Children's Health

All you need to know about influenza and H1N1

December 24 , 2019
Dr. Linda Abu Jaber

Influenza is a highly contagious illness that can occur in children or adults of any age. It occurs more often in winter because people spend more time in close contact with one another.

Infection is spread easily from person to person by coughing, sneezing, or touching surfaces and it may cause severe complications like pneumonia and ear infections.

This year the most common Influenza virus infecting the region is the H1N1 strain which is also called swine ‘Flu because originally all the people infected with it had been in contact with pigs. However, the recent strains which have developed spread from person to person with no need for contact with pigs.

What are the symptoms?

Influenza symptoms can come on very suddenly, main symptoms are:

  • Cough
  • Fever.
  • Sore throat.
  • Stuffy or runny nose.
  • Body aches; kids may want you to hold them but cry when you do because their bodies ache.
  • Headache.
  • Chills.
  • Extreme tiredness.
  • Children tend to get more vomiting and diarrhea with Influenza than adults even though Influenza is a primarily a respiratory virus.

How you get it?

When infected people cough or sneeze, they spray tiny droplets of the virus into the air. These droplets settle on surfaces (doorknobs or sinks) where you can come into contact with them and get infected by touching the surface and then touching your eyes and nose or your child’s eyes and nose without washing your hands.

You can also get infected by touching something an infected person just touched or by coming in contact with their mucus which is why handwashing is such an important part of preventing infection.

Who is at risk of getting severe influenza?

Certain people are at high risk of getting severe illness or complications of Influenza:

  • Children under 5 years old, especially newborns and infants in the first 2 years .
  • People 65 years of age or older
  • Children under age 19 who are getting long-term Aspirin treatment. 
  • Pregnant women and women who have given birth within the last 2 weeks.
  • Adults and children with chronic diseases like diabetes or metabolic problems. Long term illnesses of the lung (asthma), heart, liver, kidneys, blood,  or nervous system.
  • Adults and children who have weakened immune systems because of medications they may be taking or certain types of infections or after organ or stem cell transplants
  • People in nursing homes and other long-term care facilities

How is it diagnosed?

Influenza is usually diagnosed based on the symptoms of fever, cough, and muscle aches.

There is a lab test for Influenza which is performed mainly in patients who are at increased risk for complications.

Treatment of Influenza

Most healthy kids do not need antiviral treatment for Influenza because they get better on their own within 1-2 weeks. Kids and adults at high risk of complications may be given antiviral medications.

The antiviral medications used to treat the flu include oseltamivir, zanamivir, peramivir, and baloxavir. Antiviral treatment is most effective when it is given within the first 48 hours of development of flu symptoms.

Most antivirals cause mild side effects which don’t prevent kids from continuing the medicine.

Antibiotics DO NOT treat Influenza and so should not be taken for it. Antibiotics can cause side effects and, lead to the development of resistant bacteria. They are only used if pneumonia or ear infections complicate the Influenza infection.

What to do if your child or you have Influenza?

  1. Stay home.
  2. Rest.
  3. Give your child plenty of fluids. He may not want to eat for a few days but it is very important that he drink.
  4. Use Paracetamol or Acetaminophen and NOT Aspirin to treat fevers and muscle aches if your child is less than 19 years old. Aspirin can cause a serious complication called Reye Syndrome.

When to call the doctor

You call the doctor if your child's age is less than 6 months and has a fever of 38 or above, and if his age is betwwen 6 months - 2 years and has a temperature above 38.5 plus any of the following symptoms:  

  1. Has difficulties breathing or is breathing fast iwhen his temperature is normal
  2. Is turning blue
  3. Is not drinking enough liquids
  4. Has severe vomiting.
  5. Is not urinating enough
  6. Won’t wake up or won’t interact with you
  7. Is fussy and doesn't want to be held. 
  8. Got better but then quickly got sick again with a fever or a cough.

When is my child ready to go back to childcare?

when you feel he is doing better and his temperature has been normal for 24 hours without the use of medications for fever. 

Prevention of Influenza

  1. Influenza vaccine

The best way to prevent Influenza is to get the vaccine every year.

There are 2 main types of vaccine:

  • The inactivated vaccine which is safe for everyone above 6 months of age
  • The live weakened form which can’t be given to certain people.

Talk to your doctor about which one is best for your child and you.

Any child between 6 months to 9 years of age who has never received Influenza vaccine will need 2 doses of the inactivated vaccine 1 month apart, to ensure they make a good amount of protective antibody.

Babies less than 6 months can’t receive the vaccine which is why it is so important for all their family members to be vaccinated which prevents their exposure to the virus.

In kids above 9 till adulthood it takes 2 weeks after getting the vaccine to make protective antibodies. Kids 6 months to 9 years of age who have never received the Influenza vaccine before don’t make enough protective antibody till after the second dose of vaccine.

It is important that you know that the vaccines do not necessarily prevent infection with the Influenza virus, but they do prevent severe disease, hospitalization and death from Influenza.

The most common side effects of the vaccine:

  • Redness, swelling, and/or soreness at the site of injection are the most common.
  • Other possible side effects are usually mild and go away within 1-2 days. These are: Body aches, headache, low-grade fever (usually less than 100.4ºF or 38ºC).

The vaccine decreases the severity of the disease, it also lowers the chances of complications, hospitalization and death from Influenza . 

  1. Handwashing

Your baby most commonly gets exposed to cold viruses through touch. Cold viruses are transferred to everything an infected person touches. When you touch something with a cold virus on it and then touch your baby without washing your hands, you transfer the virus to him.

If you are sick cough into the crease of your arm and not your hands. Make sure you and your child wash your hands frequently.

Avoiding taking your child around sick people or to public places where they might be accidentally exposed to Influenza infection.

  1. Strengthening your baby’s immune system

The most holistic way to strengthen your baby’s immune system is through nutrition. A strong immune system not only prevents colds but makes it easier for your baby to recover from a cold or sickness.
And in order for your baby’s immune system to be strong and healthy, you need to consider the following:

  • Breastfeeding: Breastfeeding is the best way to strengthen your baby’s immune system. It gives your baby everything they need to grow healthy intestinal bacteria (microbiome).

Another advantage of breastfeeding is that any antibodies you have against cold viruses are transmitted to your baby through your breastmilk and will help protect him.

  • Eating foods that strengthen your baby’s immune system: Once your baby is old enough to eat solid food, around 6 months of age, you can start using food to strengthen your baby’s immune system Like: Vegetables and fruits, fatty acids, vitamin C, probiotics, garlic, water, zinc, vitamin D3 and some kinds of herbs