebral palsy, mental retardation, developmental delay, spinal cord injury, muscular dystrophy;
- heart disease;
- diabetes or other endocrine problems;
- kidney or liver disease;
- immune system abnormalities such as HIV infection, cancer, or steroid drug use;
- children on long-term therapy with "Aspirin".
Diagnostics
If a child's illness occurs during the flu season, the doctor may assume that the child is simply sick with the flu, observing classic symptoms such as fever (over 40 ° C), lethargy, breathing problems, and muscle pain. Nasal or throat swab tests will be ordered. Several high-speed diagnostic tests are available with a fairly high degree of accuracy.
A chest x-ray may be needed to rule out pneumonia.
How to treat the flu in a child?
Treatment for influenza in children is not specific. Most children with the flu will have relatively mild illness and do not need antiviral drugs. But in persons with a more severe form of the disease or with other chronic diseases, in children under 2 years of age, the risk of complications is increased. Antiviral drugs will help here.
If, within 2 days of the onset of symptoms, antiviral agents reduce the severity and duration of symptoms, then their ability to prevent complications of influenza A has been established. The main disadvantage of these types of drugs is that resistant viruses can render them ineffective.
There are currently no antiviral agents to fight influenza C infections.
- Neuraminidase inhibitors are FDA-approved for uncomplicated influenza when the first signs of illness appear in less than 48 hours. The main advantages of drugs in this group are their activity against influenza A and B and activity against current circulating strains: 1) Zanamivir is approved for the treatment of children from 7 years of age, but it is not approved for prevention. The drug is available as a powder, administered by a breathing inhalation device; 3) Oseltamivir (Tamiflu) is licensed for children 1 year of age and older and recommended for children under 1 year old when needed. It is available in tablet and suspension form and is usually taken within 5 days; 4) under certain circumstances, Tamiflu can be prescribed as a preventive medicine; 5) Peramivir is approved for patients aged 18 and over.
- M2 inhibitors include Amantadine and Rimantadine. Both have been used to prevent and treat influenza type A. However, annual changes in circulating strains of influenza have made these drugs less effective. These antiviral agents are not effective against influenza B and are not approved for use in children under one year of age. Rimantadine has not been approved for the treatment of children under 13 years of age.
Broad spectrum antiviral agent - Ribavirin may be useful, but its effectiveness is still being studied. At the moment, its use is controversial and not recommended for treatment or prevention.
Home child care
Flu symptoms can last for more than a week. Parents can relieve and soothe childhood pain and discomfort with home care.
- Bed rest must be observed.
- Let your child drink a lot.
- Fever can be controlled with paracetamol or ibuprofen, at temperatures above 38.5 ° C, according to the instructions or after consulting a doctor.Ibuprofen should not be given to children under 6 months of age. Do not give Aspirin because it puts you at risk for Reye's syndrome. Reye's syndrome is a potentially fatal disease that affects the brain and liver.
- Use a humidifier in your child's room to help him breathe.
- Children with the following symptoms may require more careful attention: 1) Runny nose. Babies usually breathe through their nose and usually do not breathe through their mouth. Even adult children find it difficult to breathe through the mouth and eat something at the same time. Therefore, it is very important that the baby's nose is clean before feeding and before bed. Suction is a method for clearing the nose. For young children, use an aspirator to gently remove the discharge. Older children may blow their nose, but strong pressure can carry discharge into the eustachian tubes or sinuses; 2) stuffy nose. It's important to remember that most stuffy noses are blocked by dry mucus. Blowing your nose or using an aspirator alone cannot remove dry mucus. The use of saline nasal drops is helpful in thinning mucus. These nasal drops are available at many pharmacies. One minute after using the nasal drops, use an aspirator to gently remove mucus.
- Nutrition. Although it is best to eat light and nutritious foods, there is no need to force children with the flu to eat. Protein-rich foods such as meat, eggs, dairy, and beans can help rejuvenate. It is recommended to offer your child various fruits with vitamin C.
Prevention
Take precautions to prevent infection.
Here's what you can do to protect your child from the flu:
- practice good hygiene habits to prevent the spread of the virus. Encourage your children to wash their hands regularly, especially before eating.
- Do not allow your children to share accessories, cutlery, or food with other children, even if they do not have flu symptoms.
- Cover your mouth when you cough or sneeze and ask others to do the same.
Prevention of disease with antiviral drugs
Two antiviral flu medicines are approved for use in children. Oseltamivir (Tamiflu) is recommended for the prevention of influenza in children 3 months and older.
Zanamivir is recommended for prophylaxis in children over 5 years of age. If a child is exposed to the flu and has an above average risk of complications, the doctor may recommend taking one of these medications before symptoms begin. These drugs are also used to reduce the severity of flu in children.
Immunization
The flu shot for children is important to prevent getting sick. The vaccine is also needed to prevent superinfections in people with chronic lung disease. There are traditional influenza vaccines (trivalent vaccines) and seasonal influenza vaccines (quadrivalent vaccines).
Seasonal vaccines should be given every year. Typically, there are two different types of seasonal flu shots: injections and nasal aerosol vaccines. Recently, scientists have developed an intradermal vaccine that can be injected into the skin rather than into the muscle.
Vaccines are safe. Serious side effects associated with influenza vaccination are very rare.
However, you may need to prepare for minor side effects and consequences of vaccination, which include:
- muscle pain;
- mild fever;
- soreness and pain at the injection site;
- allergic reactions (very rare).
The flu virus changes slightly every year and makes the previous year's vaccine less effective. A new vaccine is being prepared every year to combat mutations and changes that may have occurred during this time and may have caused the virus to renew. This is why it is important to vaccinate your child every year.
Influenza is seasonally inherent and affects children every year. You may not always be able to protect your child from the virus, but you can help him recover faster with home remedies and other treatment options.
