The 2014-15 influenza season is off to a roaring, early start.  The predominant strain circulating nationwide is influenza A (H3N2), and this virus is already at epidemic levels, occurring several weeks earlier than previous years.  So far Pennsylvania has seen a “moderate” number of flu cases, with Allegheny County leading the way for the state as a whole.  Even though the current flu vaccine may be a little less effective than in years past (due to a genetic “drift” — a mutation that occurred after the virus had been isolated and incubated for this season’s flu vaccine production), the CDC is still saying a less-effective flu vaccine is better than none:

The timing of flu activity can vary in different parts of the country. Flu activity is expected to continue in the coming weeks, with increases occurring especially in those states that have not yet had significant activity. CDC continues to recommend vaccination as long as flu viruses are circulating. If you have not been vaccinated yet this season, get vaccinated now.


(Emphasis mine.)

We have seen numerous cases of influenza in our Pediatric Alliance offices in the last two weeks or so, and many, many more calls from parents whose children have influenza-like illnesses where we advise the usual treatments: fluids, rest, fever-reducers, and isolation from the rest of the family (and the pediatrician’s office).  Some parents ill-advisedly bring their children to one of the many local urgent care “Doc-in-the-Boxes” where providers are more than happy to x-ray your child’s chest with radiation she or he doesn’t need, offer antibiotics which don’t treat viral symptoms, or prescribe antiviral medications like Tamiflu when they are not indicated (which has led to a nationwide shortage of the drug that, for people with chronic conditions or children under two years of age, can be potentially life-saving).

All too often, influenza is treated casually by parents and young adults who find it is up to them to decide on rolling up a sleeve and getting a flu vaccine.  I’m sure parents probably get tired of their pediatricians constantly reinforcing this simple principle of prevention and encouraging — really, forcefully pushing (in my case, anyway) — the administration of influenza vaccine to their children and to themselves.  Every year pediatricians see horrible outcomes from this “casual” disease.  Every year we read stories like Josh Lev’s:

Shannon Zwanziger seemed perfectly healthy. She was an active 17-year-old who rarely got sick and hadn’t been to a doctor in more than three years.

Then one day, she came home with the flu. She died a week later.


Lev’s article has all the required quotes from the “grief-stricken mother” about her “incredible kid” — the “perfect kid”who was “living life to the fullest.”  Her parents “gave their daughter the choice” of whether or not to get a flu vaccine.

Imagine that.

There are other ways — in addition to getting a flu vaccine — to prevent getting such a brutal infection:

  • Cover your mouth when you cough or sneeze.  Parents of young children know this is easier said than done, though I find that older kids and teenagers have been taught well and are pretty good at this.
  • Wash your hands!  Soap and water is best, though the commercially made hand sanitizers can be used in a pinch. Make sure you lather up your hands with soap for 20-30 seconds before rinsing.  Periodically use a good moisturizer for your hands when they get dried and cracked from frequent washing.
  • Keep kitchen, bathroom, and living area surfaces clean.  Door knobs and sink faucets are common places for viruses to live for the few hours they have once they leave our bodies.  Make sure whoever is sick puts their own dishes in the dishwashing machine!  Disinfect TV remotes, video game controllers, and computer mouses and keyboards. And the handle of the dishwasher, too!
  • Stay away from other people, whether they are sick or you are.  And remember that even if your child is sick with a fever, runny nose, cough, sore throat, or other flu-like symptoms, it doesn’t mean you necessarily need to bring them into our offices (or to an emergency department or urgent care facility).  Do call us so we can decide together whether your sick child needs more attention than what you, the parent, can provide at home.


Finally, parents should focus on two key areas when treating and monitoring their child’s illness:  hydration and breathing.  A sore throat or earache is usually not an emergency.  A fever is usually not an emergency (unless it occurs in a very young infant or in children with compromised immune systems).  Not drinking more fluids than are being lost (say, from vomiting or diarrhea) — or not drinking much at all — is an emergency.  Difficulty breathing — manifested by an increase in the respiratory rate, noisy breathing, and labored breathing (a child who is expending a lot of energy to get a breath) — is an emergency.  A cough, generally, is not an emergency, but a cough with those other signs is an emergency.

If you aren’t sure whether to worry or not, then please call us first so we can discuss the situation.  That’s what we’re here for!

Read previous 2014-15 flu updates on The PediaBlog here and here.