A Christmas Story
It’s Christmas Eve and your child is feverish. She started with a runny nose yesterday and a mild sore throat but now she seems sicker. Moans and groans abound and she’s not interested in doing much. Even with Santa just a few hours away all she wants to do is rest on the couch.
Its Christmas morning and while her brother eagerly opens presents and plays with his new toys, she has to be coaxed to finish up. She wants to enjoy the presents but her cough is getting in the way and her ‘eyes look sick’. You take her temperature and see it’s 103. You and your spouse aren’t sure if you need to go to urgent care, if you can go to Gramma’s house, or if you just need to stay home.
So, like all smart parents what do you do? You google it! And then you freak out. You see that all of your child’s symptoms point to influenza. You see the recent news story about the child who died from influenza. Could she have the same strain responsible for the death in the nearby community? You start second guessing yourself and scrutinizing your child’s every move. You start taking and re-taking her temperature and call off Christmas worried she is too contagious to be around others.
Was all that worry necessary? Did Christmas really need to be canceled??
Influenza: What’s the big deal?
Influenza. The name alone can be frightening for some parents. With good reason. Influenza is the only seasonal viral illness we offer a vaccine for because it can be so severe. It’s the only virus that sweeps through the community affecting everyone with consistently moderate to severe symptoms no matter your age. It’s the only only virus that changes enough each year that a new vaccine needs to be designed to combat it. It’s the only virus that routinely kills 15-80,000 Americans annually (according to CDC data). Infants, chronically ill children, pregnant women, and older adults are particularly vulnerable. Even if you are a healthy child or adult Influenza is a long (9-12 day), miserable illness.
Is it a cold or Influenza???
Influenza hits you like a freight train. You are feeling pretty good one day and by the end of the next day you are feeling pretty lousy. High fever (over 102), runny nose, cough, sore throat, body and head ache are frequent symptoms and sometimes some nausea, loose bowel movements and even vomiting once or twice may occur. Unlike the stomach flu which has a lot of vomiting and diarrhea, Influenza has mostly head cold symptoms and fever.
Non-influenza viruses often have similar symptoms so sometimes it can be tough to tell when a ‘cold’ is Influenza and when the symptoms are caused by one of the many other winter viruses. One way to tell the difference is severity. Influenza is pretty bad. The fever is higher, the body aches debilitating, the cough wrenching, and the fatigue exhausting with Influenza. ‘Regular’ upper respiratory infections (the official name for a common cold) will be more manageable: lots of congestion, headache, cough and maybe even some fever but you can get yourself out of bed.
I hear there are medicines for Influenza…..
If you are healthy and over 2 years old (and not a senior citizen!), whether or not Influenza is the culprit or not probably doesn’t matter much. Although there are medications available to treat influenza they have significant side effects and only shorten the course of illness by a day or so. The children who should use the anti-viral medications (like Tamiflu or Xofluza) are high risk kids: children under 2, children with asthma, diabetes, heart disease, or other chronic illness, or children with infants too young to be vaccinated in the household.
If your child is high risk, or if she is very sick and we are worried she may be on the road to hospitalization for severe illness, Tamiflu or Xofluza (for people 12 years and older) are good options. Coming in within the first 48 hours of symptoms is essential so you can start these medications. Anti-virals don’t work if not begun at the first signs of illness so you have to act fast!
Since medication probably won’t be used, you can always fall back on the standard home remedies of warm ginger tea with honey, chicken soup, and lots of rest. Of course, appropriate use of fever reducing medication such as acetaminophen or ibuprofen will also help with the aches and fever that accompany Influenza.
Influenza is contagious. And so are any other viruses that cause fever. As long as you have a fever of 100.5 or higher you are contagious to others. The snot and cough droplets are what is contagious but the virus is so easy to catch it only takes a few germs to cause infection. Good hand washing and coughing into your elbow can help decrease spread. In our ‘Christmas story’ above, the family was right to cancel Christmas if they were hosting. Of course they could have folks come over and quarantine their daughter to a bedroom to avoid contact with others as an alternative.
Come in early or not at all?
The take home message then is this: if your child is high risk or much sicker than you’ve seen them before, google isn’t your go-to, and neither is an urgent care. Your pediatrician is. Call them! Or visit them! Or email them! You will get the best care, the best decision about medication and therefore the best outcome for your child in the hands of the specialist who knows your child best.
Most children will weather winter viruses, even ones with high fevers, without any need for medication or even a visit to the pediatrician but if your child seems very sick, is in a high risk group, or you just want to be sure, your pediatrician is the best person to see.