All you need to know about the flu

Posted by Xanit Internacional Xanit Internacional | Posted in Pediatrics | Posted on 15-02-2020


Family ill with flu at home

The flu season is already upon us like any other year during the winter months. As soon as the cold weather sets in, the circulation of respiratory viruses increases, especially among children. Of all viruses, influenza is particularly relevant because of its high-frequency occurrence, elevated impact on the health of those affected and their families, and the possible complications that it might entail. Today we spoke with Dr Conejo, Head of the Paediatrics Department at Vithas Xanit International Hospital, and we clarified some of the most frequent doubts and uncertainties regarding the flu so common during winter months.

What is the flu?

It is an infection caused by the influenza virus that periodically affects everyone, every year during the cold months, which alternate between the two hemispheres.

What is the flu virus?

It is a virus with great ability to mutate, fundamentally infecting the respiratory system and is transmitted from person to person through the air (coughing, sneezing…), hands or other objects that have become contaminated with the virus with the respiratory secretions or the hands of the infected (doorknobs, railings, toys, etc.).

How many types of viruses are there?

There are basically 2 types of viruses that infect humans: type A and type B. Although the ratio of one to the other changes in each season, in general the most common virus is the influenza A virus.

Within each type, in turn, there are many different subtypes, as it is a virus with great ability to mutate and evolve into new different viruses. Since it is a virus that varies so much annually, it is necessary that get vaccinated each year at the beginning of the flu season.

Thus, the famous influenza A (H1N1) virus that caused the 2009 pandemic was a new variety of A viruses that emerged that year and has since remained as part of the usual viruses that we are exposed to each year.

This is why we should not be alarmed when we talk about “influenza A”, as it is the most common virus, although we all can remember the 2009 pandemic.

Who does the disease affect?

Influenza is a universal infection, capable of affecting everyone, although it mostly infects children under 14 years of age. It makes the paediatric patients the most vulnerable from the flu epidemic and, also, the main transmitters of the disease to other age groups. Besides, up to 20% of hospitalised patients for severe influenza are also children under 14 years of age, the vast majority of times in previously healthy children.

However, most severe cases occur in people over 65 years of age or those with some risk factors (lung disease, heart disease, etc.).

What are the symptoms of the flu? How is it different from a normal cold?

In many cases, the symptoms of influenza and the common cold are indistinguishable, as most influenza syndromes are mild in children.

In general, the main symptom of influenza is elevated fever over 39º C), which is usually accompanied by muscle aches and headaches. These symptoms generate great general malaise and a major feeling of weakness, which is often a source of concern on behalf of child’s parents (the child is usually very down, with a loss of appetite or desire to play, etc.). It is usually accompanied by cough, phlegm, sore throat, nasal congestion and sneezing, although in general, the symptoms are less intense than in common cold. Most often, symptoms resolve themselves within 5-8 days, although coughing and tiredness can last for several weeks.

On the other side, the symptoms of common cold and other viral infections usually start progressively over several days (first cough and phlegm and then fever or the rest of the symptoms may appear), the fever is usually less intense, although it can also be high, and is usually accompanied by less affectation of the general condition and less headache. In the case of common cold, the predominant symptoms are the affectation of the upper respiratory tract, with more phlegm, nasal congestion and more intense cough. Finally, the duration of the fever is usually shorter in these cases, between 3 and 5 days most of the time, although the rest of the symptoms (cough, phlegm…) can take up to 2-3 weeks to completely disappear and some infections usually overlap with others.

How is the flu treated?

As it is a viral infection, and although some antivirals are available that could be used in very specific cases, there is no curative treatment capable of shortening the duration of symptoms that can be applied to the general population. As the popular saying goes, the flu “lasts 7 days without treatment and a week with treatment.”

The only thing we can do is control the symptoms so that the patient is as comfortable as possible for the duration of the infection. If there is fever or discomfort, the usual painkillers (paracetamol, ibuprofen) can be used, avoiding the use of aspirin or influenza compounds containing it. It is also important to maintain good hydration and avoid other toxic irritating agents, such as tobacco smoke. It is not recommended to force food intake. It is recommended to rest at home, at least up to 24 hours after fever stops.

For paediatric patients, it is not recommended to use anti-catarrhal drugs, anti-cough medication, mucolytics, influenza compounds, anti congestive drugs, antihistamines, vitamins, etc., since their effectiveness is not proven and can be associated with adverse effects. Antibiotics have no beneficial effect and should be avoided in the absence of complications.

When is a consultation with the paediatrician recommended?

In the vast majority of cases, the flu behaves like a mild illness, from which the child will eventually recover smoothly. However, you should consult your paediatrician if:

  • The fever is very high and persistent.
  • The child is very irritable or sleepy.
  • The child looks bad or has shortness of breath.
  • If the child has a rash on the skin.

How can it be prevented?

The flu is very contagious and it is impossible to completely avoid infection in epidemic times. However, some means may minimise the risk of infection. General hygiene measures focusing on proper hand hygiene, have been shown to reduce transmission of the virus partially and are universally recommended, as are other measures such as the use of disposable handkerchiefs, covering the mouth with the inside of the elbow rather than by hand when coughing or sneezing or using masks in certain environments.

The most effective measure we have today to prevent serious cases is the influenza vaccine. Although it does not have a 100% efficacy (no vaccine has it), it has been useful to avoid up to 60% of severe cases, depending on the degree of concordance between the viruses included in the vaccine each year and the viruses that eventually circulate in each season.

The Vaccine Advisory Committee of the Spanish Association of Paediatrics recommends influenza vaccination in the following cases:

  • Risk groups: children from 6 months of age and adolescents in certain situations or those with basic diseases (diabetes, asthma, etc.).
  • Healthy children from 6 months of age, adolescents and healthy adults living together with patients at risk.
  • Members of the family with infants younger than 6 months of age and with risk factors, since the infants cannot receive the flu vaccine.
  • Pregnant women, regardless of the weeks of gestation.
  • All healthcare professionals.

Vaccination of children without risk factors (universal vaccination) can also be assessed, as it is common in many developed countries (United Kingdom, USA). USA, Australia, etc.).

But also to be vaccinated are:

  • People over 65 years of age or those of any age who have long-term health problems.

Who should not be vaccinated?

  • People who have had a severe allergic reaction to previous vaccination with a flu vaccine.
  • Children under 6 months.
  • If a person has an acute illness with a high fever, we should wait until the underlying condition is resolved first.