Here comes the flu season again

We can protect our children against influenza

Influenza viruses cause respiratory infections every year during the winter months. These infections are most serious for the very young and the elderly. The typical features of the flu include a sudden high fever, headache, aches and pains, fatigue and weakness, a runny nose, a sore throat, and sometimes sneezing. There may be rapid breathing and a non-productive cough.

Simple measures to protect children

Infection with the influenza virus occurs through contact with material produced by sneezing and coughing. The virus enters the body through the nose, mouth, or eye. Young infants and toddlers frequently obtain the infection from older brothers and sisters, or from other children at home or at daycare.

Handwashing

Infection control measures, especially hand and respiratory hygiene, play a very important role in reducing the frequency of influenza infections by limiting the spread of the virus. Frequent and proper washing of the hands is a very important method to prevent infection.

Respiratory hygiene, covering your mouth when coughing, has a very important role in reducing contamination. By covering your mouth, eating and drinking utensils, toys and books, clothing, furniture and other surfaces are less likely to be contaminated with respiratory secretions.

Spread of the flu virus can be limited by making sure that

• runny noses are wiped with a soft, disposable tissue
• the nose and mouth are covered with a soft, disposable tissue during sneezing or coughing
• hands are washed thoroughly if they have come into contact with any respiratory secretions

Immunisation also protects children against influenza

Immunisation is the most effective means to reduce the impact of influenza within our communities. Programs usually focus on children, adolescents and adults who are at high risk for influenza-related complications. Vaccinations are also important for those who could transmit the flu virus to at high risk individuals, and for those who provide essential community services.

Children at high risk of influenza-related complications include:

• All children age six to 23 months.
• Children with heart or lung disorders including chronic lung disease of prematurity, cystic fibrosis, and asthma.
• Children with chronic conditions such as diabetes mellitus, metabolic diseases, cancer, immunodeficiency disorders, suppression of the immune system due to underlying disease or therapy, renal disease, anaemia, sickle cell disease and thalassemia.
• Children with any condition that compromises the management of respiratory secretions associated with an increased risk of inhaling secretions into the lungs.
• Children or youth with conditions treated for long periods of time with acetylsalicylic acid (Aspirin).
• Residents of chronic care facilities.

Adults who might transmit influenza to children at high risk of influenza-related complications include:

• Pregnant women
• Members of households expecting a baby during the flu season
• People providing childcare to children less than two years
• Health care and other service providers

Canada’s National Advisory Committee on Infection recommends annual immunisation against the flu for children aged six months to two years because they are at a greater risk of getting severely ill or needing to go to the hospital because of the flu. The Committee also recommends that healthy persons aged two to 64 years receive the vaccine even if they are not in one of the previously mentioned risk categories.

Immunisation is effective

In children, the vaccine is about 80% - 90% effective in preventing the flu and about 60% - 70% effective in preventing illness with fever.

The recommended time for influenza immunisation is the period from mid-October through mid-November. The flu vaccine is designed to be most active against the important viral strains of the previous flu season. There is usually adequate protection against the flu, even though the genetic make-up of the influenza viruses changes each year.

If there has been a major change in the flu virus’s genetic make-up from the previous season, then the vaccine will offer far less protection than usual during the current flu season. Fortunately, a major shift in genetic characteristics only occurs every few years.

The influenza vaccines available in Canada for the 2008-09 flu season are based upon the recommendations of the World Health Organisation. Canadian vaccines contain A/Brisbane/59/2007 (H1N1), A/Urguay/716/2007 (H3N2), and B/Florida/4/2006 virus antigens. All three components of the 2008-2009 vaccine are changed from the 2007-2008 version.

Flu immunisation will only offer protection against infection by the influenza A and B viruses. Many other viruses also cause infection of the nose, throat, windpipe and lungs in young infants and children. These include rhinoviruses, the respiratory syncytial virus, parainfluenza viruses, adenoviruses, and the human metapneumovirus. The flu vaccine cannot protect your child against infection by these viruses.

Immunisation is safe

The risk of the vaccine causing serious harm is extremely small.

Mild local reactions, primarily soreness at the vaccination site, occur in seven percent of healthy children who are less than three years old. Developing a fever after vaccination occurs in about 12% of immunized children age one to five years. Life-threatening allergic reactions to the vaccine are very rare.

Influenza vaccine should not be given to children who have had an anaphylactic reaction to a previous dose or who have known allergy to eggs.

The flu vaccine is safe for pregnant women at all stages of pregnancy and for breastfeeding mothers.

Young infants and children cannot get the flu from the vaccine. Influenza immunisation cannot cause influenza, because the vaccine does not contain live virus.

If you wish to immunize your child against influenza, discuss the flu immunisation with your child’s health care provider.

 

Andrew James MBChB FRACP FRCPC
Chief Medical Editor, AboutKidsHealth