Better Protection Against the Flu for Infants and Toddlers

< Oct. 15, 2008 > -- The Centers for Disease Control and Prevention (CDC) has updated its recommendations about giving the flu vaccine to children for this year's upcoming flu season.

The American Academy of Pediatrics (AAP) recommends all children, both healthy and with high-risk conditions, ages six months to 18 years, be vaccinated annually with the influenza (flu) immunization - especially during the flu season. The CDC and the Advisory Committee on Immunization Practices (ACIP) are in agreement with this recommendation, and state that a yearly influenza vaccine is the most important step toward protection against this potentially serious illness.

Details of the New Recommendations

The CDC, ACIP, and AAP recommend that all children begin getting vaccinated before or during the 2008-2009 flu season, if feasible, but no later than during the 2009-2010 flu season.

Based on the new recommendations, children who are younger than age nine and receiving the flu vaccine for the first time, should have two doses scheduled at least four weeks apart to be protected against the virus.

Healthy children ages two and older can be given a nasal-spray vaccine. The nasal-spray vaccine is not recommended for children under five years old who have recurrent wheezing and chronic health problems. They should receive the flu injection.

Infants under six months of age have the highest rate of hospitalization due to the flu virus. The influenza vaccine is not recommended and has not been approved for infants younger than six months. According to the CDC, the best protection for this age group is to make sure that every member of the household and each caregiver is vaccinated.

Mild illnesses, with or without fever, do not contraindicate the use of influenza vaccines, particularly among children with mild upper respiratory infection symptoms or allergic rhinitis, according to the CDC and AAP.

People who have a history of severe reactions after a previous flu vaccine or flu shot, allergies to eggs or egg products, and Guillain-Barre' syndrome should consult with their physician before getting the vaccine. It is also recommended that people who are moderately or seriously ill, with a fever, should wait until they recover before getting the vaccine.

How Dangerous Is the Flu?

Many are unaware of the seriousness of influenza and that complications, including death, can occur in healthy children.

Dr. John Treanor, a professor of medicine and of microbiology and immunology at the University of Rochester Medical Center in New York, says "flu is a killer, no question. And even though we usually think about flu as being a killer of old people or those with chronic disease, which it is, we've also become more aware of deaths in young children."

According to recent reports, serious complications associated with influenza may include pneumonia, dehydration, and worsening of long-term medical problems like heart disease and asthma. Sinus infections, ear infections, and other bacterial infections can also be exacerbated by the flu.

Eighty-three flu-related deaths in children have been reported during the 2007 to 2008 flu season. A high mortality rate has occurred during the past two flu seasons and may have been due to a poor match between circulating flu strains and those included in the vaccine, which are updated every year. However, officials are predicting that this year's vaccine will be a better match and in plentiful supply.

When Is Flu Season?

The CDC states that flu season varies somewhat each year but can start as early as October, usually peaking in January or after, and even as late as March.

"It's hard to say, but in a typical year, we see the first cases usually around December, and things start to pick up when kids go back to school after the Christmas holidays,"says Dr. Treanor. "Maybe if we could stamp it out in kids, it wouldn't spread to adults."

There are several other ways to protect yourself from "catching" flu.

Cleaning your hands frequently with alcohol-based hand rubs and gels or washing your hands with ordinary soap and water offers protection. Try to stay at least three feet away from anyone who has the flu.

Be sure to get plenty of sleep, drink plenty of water, and eat nutritious foods. Wear a mask if you must be close to people who might have the flu. If you have the flu, avoid going out in public.

Always consult your physician for more information.

Influenza

Influenza (or flu) is a highly contagious viral infection of the upper respiratory system and is one of the most severe illnesses of the winter season. An estimated 5 to 20 percent of the population in the US contract influenza each year.

Influenza in children can cause a sudden onset of illness.The whole body seems to suffer when a child has it. Symptoms may include fever, which may be as high as 103 to 105 degrees Fahrenheit, aches and pains, headaches, and a stuffy or clear nose.

Additional symptoms may include a nonproductive cough, sore throat, nausea, vomiting, and diarrhea, as well as fatigue and a general sense of feeling unwell "all over".

Your child can contract the flu by coming in contact with airborne viruses from an affected person who is sneezing and coughing.

The virus can also live for a short time on objects such as doorknobs, pens/pencils, keyboards, telephone receivers, and eating or drinking utensils, for example. Therefore, it may also be spread when your child touches something that has been handled by someone infected with the virus and then your child touches his/her own mouth, nose, or eyes.

The symptoms of influenza may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

Preventing the spread of flu is often difficult, especially in children. The contagious stage generally begins 24 hours before the symptoms are evident. This may cause unsuspected transmission. By day seven, the risk of infecting others has greatly decreased or subsided.

In an attempt to prevent flu, a new influenza vaccine is introduced each September. Two antiviral medications (zanamivir or Relenza and oseltamivir or Tamiflu) are approved for use in preventing the flu in children. These medications are available by prescription and a physician should be consulted before any medication is used for preventing the flu.

A nasal-spray flu vaccine, called FluMist® (LAIV), is currently approved to prevent flu viruses in healthy children and adolescents (ages two to 17), and healthy adults (ages 18 to 49). As with other live virus vaccines, FluMist should not be given for any reason to pregnant women and people with immune suppression, including those with immune deficiency diseases, such as AIDS or cancer, and people who are being treated with medications that cause immunosuppression.

The most serious side effect that can occur after influenza vaccination is a reaction in people who have a severe allergy to eggs. For this reason, children who have an allergy to eggs should not receive the influenza vaccine. According to the National Center for Immunization and Respiratory Diseases (NCIRD) influenza vaccine causes no side effects in most children who are not allergic to eggs.

Less than one-third of people who receive the vaccine experience some soreness at the vaccination site, and about 5 to 10 percent experience mild side effects, such as a headache or a low-grade fever for about a day after vaccination.

Specific treatment for influenza will be determined by your child's physician based on your child's age, overall health, and medical history. There is no cure for influenza.The goal of treatment is to help prevent or decrease the severity of symptoms.

Treatment may include medications to relieve aches and fever. Aspirin should not be given to children with a fever without first consulting your child's physician. The length of therapy will also be determined by your child's physician.

Always consult your physician for more information.