There are many respiratory diseases in children in winter, among which influenza virus is one of the common pathogens. On the questions that parents and friends are concerned about, the National Children’s Medical Center Beijing Children’s Hospital answered authoritatively.
1. What are the typical symptoms of influenza?
Children infected with influenza virus can show fever, chills, headache, myalgia and general malaise, often accompanied by respiratory diseases such as cough, sore throat and runny nose. The degree of fever in young children may be heavier, and some children may also have febrile convulsions; In addition, they will have more gastrointestinal symptoms, such as nausea, vomiting, diarrhea and poor appetite. Very few children infected with influenza may develop into severe influenza, causing laryngitis, pneumonia, encephalopathy, myocarditis and so on.
2. How does the flu spread and how long is the incubation period?
Influenza virus can spread from person to person through respiratory droplets (such as sneezing, coughing and talking) or after polluting the surface of objects. Influenza viruses can also spread through small air particles released by influenza patients when they breathe. Influenza patients are the main source of infection. The incubation period of influenza is generally 1-7 days, and most of them are 2-4 days.
3. How long is the general course of influenza and what is the change of the course?
For children without basic diseases, the course of influenza virus infection is acute and self-limited, and most symptoms disappear in about 2-3 days after onset. Some children’s fever lasts for 5 days, and most patients recover within 1 week, but cough may last for a long time, and fatigue and fatigue of a few elderly children (over seven or eight years old) may last for several weeks.
4. How to distinguish the flu from the common cold?
The full name of the flu is called "influenza", and you may think it is similar to the common cold, but the flu and the common cold cannot be confused.
The common cold can be caused by many pathogens, among which viruses are the most common, including rhinovirus, adenovirus, metapneumovirus, bocavirus, etc. Bacteria and mycoplasma can also cause the common cold. The symptoms of the common cold are mild, usually low-to-moderate fever, which lasts for 1-2 days, and may be accompanied by other catarrhal symptoms such as sneezing, runny nose, stuffy nose and slight cough, while the systemic symptoms such as chills, headache and joint muscle pain are very mild. Generally, there are no serious complications.
Influenza is mainly caused by influenza A and B virus infection, with high fever, severe systemic symptoms such as chills, headache and joint muscle pain. A few influenza patients may have complications such as rhabdomyolysis, pneumonia, encephalitis and encephalopathy.
In the flu season, children with flu-like symptoms, especially those with a history of contact with influenza patients, should first consider influenza virus infection, which can be diagnosed by influenza virus antigen detection or influenza virus nucleic acid detection.
5. How is the flu generally treated?
After being infected with influenza virus, the treatment measures include antiviral and symptomatic treatment.
Anti-influenza drugs: At present, the oral antiviral drugs for influenza virus are mainly neuraminidase inhibitors, commonly used drugs include oseltamivir and mabaloxavir, and intravenous drugs include paramivir. Once you have the flu, the sooner you use anti-influenza drugs, the better, especially within 48 hours of onset. However, even if the course of the disease exceeds 48 hours, once the flu is confirmed, you should actively use drugs.
Symptomatic treatment measures: mainly to reduce fever and relieve discomfort. You can choose antipyretics scientifically, and you can also use some drugs to relieve symptoms such as cough and stuffy nose. It should be noted that the pharmaceutical ingredients of some compound preparations may overlap with other therapeutic drugs, and the combined use may cause an excessive amount of one ingredient and cause adverse reactions in children.
6. Is there any specific medicine for influenza and can it be prevented by drugs?
Oseltamivir is an antiviral drug specifically for influenza virus, which can shorten the duration of clinical symptoms. However, it is not recommended that children take anti-influenza drugs as soon as they have a fever, because there are many respiratory pathogens that cause fever, and oseltamivir is only effective for influenza.
The best way to prevent influenza virus is to actively vaccinate. If there is no contraindication, people over 6 months are advised to actively vaccinate against influenza. For children with high risk of severe influenza or influenza complications, who are contraindicated by influenza vaccine or have not been vaccinated (or within 2 weeks after vaccination), drug prevention should be considered. Drug prevention can reduce but not eliminate the risk of influenza, and the susceptibility to influenza will be restored after drug withdrawal. Therefore, routine drug prevention for children is not recommended.
7. Are azithromycin and other antibacterial drugs useful for influenza?
Antibacterials, including azithromycin, are ineffective against viral infection. However, if there is a mixed infection of influenza virus and bacteria or mycoplasma, doctors will also consider the use of anti-influenza drugs combined with antibacterial drugs.
8. Fever is one of the typical symptoms of children. What misunderstandings should be avoided in home care?
The main purpose of taking antipyretics for children is not to reduce the body temperature to normal, but to increase the comfort of children and let them spend the fever period comfortably and safely.
First of all, you can’t take two antipyretics at the same time, which will increase the burden on your child’s liver and kidney and cause adverse reactions; It is also not recommended to use the two antipyretics alternately, because it can not increase the antipyretic effect, but may mistake the time and even lead to overdose.
