Influenza Questions and NO EXPOSURE in the last 7 days

1. Influenza General Information:

   • For most healthy people, the symptoms of seasonal influenza are similar to those of the common cold.

   • However, with flu, the onset if more abrupt and the symptoms are more severe.

   • Feeling very sick for the first 3 days is common.

   • The treatment of influenza depends on your child's main symptoms and usually is no different from that used for other viral respiratory infections.

2. Influenza Symptoms:

   • The main symptoms are fever, cough, sore throat and runny nose.

   • Fever is usually present. (Exception: immune-compromised children)

   • Other common symptoms are muscle pain, headache and fatigue.

   • Some people also have vomiting and diarrhea, but never as the only symptom.

3. Influenza Diagnosis and Flu Tests:

   • If influenza is widespread in your community and your child develops flu symptoms with fever, then he or she probably has influenza.

   • Your child doesn't need any special tests.

   • You should call your doctor if your child is HIGH-RISK for complications of flu: 1) under 2 years of age OR 2) has underlying health problems. (e.g., asthma or weak immune system (see the HIGH-RISK list)

   • For LOW-RISK children, you don't need to call or see your child's doctor, unless your child develops a possible complication of the flu.

4. Influenza Treatment:

   • Tamiflu (oseltamivir) is the main antiviral drug used to treat influenza in children.

   • Treatment is recommended for any patient with severe symptoms AND for most HIGH-RISK patients (see that List) with any flu symptoms. (AAP) It usually is reserved for hospitalized children with severe symptoms OR who have underlying health problems.

   • Treatment is generally not recommended for LOW-RISK children with mild to moderate influenza illness (per AAP).

   • Most patients recover without taking Tamiflu.

5. Influenza Contagiousness and Return to School:

   • Spread is rapid because the incubation period is only about 2 days (range 1-4 days) for seasonal flu and the virus is very contagious.

   • Keep your child home and out of child care or school for at least 24 hours after the fever is gone (CDC: August 2009).

   • The influenza virus is spread by airborne droplets from sneezing and coughing.

   • It also can be transmitted by hands contaminated with secretions.

6. Call Your Doctor If:

   • You have other questions or concerns

Influenza Prevention Questions

1. How to Protect Yourself From Getting Sick:

   • Wash hands often with soap and water.

   • Alcohol-based hand cleaners are also effective.

   • Avoid touching the eyes, nose or mouth. Germs on the hands can spread this way.

   • Try to avoid close contact with sick people.

   • Try to avoid unnecessary visits to the ER and urgent care centers because those are the places where you are more likely to be exposed to influenza, if you don't have it.

2. How To Protect Others - Stay Home When Sick:

   • Cover the nose and mouth with a tissue when coughing or sneezing.

   • Wash hands often with soap and water, especially after coughing or sneezing.

   • Limit contact with others to keep from infecting them.

   • Stay home from school or work for at least 24 hours after the fever is gone (CDC, August 2009).

3. Flu Shot:

   • Getting a flu shot is the best way to protect you and your child from flu.

   • Yearly influenza vaccines are strongly recommended for all children over 6 months of age. (AAP)

   • When the vaccine is a good match to the circulating flu virus, it is highly effective at completely preventing the disease.

   • Even when the vaccine doesn't match the circulating flu virus, it usually reduces the severity of the symptoms.

4. Anti-Viral Medication:

   • Tamiflu can be used for prevention following close contact with a person who has influenza.

   • It is only recommended for HIGH-RISK patients (CDC).(see that list)

5. Call Your Doctor If:

   • You have other questions or concerns

Tamiflu Prescription Questions

1. Treating Influenza - Tamiflu:

   • Tamiflu is a prescription anti-viral medicine that is helpful in treating the influenza virus.

   • The benefits are limited. Tamiflu usually reduce the time your child is sick by 1 to 1.5 days. It helps reduce the symptoms, but does not eliminate them.

   • For optimal results, antiviral drugs (such as Tamiflu) should be started within 48 hours of the onset of flu symptoms.

   • Indications: Severe symptoms OR underlying health problems (HIGH-RISK group)

   • For HIGH-RISK children, call your child's doctor at the start of flu symptoms.

   • Most patients have mild to moderate symptoms and Tamiflu treatment is not necessary.

   • Tamiflu also has side effects: Vomiting in 10% of children.

2. Preventing Influenza - Tamiflu:

   • The drug Tamiflu may help prevent influenza.

   • Indications: Recent close contact with person with confirmed influenza AND the exposed person is in HIGH-RISK group (age under 2 years, underlying heart or lung disease, weak immune system, etc) (CDC)

   • It is effective only while your child is taking it and ceases once your child stops taking it.

   • Your child should only take Tamiflu if your child's physician recommends it.

   • HIGH-RISK Adult: If a High-Risk adult (e.g., adult with a chronic disease, pregnant, over 65 years old, etc) has been exposed to influenza in the home, call that person's doctor within 24 hours. (Reason: May need anti-viral medicine)

3. Personal Stockpiling of Tamiflu - Not Recommended:

   • Definition: Some people request a prescription for Tamiflu for all family members just in case they come down with flu symptoms. They currently are well and have not been exposed to influenza.

   • Doctors are opposed to this practice, as is the CDC, the AAP and your State's Public Health Department.

   • The supply of Tamiflu is limited and needs to be kept available for patients who have severe symptoms OR have underlying health problems.

4. Call Your Doctor If:

   • You have other questions or concerns

Influenza Exposure Within the Last 7 Days but LOW-RISK child

1. Reassurance:

   • Although your child was exposed to influenza, your child does not have any symptoms.

   • Symptoms usually develop within 1-4 days of exposure to another person with seasonal flu (7 days is an outer limit with the H1N1 strain of flu).

   • Even if your child did develop symptoms of influenza, at this time, anti-viral treatment (Tamiflu) is not indicated for LOW-RISK children.

   • Patients recover from influenza with supportive symptom care.

2. Call Your Doctor If:

   • You have other questions or concerns

Influenza Minor Contact (same school) BUT NO True Exposure (Close Contact)

1. Reassurance:

   • To catch influenza, your child would need to have close contact with an infected person.

   • Close contact includes kissing or embracing, sharing eating or drinking utensils, close conversation, interactions within 3 feet (1 meter), being in the same child care group or car pool, etc.

   • Because your child did not have close contact, it is highly unlikely that he will develop influenza.

   • Even if your child did develop symptoms of influenza, at this time, anti-viral treatment (Tamiflu) is not indicated for LOW-RISK children.

   • Healthy children recover from influenza with supportive symptom care.

2. Call Your Doctor If:

   • You have other questions or concerns

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.