FLU: Facts You Should Know

Written by: Mark Freilich M.D (Developmental Pediatrician, UCP of NYC) & Vincent Siasoco M.D. (Medical Director, UCP of NYC), Reviewed by: My Child Without Limits Advisory Committee November 2009

Winter will be here soon, and so will influenza (the “flu”). Influenza is an infection of the nose, throat and lungs that spreads easily from person to person. Most people with influenza are sick for a few days, and then get better. But some people, especially infants, young children and people with certain health problems, such as asthma, heart conditions, diabetes and weakened immune systems can get very sick. Children with any condition that affects respiratory functions including neurologic conditions such as intellectual and developmental disabilities, cerebral palsy, spinal cord injuries, seizure disorders, metabolic conditions, or other neuromuscular disorders have a higher risk for complications from influenza infections.

This year we may see two types of influenza – the regular seasonal influenza and the newer H1N1 influenza. (also called “swine flu”).

There has been much confusion about the manifestations that develop with the flu, whether or not on actually as the seasonal flu or H1N1 (or a cold or another viral/bacterial illness) and what to do when symptoms develop. Here are a few tips to help sort out the symptoms you experience and what they mean.

Cold Versus Flu

Symptoms	Cold	Flu
Fever	Rare	Characteristically High (102-104) Lasting three to four days
Headache	Rare	Prominent
General Aches and Pains	Slight	Usual; often severe
Fatigue, Weakness	Quite Mild	Can last up to two to three weeks
Extreme Exhaustion	Never	Early and Prominent
Stuffy Nose	Common	Sometimes
Sneezing	Common	Sometimes
Sore throat	Common	Sometimes
Chest Discomfort, Cough	Mild to Moderate; hacking cough	Common, can be severe

Flu Versus H1N1*

H1N1	Seasonal Flu
Fever (102-104)	Fever (102-104)
Aches	Aches
Chils	Chills
Cough and respiratory problems	Cough and respiratory problems
Runny nose	Runny nose
Fatigue
Vomiting and Diarrhea*	Vomiting and Diarrhea*

*Symptoms of H1N1 and the seasonal flu are very similar. The main difference is those that have H1N1 may experience more vomiting and diarrhea more so than the seasonal flu. A lab test is required to determine whether one has the seasonal or the H1N1 flu. Your doctor can not make the H1N1 diagnosis just by a physical examination.

*Remember, having diarrhea and vomiting is only an indicator. You can still have the H1N1 flu without these symptoms and that also holds true for the other way around. You can have the regular seasonal flu accompanied with diarrhea and vomiting.

So what should you do if you become ill?

If You Are	And you have	You Should
Not at High Risk	Fever (100.4 or higher) plus cough and/or sore throat	Stay home until you feel completely wel for a day. Do not go the the hospital.
High Risk* or symptoms persist	Fever (100.4 or higher) plus cough and/or sore throat	Call your doctor to discuss whether you need medicine for the flu. Do not go to the hospital.
Anybody with a severe illness like difficulty breathing		Go to a hospital right away. If you call 911 tell them you may have the flu.

* people who are at higher risk of complications for the flu include: children and adults with asthma, diabetes or other conditions affecting the heart, the lungs, the blood, the liver or the kidneys and people with weakened immune systems.

The flu is spread by coughing, sneezing, and unclean hands. There are several ways that you and your child can prevent the spread of illness such as the following:
Cover your nose and mouth with a tissue when you cough or sneeze.
If you don’t have a tissue, cough or sneeze into your upper sleeve, not your hands.
Clean your hands after coughing or sneezing. Wash hands frequently with soap and water for 20 seconds (long enough for children to sing the “Happy Birthday” song twice). You can also clean your hands with an alcohol-based hand cleaner.
Avoid touching your eyes, nose, and mouth.

If you get sick, stay home from work or keep your child home from school. Limit your contact with others to keep them from getting them infected. Children who are sick should stay home for at least 24 hours after they are free of fever (100′F) or signs of a fever without the use of fever-reducing medications.

Vaccines are one of the ways to prevent illness. There are two types of flu vaccines available.

The Seasonal Flu vaccine is recommended for all children between the ages of 6 months to 19 years.
The newer vaccine, the H1N1 (Swine Flu) vaccine is recommended for children between the ages of 6 months through 24 years, household contacts of infants less than 6 months old, pregnant patients, healthcare and emergency service personnel.

The H1N1 vaccine comes in two forms: intranasal and injectable. You should talk to your child’s physician to discuss which one is appropriate for your child.

Contraindications to both vaccines include severe allergic reactions to chickens or eggs or any component of the vaccine or a life-threatening reaction to a previous dose of the influenza vaccine. Please discuss with your physician in regard to the pros and cons to both the seasonal flu vaccine and H1N1 flu vaccine, whether you or your child need to receive the vaccine or if alternatives to the flu vaccine are available and right for you.

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