Seasonal Flu

A five year old girl came to my office with a fever for three days. Her mother stated it had been as high as 102 but goes down with Children's Motrin. She also complains of cough and belly pain. The girl had no significant medical history and received her flu shot earlier in the month. Her physical exam was unremarkable. She was sent to the lab for testing and her results came back positive for Influenza A. Her mother was advised to provide supportive care and to follow up if the symptoms don't improve in several days.

There has been a lot of focus on the flu, especially the H1N1 virus. I have seen a decent amount of patients with "flu-like" symptoms but only a handfull who were positve for the H1N1 virus. The concern for the H1N1 is warranted with over 500 deaths in the US but we should not lose our focus on the seasonal flu. The seasonal flu typically hospitalizes 200,000 people each year and over 30,000 die due to the flu and its complications. Approximately, 10-20% of Americans get the flu. So, how do we prevent this disease???

1. Get a flu shot. (but you still can get a type of the flu that is not covered by the vaccine)
2. Wash your hands frequently.
3. Eat healthy and get enough sleep.
4. Cover your mouth when you cough or sneeze.
5. Avoid individuals with confirmed flu.

What are the signs and symptoms of the flu?
1. Fever (often over 101)
2. Cough
3. Stuffy nose
4. Body aches
5. Chills
6. Fatigue
Patients have told me that it's like being hit by a truck.
According to the CDC, the H1N1 is potentially more severe with associated vomiting and diarrhea.

The flu could last as short as two days or as long as 14 days. It can cause complications, especially with individuals with other medical conditions such as asthma, diabetes, and heart disease.

How do we treat the seasonal flu?
1. Drink, Drink, Drink...stay hydrated!!!
2. Use Motrin/Tylenol for the fever and aches (use the appropriate dose)
3. Saline nasal sprays
4. Rest!!!
5. Anti-viral medications if indicated but will need to be started within 48 hours of onset of symptoms

Is there a test for the flu?
Yes...there is a rapid nasal swabbing test that can be performed. This test does not differentiate between seasonal and H1N1 flu. For instance, as of this posting, Lebron James was tested and confirmed to have Influenza A on nasal swabbing but not H1N1. H1N1 and the seasonal flu are subtypes of Influenza A therefore if your rapid comes back positive for A it may or may not be H1N1. There is a test for H1N1 called RT-PCR but may take several days to return but usually does not alter typical influenza treatment.

Usually with some rest, fluids, TLC, and over the counter medications, the flu will subside. If the symptoms do not improve over a week, call your health care professional. In children, if the following symptoms occur, please contact their primary care physician:

1. Trouble breathing
2. Bluish or grayish skin
3. Not drinking well
4. Not urinating well
5. Not acting normally
6. Rash
7. Fever getting better then returning several days later
8. Being irritable even after the fever goes down

I hope this was informative. Keep those hands clean!!!