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Influenza in Children

4 September 2024

Influenza is a seasonal viral disease of the respiratory tract. The disease can be especially dangerous for babies and children up to the age of 5, who may develop various complications, the main and most common of which is pneumonia, a disease that occasionally requires hospitalization and treatment in a hospital and, in certain circumstances, can even result in death. The risk of complications is higher when there is another chronic underlying illness such as asthma, diabetes, metabolic diseases and diseases involving immunosuppression.

The illness generally lasts one week, with symptoms such as high fever (over 38 degrees), muscle pain, weakness, overwhelming fatigue, headache, sore throat, dry cough, runny nose and loss of appetite. It is important to know that infection begins the day before the onset of the first symptoms (sometimes even earlier) and can occur for up to 5 days after the onset of the symptoms.

Treatment

It is important, first of all, to rest and drink enough fluids. If you want to give an over-the-counter medicine to relieve the symptoms of the disease, first consult a physician or pediatrician, and under no circumstances should you give a medication that contains aspirin, which can cause serious complications.

Critical warning signs

There are several signs that require immediate medical attention:

  • Rapid breathing or respiratory difficulty.
  • Cyanotic skin tone.
  • Difficulty waking up or lack of response to the environment (apathetic)
  • extreme irritability to the point where they won't let the parent hold them.
  • Insufficient fluid intake, to the point of dehydration.
  • No urination or tearless crying.
  • Severe or continual vomiting.
  • If symptoms of the disease improve but return with even higher fever or more severe cough.

Prevention

The main way of preventing the disease is by receiving the influenza vaccine at the HMO. The vaccine is recommended for infants from the age of six months and offers the best protection against strains of the flu in the upcoming winter season. In addition, to reduce the chance of getting infected or of infecting others, it is important to wash your hands often and cover your mouth and nose when you cough and sneeze. You should stay at home when you are sick.

Influenza is a viral disease that attacks the respiratory tract. The influenza virus is divided into three types: A, B, and C, with A being the strain responsible for the majority of seasonal flu cases. Every year, just before winter, the incidence of infectious diseases of the respiratory tract increases, including seasonal influenza. While influenza can affect people at any age, infants and children under the age of 5 are at high risk of developing complications as a result of the infection.

Parents should become familiar with the symptoms of the disease, the method of treatment, and possible complications. More importantly, they must be aware of the importance of prevention through vaccination against the disease and of several simple rules of conduct.

Possible symptoms

Influenza does not show any symptoms at first. Typical symptoms consist of:

  • Extreme weakness and fatigue
  • High fever (over 38 degrees)
  • Muscle pain
  • Headache
  • Dry cough
  • Sore throat
  • Runny or stuffy nose
  • Loss of appetite
  • Upset stomach and diarrhea

At-risk groups

Influenza is a potentially fatal disease, particularly for several groups in the population who are at high risk of developing complications:

  • Infants and children under the age of 5.
  • Pregnant women and postpartum women (up to 3 months following childbirth).
  • Elderly people.
  • Immunosuppressed people.

For infants and children, it is important to note that the chances of complications are even higher when there is another chronic underlying illness, such as chronic lung disease, including asthma, hematological diseases and endocrine diseases including diabetes.

Transmission

Patients with influenza are considered to be contagious from the day before the onset of the first symptoms (sometimes even earlier) and for up to 5 days after the onset of the symptoms. Influenza is spread through droplets; in other words, coughing, runny nose, and sneezing spread the virus in the patient’s environment and cause influenza. Anyone inhaling these droplets or who has come into contact through the nose or mouth may contract the disease. Another way the virus spreads is by coming into contact with a surface touched by a person with influenza, such as a door handle or elevator button, and then touching your nose or mouth.

Diagnosis

Influenza is generally diagnosed through a clinical examination by a physician.
For patients in the community and those who are hospitalized, a swab PCR test is generally performed.

Important to emphasize: there are other viral respiratory tract diseases that cause flu-like symptoms, but the risk of severe morbidity, complications, and mortality from influenza is even higher.

Duration

Influenza generally lasts about one week.

Treatment 

If your child has influenza, it is first and foremost important that they rest and drink enough fluids. If you want to give an over-the-counter medicine to relieve the symptoms of the disease, first consult a pediatrician, and under no circumstances should you give a medication that contains aspirin, which can cause serious complications.

In the case of influenza in children who are immunosuppressed or or who have underlying diseases, you should also consult a pediatrician.

Critical symptoms

There are several symptoms that may appear in sick infants and children that require seeking immediate medical attention:

  • Rapid breathing or respiratory difficulty.
  • Cyanotic skin tone.
  • Difficulty waking up or lack of response to the environment (apathetic).
  • extreme irritability to the point where they won't let the parent hold them.
  • Insufficient fluid intake, to the point of dehydration.
  • No urination or tearless crying.
  • Severe or continual vomiting.
  • If symptoms of the disease improve but return with even higher fever or more severe cough.

Complications

The main and most common complication of influenza is pneumonia.

  • Other possible complications

    • Middle ear infection.
    • Sinusitis.

  • Rare complications

    • Myocarditis.
    • Encephalitis.
    • Reye Syndrome.
    • Guillain Barre Syndrome.

Prevention

There are several methods that may reduce the chance of contracting influenza:

  • Influenza vaccine: every year, generally in the autumn months, you can receive an influenza vaccine in your HMO. This vaccine is also administered to children in the 2nd, 3rd, and 4th grades at school, as part of the student health services, to provide good protection against the strains of influenza of the coming winter. Vaccination is very important among populations at risk, such as children from six months to 5 years old and pregnant women (the vaccine provides protection to the mother and the fetus), and in fact this is the best way to protect infants and children from influenza.
    You should take into account that the vaccine does not provide immediate protection to the body but only after two weeks of receiving the vaccine; it is therefore recommended to get vaccinated in early autumn. The vaccine provides protection for a period of 6–8 months, and the vaccination should be repeated every year.

    Important: ever since COVID-19 entered our lives, the importance of receiving the influenza vaccine before winter has increased, as there is a need to prevent comorbidity. The influenza vaccine and the COVID-19 vaccine may be received at the same time or in close proximity to each other.

  • Washing hands: handwashing frequently reduces the chance of contracting or spreading disease. Wash your hands thoroughly with soap and water, especially before eating, before touching food, after leaving the toilet, after contact with secretions, after coughing and sneezing, and after contact with a used tissue. If soap and water are not available, alcohol gel or wet wipes can be used. Apply the gel all over the hand and wait until the hands are dry. 
  • Covering the mouth and nose when coughing and sneezing: preferably not with your palm - it is recommended to use a tissue and throw it in the trash. If there is no tissue, it is better to sneeze into your elbow rather than your hand, thereby lowering the chance of infecting others when touching shared objects.
  • If you do not feel well, stay at home: if you feel the beginning of an illness, you should not leave the house and you should not send sick children to school. Only after you recover and feel well can you go back to your routine.

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