Here’s how to recognize flu symptoms and get your child treated.
The US is in the middle of a severe flu season, and 53 children have died so far.
Influenza hits the US every winter, but this year's season has been particularly rough. According to the the Centers for Disease Control and Prevention, the 2017–18 influenza outbreak has now led to the highest measured hospitalization rates for the virus.
"This is a very difficult flu season," acting CDC director Anne Schuchat told reporters last week. "We are not out of the woods yet." There are still weeks to go in this flu season, and cases can pop up as late as April and May. Although flu activity is starting to go down in Western states, such as California, it's still high in the rest of the US and increasing on the East Coast.
There are three strains circulating this year: H3N2, H1N1, and influenza B. The prevailing strain, H3N2, is known for being particularly vicious and is likely to cause more complications and deaths among the very old and very young.
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The flu kills children every year, so this isn't unusual. But it is concerning, so here's what parents need to know.
The flu killed 101 children last year and 128 in 2014–15. "We had a very serious flu season in 2014–2015 and it's looking a lot like that right now," Dr. Robert Jacobson, pediatrician and vaccine researcher at the Mayo Clinic in Rochester, Minnesota, told BuzzFeed News.
Children are more vulnerable because their immune and respiratory systems are less mature, Jacobson says, which means they struggle more to fight off a virus like the flu, which puts stress on the heart and lungs. When the flu kills children, it typically does so by overwhelming the cardiorespiratory system or causing a secondary infection, such as pneumonia.
"Children, like the elderly, also struggle to stay hydrated and end up under-eating when they have the flu, which puts them at higher risk," Jacobson says. During most flu seasons, the hospitalization rates for children are typically the same or just below those for people over 65.
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Most healthy children will recover from the flu — but some can develop life-threatening complications.
Typically, healthy children who get the flu will recover within a week or so. Children who are at high risk of serious complications from the flu include those under the age of five (especially under the age of two), children with an underlying chronic health problem, such as asthma or diabetes, an immunodeficiency disorder, or who require immunosuppression therapy, and those with neurological and neurodevelopmental disorders.
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If your child gets sick and they aren’t in a high-risk category, keep them home and treat any symptoms as necessary.
In children, flu symptoms can include a fever, chills, fatigue, vomiting, aches, cough, and congestion. A doctor can do a rapid flu test in the office with a nasal swab to confirm the diagnosis.
It's important for the child to get plenty of rest, fluids, and proper nutrition to help the body as it fights off illness. Over-the-counter medications like ibuprofen or acetaminophen (the preferred options for kids) can ease some symptoms, but make sure you adjust the dose for a child per the medication instructions. Children should never be given aspirin due to the risk of Reye’s syndrome, a rare condition that can harm the liver and brain.
Most important, keep your child out of school and have them stay home until they are better, Jacobson says. Staying home from school is both better for recovery and it helps prevent the spread of illness to other schoolchildren.
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The flu can progress very quickly. So it's important to be vigilant and seek medical care if symptoms become severe or start to worsen.
"Symptoms to look for in a child are a sudden fever of 102 degrees or higher, persistent fever, difficulty breathing, inability to eat or drink, not urinating for over 8 hours, cottonmouth, sunken eyes, or dizziness," Jacobson says. If your child has any of these symptoms, you should seek medical care — whether that means going to the doctor or urgent care or an emergency room. "If the child goes into respiratory distress or shows signs of collapsing, call 911 right away," Jacobson says.
Another thing parents should watch out for is a fever that comes back after going away. "Anyone who has had a fever that went away for at least three days and came back should go to the hospital or doctor's office, because this could be a sign of a bacterial infection in the lungs — even if it's just a middle ear or sinus infection, you should get it checked out; it could be life-threatening," Jacobson says.
Most important, parents should trust their instincts. If, in your gut, you know something is wrong with your child, then call or go see a pediatrician or take them to the hospital.
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If your child is considered high risk and you think they have the flu, go to the hospital. They may be able to benefit from antiviral medication.
If a child is younger than 12 months, has an underlying or complicating illness, or is significantly immunocompromised, skip waiting for the doctor and go straight to the hospital, Jacobson says.
These high-risk children can be treated with prescription antivirals (like Tamiflu), which can lessen the severity of the flu and shorten its course. Antivirals can also help prevent serious complications from the flu, such as pneumonia. "Anyone who is high risk should get treated with antivirals as early as possible," Jacobson says, because they are more vulnerable and can benefit the most from antivirals.
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In past flu seasons, between 80% and 85% of flu-related pediatric deaths occurred in children who had not gotten a flu vaccine.
"The most important point is that the majority of children who died from the flu in other seasons were unvaccinated — and no more than half of them had underlying diseases that put them at risk to die from the flu," Jacobson says. It's unclear how many of the children who died this season were vaccinated, and that information will not be available until the season is over.
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The best thing parents can do is get their child (and their whole family) vaccinated every flu season.
What can you do to protect your children? "Based on all our experience over the years, the best thing you can do is to get your kids vaccinated and get everyone else in the house vaccinated," Jacobson says. The flu vaccine is recommended for most children over the age of six months, and getting older children vaccinated can help protect babies who are too young to be vaccinated themselves.
When you get your children and family vaccinated, you aren't just protecting yourself. "You create a halo around loved ones, friends, neighbors, coworkers — and in kids, we see lower rates of outbreaks in schools with vaccination requirements," Jacobson says.
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So if you or your child hasn't gotten a flu shot yet, do it now. It's not too late.
"If you get your vaccine now, you're protecting yourself for the rest of the season — which could go on for months in certain parts of the country," Jacobson says. Some children under the age of nine actually require two doses of the flu vaccine, so talk to your doctor about your child's vaccination needs. "Getting your kid vaccinated today, even at height of flu season, makes sense because it will protect them for the next few months, but it might also prepare them for next year," Jacobson says.
Experts will not know how effective the 2017–18 flu vaccine is until this season is over, but current predictions are around 17% for H3N2, BuzzFeed News previously reported. However, the flu shot also protects against H1N1 and influenza B, which have a higher vaccine effectiveness and are also circulating this year.
Even if the flu shot isn't super effective, it's better to have some protection against the circulating strains than no protection at all. The vaccine can also mitigate illness, so if you do get the flu, it will be a less severe, shorter course. In short, the flu shot can keep you out of the hospital.
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And remember: Wash your hands constantly and teach your kids to do the same!
"Remember to wash your hands with soap and water throughout the day and teach your kids to do the same — especially after they play with other kids, use the bathroom, and before they eat," Jacobson says. You can also use hand sanitizer if the sink isn't an option. Parents should also take special care to clean their hands before touching their child's face or preparing their food.
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