Secondly, when parents choose antipyretics for their children, they should not only choose drugs suitable for their age, but also read the instructions carefully, and give them to their children in strict accordance with the instructions, paying attention to the dosage and time interval. Remember not to increase the dosage or frequency at will because the child’s body temperature has not dropped to normal.
Finally, if you give your child a compound cold preparation at the same time, you must read the drug ingredient list to avoid duplication with other drugs being used, such as antipyretics. If there is duplication, please use it with caution to avoid overdose.
In daily life, children should be kept in a regular routine to ensure adequate sleep; In terms of diet, we should pay attention to nutrition, have a balanced diet, eat more fruits and vegetables and drink more water. At the same time, avoid the family environment being too dry and ensure the humidity, which is conducive to the recovery of children. Parents should also pay attention to the fact that children should neither cover up their fever nor let them catch cold again. Parents should maintain a peaceful attitude, pay attention to their children’s fever, and don’t be overly anxious, carefully observe their children’s situation and help them recover as soon as possible.
9. I am particularly worried about my child’s febrile convulsion. What should I do if there is febrile convulsion?
If the child has a febrile convulsion, parents must keep calm and don’t panic: (1) Let the child lie on his side or tilt his head to one side, and clean up things with sharp corners around him to ensure that the child will not be hurt when the convulsion occurs. (2) When convulsions occur, don’t stuff anything into the child’s mouth, and don’t feed anything, and don’t try to stop twitching by pressing the limbs. (3) Record the duration and seizure characteristics of convulsions. If the duration of convulsions exceeds 5 minutes or the status quo of convulsions has occurred in the past, call an ambulance. In most cases, febrile convulsions will stop within 5 minutes.
10. What happens that requires timely medical treatment?
Most children with influenza are mild patients, so they can take care of them at home. However, if the following situations occur, they should seek medical attention in time: children who have been diagnosed with influenza have high fever or fever for more than three days, poor mental health or even consciousness disorder, shortness of breath/dyspnea, chest pain, blue skin on the lips, frequent vomiting or diarrhea, convulsions, refusal to eat, scanty urine or urine turning red, and obvious muscle pain; Or if the symptoms are repeated, such as fever again after the flu symptoms are relieved, you need to seek medical advice in time to avoid aggravation and even danger.
11. Which children are at high risk of severe influenza?
High-risk children with severe influenza include: children under 5 years old, especially children under 2 years old; There are basic diseases, such as asthma, tumor, kidney disease, immunodeficiency, taking immunosuppressive drugs, etc.; Obese children are also high-risk groups. When high-risk people have fever during the influenza epidemic season, they should attach great importance to it and seek medical treatment as soon as possible. Once influenza virus infection is considered, antiviral treatment should be started as soon as possible. If there are no contraindications, people at high risk of severe influenza should be actively vaccinated before the flu season begins.
12. Will you get the flu if you are infected with mycoplasma pneumonia recently?
I will. Because the body’s resistance will decrease when it is infected, it may be easy to be infected with other pathogens. Measures to prevent cross-infection include paying attention to self-protection, trying not to take children to crowded places, especially places with poor air circulation, during the high incidence season of respiratory diseases; Pay attention to open the window regularly for ventilation indoors, and isolate it from the sick family if possible; Pay attention to hand hygiene and remind children not to touch their eyes, nose and mouth with unclean hands.
13. Will children have sequelae after the flu?
Most children will not leave sequelae after being infected with the flu. However, after the flu temperature is normal, cough and runny nose may last for a week or even longer. The treatment is mainly symptomatic, keeping the air moist and promoting airway recovery. If cough seriously affects rest, you can take some antitussive drugs under the guidance of a doctor. Some children may have chronic cough due to airway hyperresponsiveness, especially those with eczema and wheezing history, and can be given medication under the guidance of a doctor.
14. How to prevent the spread of influenza in schools and families?
Schools should organize and mobilize students and faculty to get flu vaccine before the flu season begins; It is necessary to strengthen health education for students and their families, help and urge students to develop good hygiene habits, such as washing hands frequently and maintaining environmental hygiene; The classroom should be ventilated regularly; The school monitors students’ body temperature to find sick children in time; Once students are infected with influenza virus, they should rest at home and not go to school with illness; Attach importance to students’ physical exercise and enhance their physique and disease resistance.
Children suffering from influenza should ensure adequate rest, balanced nutrition, drink plenty of water and eat easily digestible food at home; Family members should maintain good hygienic living habits, pay attention to environmental hygiene and cough etiquette. If possible, we should try our best to isolate ourselves from sick family members; If you can’t isolate, you should wear a mask for protection. In addition, the indoor window should be ventilated regularly, but we should pay attention to keep warm in winter to avoid catching cold.
Authors: Zhao Guangyuan, the attending physician of emergency medicine in Beijing Children’s Hospital.
Audit: Wang Quan, Director of Department of Critical Care Medicine, Beijing Children’s Hospital
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