Q&A with Dr. Fleming

Dr. Fleming MD, CCFP, FCFP QandA-Dr-F-V-1I4

What is influenza?

Influenza is a viral respiratory illness that occurs November to April typically. The common cold is not influenza though we often hear it referred to as “the flu”.

What are the Symptoms?

Influenza is characterized by fever, chills, headache, muscle aches, dry cough, sore throat, and profound fatigue. Influenza, unlike a cold, usually knocks both adults and children on their backs. Children may present atypically, especially when they are younger. They may only present with a fever or may even have vomiting or diarrhea. Influenza may lead to croup (infection in upper airways), bronchiolitis (infection in smaller lower airways), or pneumonia (lung infection) in children. Rarely influenza can affect the brain or heart. Fortunately, most healthy adults and children recover fully with fever resolving in days but fatigue and cough can persist for a couple of weeks.Influenza is most severe in children under two and those with chronic illness (eg. Asthma, heart, disease, diabetes etc.)

How is it treated?

You must treat symptoms, for comfort, just as you would in any other viral illness. Acetaminophen is used in all age groups and ibuprofen can be used in children over six months of age for fever and pain. You should never use any product with acetylsalicylic acid in children or teenagers because of the risk of Reye’s Syndrome which can lead to brain and liver damage. Cool mist humidifiers and saline nose sprays are useful for nasal congestion. You always need to encourage fluid intake to ensure children remain well hydrated especially for fever. It is a viral infection so antibiotics are NOT useful. There are antivirals that can be used but generally these are reserved for higher risk groups not otherwise healthy children.

How can it be prevented?

Vaccination is an excellent way to prevent influenza. The influenza viruses can transform itself year to year which is why yearly vaccination is required (unlike the other childhood immunizations). The influenza vaccine is available yearly in the fall. The vaccination requires two weeks before it becomes effective. The vaccine is unfortunately ineffective for children under six months of age. Children nine years and under require two doses four weeks apart the first year they receive it. The current Canadian Pediatric Society guidelines recommend that all children between the ages of six and twenty three months receive the vaccination. Children with chronic illness should also be vaccinated.

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