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Be Well, Be Well Informed

Cold and Flu Care for Kids

Posted on Jan 28, 2014

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During the winter season, nearly every parent worries about “the flu” (influenza). This year the predominant influenza strain circulating is pH1N1, the same strain that caused severe illness in adolescents and young adults, as well as older adults, in 2009-2010.

If your child comes home sick with a sore throat and runny nose, how can you tell if it’s the flu or a common cold virus? That’s a question pediatric infectious disease specialist Mary Ann Carmack, M.D., Ph.D., hears every week at the Palo Alto Medical Foundation.  

“Both are caused by upper respiratory viruses, so the symptoms can be similar. But the hallmark of influenza is that it’s generally much more severe, with higher fever which typically lasts days longer, muscle aches, headache and cough,” she says.  Cold viruses typically cause a runny nose, sore throat, cough and a lower fever if one at all.

Dr. Carmack offers these five tips for parents to help their children stay healthy.

Have your family get flu shots.

Influenza vaccine is 50 percent to 95 percent effective, depending on the year and the strains of virus circulating. This year there is a new flu vaccine that offers protection against four different influenza viruses, including pH1N1. With outbreaks of influenza ongoing (here’s the latest map from the CDC), it’s still worth getting vaccinated if you haven’t already.

You can still get sick after being vaccinated, but when that happens, the illness is expected to be milder.

Which vaccine is better for children – the nasal mist or the shot? Dr. Carmack says they’re both effective, though children with asthma or who live with someone who has a compromised immune system shouldn’t get the nasal mist vaccine because it’s made with live-attenuated virus. Otherwise, “it’s really a personal preference.”

Watch for serious symptoms.

“With any viral respiratory illness, we most worry about secondary complications such as pneumonia or ear infection,” Dr. Carmack says.

Both the flu and cold virus symptoms usually peak in three to four days, and then gradually improve. “If the illness starts to improve and then worsens, it’s a red flag that your child needs to be seen by a doctor,” she says. Your child may have a complication.

  •  Children with pneumonia will show difficulty when they breathe. Look at your child’s chest and rib cage to see if there’s increased effort with each breath.
  • With an ear infection, very young children or babies may touch or tug at their ear, become more fussy or having difficulty sleeping. Older children will complain that their ear hurts.

Keep your child comfortable with fluids, a fever-reducer and rest.

Unfortunately, no medicines will cure the flu or the common cold. There are anti-viral medications to help treat influenza in children, but at best they shorten the illness by a day or less. And at worst they may cause side effects such as nausea and vomiting, “so the benefit is minimal,” Dr. Carmack says.

But you can keep your child comfortable by giving acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) to reduce fever and achiness. Don’t alternate between the two types of medicine, or give a second dose before the recommended time. Pick the one that you think works better for your child.

And never give aspirin; it can cause a rare but serious illness in children called Reye’s syndrome.  Also, it is important to remember that cold medicines aren’t safe for children under four – there is little benefit to lessen symptoms and they can have serious side effects.

Be sure to offer your child plenty of fluids for hydration. If your child doesn’t want water, you can offer juices, ice pops or slushies made in your blender.  Make sure your child has plenty of opportunity to sleep to help recovery.

Let your child rest at home until fully recovered.

It’s tempting to send your child back to school at the first sign of recovery, but don’t rush. Although children are most contagious when they have a fever, they can shed virus up to five to seven days after becoming sick.

“Wait at least 24 hours after your child’s last fever, and use your own good judgment about how your child feels,” Dr. Carmack says.

Cover a cough, and wash hands often.

“The primary way we get the flu is from aerosolized viral droplets in coughs and sneezes, and from touching surfaces,” she explains. The flu virus can live on door knobs and hard surfaces for several hours.

“So, cover your cough and remember: Hand washing, hand washing, hand washing – I can’t say it enough,” Dr. Carmack says.

carmack-maryann-2012Mary Ann Carmack, M.D., Ph.D., specializes in pediatric infectious diseases at PAMF’s Palo Alto Center.