Preventing and treating influenza

The Pediatric Insider

© 2012 Roy Benaroch, MD

We’re now at what’s probably the height of influenza season. My office saw about 30 cases this week—that’s plenty of fever and misery. What’s the best way to cope?

First: an ounce of prevention. Please, if you or your children are ill, stay home. Do not go to school. Do not go to the mall. Do not go sit in Santa’s lap and cough in his beard. We need to do the right thing as individuals to help keep our communities safe.

And wash your hands, people!

Vaccines are a good idea for everyone aged 6 months and over. Don’t believe the nay-sayers. I know the fad is to look down on vaccines, belittle them, and be the cool family who doesn’t get their shots. Influenza is not cool, and you will not be happy when your kids get sick. By then it’s too late. (It’s not too late now—but it’s getting close.)

Still, even with good hygiene and vaccines and common sense, the influenza virus is fabulously contagious. Even in the best years, about 10% of vaccinated individuals are still susceptible. What do you do when you or your kids get the flu?

It’s all about comfort. Drink plenty of fluids: water, juice, Gatorade, popsicles, whatever. If it’s wet, it’s good. Yes, milk is OK—even the highest fevers of influenza aren’t nearly high enough to curdle milk.

Get rest. Stay in bed. Don’t go to work or school.

Though the fever of influenza makes you feel bad, it won’t hurt you. Still, misery is miserable, so try to treat fevers with the correct, safe doses of either acetaminophen or ibuprofen. Watch the labels, and use them correctly. It’s best to write down what you gave, and when you gave it, so no one gets confused in the middle of the night.

One strategy to help keep fevers down is to “alternate” ibuprofen and acetaminophen, giving one and then the other alternating every three hours, so neither one is given more often than every six hours. A few studies have shown that this is perhaps a little more effective than relying on one medication. But it can be confusing, and there’s concern that this regimen makes it more likely that a dangerous mistake will occur. If you do alternate, make sure you’re using careful measurements of the correct dose, and definitely write down what you’ve giving and when. Remember, though fever doesn’t feel good, it cannot hurt you. Don’t do anything unsafe because of fever fears.

Although a tepid bath can reduce fevers, never use a cold bath, and absolutely never rub down a child with alcohol to reduce fevers.

Influenza is often accompanied by some congestion and cough. Honey can be an effective cough reliever, and a steamy shower or humidified air can also help. Prescription and non-prescription cold and cough medicines just don’t work very well, and are unsafe in young children.

What about the prescription medication, Tamiflu? This is drug that specifically suppresses the spread of flu virus in your body. It can help shorten the duration and severity of flu—but really, only modestly, and only if it’s started within the first 24 hours of fever. After that, it’s pretty much useless. Tamiflu often causes nausea, so sometimes people can’t take it. If your doctor has prescribed Tamiflu, you can take it in addition to the symptomatic therapies and medicines listed above.

An ordinary case of flu includes fever, aches and misery for about 4-5 days (the disease is milder and shorter if you’ve been vaccinated, even if you’re unlucky enough to catch it anyway.) The treatment is mostly fluids, rest, and fever reducing medicine. Have some soup. Stay home, and don’t spread it around. Come to think of it: just do what your Grandma would have done, and you’re probably doing the best you can.

And make sure Grandma gets her vaccine, too!

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