Menaces of winter III: Protect your child against influenza

January 2005 — Coughs, colds, and chest infections are common in all age groups during the winter months. The respiratory syncytial virus, commonly known as RSV, is the most frequent cause of respiratory infection in infants and young children. Almost all children have been infected with RSV by two years of age.

Many other viruses cause infections of the nose, throat, windpipe, and lungs in infants and children. These include rhinoviruses, influenza viruses, parainfluenza viruses, and adenoviruses. The measles and chickenpox viruses may also cause respiratory infections in young children. These viruses can cause severe chest infections in malnourished children and in children with poorly functioning immune systems.

Influenza infections cause respiratory illness every year during the winter months. These infections are most serious for the very young and the elderly. The typical features of influenza include the sudden onset of a high fever, headache, general aches and pains, fatigue and weakness, a runny stuffy nose, a sore throat, and sometimes sneezing. There may be rapid breathing and a non-productive cough. The chest X-ray may show the presence of pneumonia.

The severity of an infant’s influenza symptoms influences the management of the infection. For mild infections, frequently drinking small quantities of fluids together with regular doses of acetaminophen to keep the infant’s temperature below 38.5°C, may be all that is necessary. A very small number of children are admitted to hospital because they need oxygen, intravenous fluids, and close observation. An even smaller number of children need help with their breathing.

The incubation period for the influenza virus is one to three days. Infected individuals shed the virus as droplets in their respiratory secretions for up to seven days. Infants may shed the virus for as long as three to four weeks. The influenza virus may survive on the skin for five minutes, on a cloth for 8 to 12 hours, and on hard surfaces for 24 to 48 hours.

Infection with the influenza virus occurs through contact with the contaminated respiratory secretions that are produced by sneezing and coughing. The virus enters the body through the nose, mouth, or eye. Infants and toddlers often catch the infection from older brothers and sisters, or from other children with whom they play in the home or at day care.

Infection control measures, especially respiratory and hand hygiene, play a critical role in reducing the frequency of influenza infections by limiting spread of the virus. Wipe your child’s runny nose with a soft tissue and discard the tissue immediately. Try to cover your child’s mouth whenever he coughs or sneezes. Frequent and proper washing of the hands is a very important method of preventing infection. It is especially important to wash your hands:

• before, during, and after you prepare food
• before you eat
• after you use the bathroom
• after you change your child’s diaper
• after handling animals or animal waste
• when your hands are dirty
• more frequently when someone in your home is sick

To wash your hands properly:

• First, wet your hands and apply liquid or clean bar soap. Place bar soap on a rack and allow it to drain.
• Next, rub your hands vigorously together and scrub all surfaces.
• Continue for 10 to 15 seconds or about the length of a little tune. It is the soap combined with the scrubbing action that helps dislodge and remove germs.
• Rinse well and dry your hands.

Canada’s National Advisory Committee on Infection recommends annual immunization against the flu for children over six months of age because they are at risk of becoming severely ill or needing to go to the hospital because of the flu. In children, the vaccine is about 80% to 90% effective in preventing the flu and about 60% to 70% effective in preventing illness with fever. Immunized children who do get the flu have fewer middle-ear infections.

The risk of the vaccine causing serious harm is extremely small. Life-threatening allergic reactions are very rare. Young infants and children cannot get the flu from the vaccine. The flu vaccine is safe for breastfeeding mothers and for pregnant women at all stages of pregnancy.

If you wish to protect your child against the flu, ask your child’s health care provider for more information.

Learn more about winter health hazards:
Menaces of winter I: Respiratory infections in young infants
Menaces of winter II: RSV infection and bronchiolitis

 

Andrew James, MBChB, FRACP, FRCPC
Chief Medical Editor, AboutKidsHealth