BY COSHANDRA DILLARD
With an early onset of the influenza virus sweeping across the country, people are either coping with the flu or trying to avoid it. Young children — along with seniors, pregnant women and those with compromised immune systems — are most vulnerable to the flu virus.
In Texas, at least six flu-related deaths of children have been reported since October. The state doesn't track adult flu-related deaths. And with school back in session, health officials say it's important to prevent the further spread of flu.
“We've certainly seen more flu this year than the last couple of years,” said Dr. Valerie Smith, a physician at St. Paul Children's Clinic. “And most of the children who are coming in have pretty classic” symptoms.
High fever, chills, aches and pains are common symptoms of the flu. In children, 100.4 degrees is considered a high fever, but Dr. Smith also notes that it is an “arbitrary number.”
Sometimes children can't articulate certain symptoms but may complain of “hurting all over,” she said. Vomiting and diarrhea are symptoms accompanying the flu this season, too, she added.
During the past couple of weeks since the students returned from the holiday break, Tyler Independent School District officials have not yet seen an unusually high number of absences.
Nancy Jones, registered nurse and Tyler ISD's coordinator of health services, said campus nurses typically log illnesses and communicate with each other to survey potential outbreaks.
“Right now, we are all just holding our breath because we're holding good,” Ms. Jones said. “Nurses, teachers and custodial staff are doing a great job making sure those door knobs and water fountains are wiped down frequently throughout the day.”
As of the last Centers for Disease Control and Prevention report, ending Jan. 5, all but two states are experiencing widespread flu activity.
Doctors assert that the best protection against the potentially serious viruses is to get the flu vaccine. This season, the vaccine covers three strains of the virus. In addition, normal, everyday hand washing and good hygiene practices are being encouraged.
Northeast Texas Public Health District officials said they have had an adequate supply of vaccines. They've placed two orders so far, with about 2,000 doses ordered in the first batch at the beginning of the flu season.
“Demand is steady but it's not overwhelming,” said Russell Hopkins, director of public health emergency preparedness at the district. “Most of flu shots that the community at large has been given was given early. Most people listened to the message and got their flu shot early.”
There, injections cost $20 and a flu mist costs $25. Low income families with no insurance can get an $8 vaccine through the Vaccines for Children program.
Hopkins said he believes the country is midway through the peak of the flu season and expects to see a decline in flu cases as early as next week.
Dr. Smith noted that it's not too late to get vaccinated. She said to keep in mind that it may take about two weeks for the vaccine to build immunity but with a few weeks left in the flu season, it may provide protection from exposure in the future.
ISOLATION IS KEY
Isolation during illness ensures that fewer people are exposed to viruses. Dr. Smith said people who are ill shouldn't run errands and if they must go out they should wear a mask.
“The way that we spread flu is that we cough, sneeze or rub our hands on objects,” Dr. Smith said. “Someone touches the object, then touches their hand and mouth. Try to be really conscious about how much you touch your face, especially your mouth, nose and eyes. The average person touches their face 200 times a day.”
School health officials say that when a child has a fever greater than 100 degrees along with other symptoms, they cannot be in school. They may return only after it has been below that temperature for 24 hours without fever-reducing medication.
“That just reduces it,” Ms. Jones said of medications. “That doesn't cure the problem. It helps the fever get under control, but it does not kill the cold and flu virus.”
Parents are encouraged to check temperatures in the mornings before a medication is used.
Babies who are younger than 6 months can't be vaccinated, so they are particularly at high risk. Dr. Smith said families should not take newborns to crowded public places during the flu season unless necessary.
“Don't let anyone hold the baby who is sick, and people should wash their hands before they hold the baby,” she said.
Emergency rooms are often a stop for people who are sick with mild flu-like symptoms. It also could be a place that harbors those viruses, potentially infected those who are there for other emergencies.
“Emergency rooms are overwhelmed with people who don't truly have emergencies,” Dr. Smith said. “Always try in those situations to see a family physician or urgent care center first.”
A commonly prescribed antiviral, Tamiflu, is most effective within 48 hours of the onset of symptoms. Many people who get the flu will have a mild course or have another type of upper respiratory infection.
“If that's all they have, they don't need to rush to the doctor,” Dr. Smith said.
Children and adults who have other respiratory problems like asthma or COPD are at the highest risk for having complications from the flu, Dr. Smith said. Those people should see a doctor as soon as they begin experiencing flu-like symptoms.
Harvard researchers and the Centers for Disease Control and Prevention state that practicing an active lifestyle, which includes adequate sleep, a good diet and exercise, helps the body fight against illness.
Nutritional supplements and over-the-counter immune boosters before or during a course of the flu aren't typically prescribed for children. Parents may want to give vitamin supplements such as zinc and herbal teas such as Echinacea, but Dr. Smith said there isn't a lot of scientific evidence that suggests it will prevent children from getting sick if already exposed to the flu or that it shortens the length of the illness.
“The best lines of defense besides vaccination is staying well hydrated and hand washing,” Dr. Smith said. “There is not, for kids, anything specific we recommend for immune boosting.”
Dr. Smith said having a diet with adequate vitamin C is a way to boost the immune system. However, it's best to get that vitamin through a regular diet and not through supplements.
As for age-old remedies, such as chicken noodle soup and warm tea with honey and lemon, it soothes the body and loosens mucus.
Preventive tips encouraged by Tyler ISD staff include hand washing, social distancing, keeping hands from the face and staying home while sick. Hand washing for about 20 seconds — about the time it takes to sing Happy Birthday twice — reduces the number of germs on hands.
Some nurses have given presentations in elementary classrooms and Ms. Jones said they have made an impression on the children. She said adults should demonstrate the hygiene practices they want children to follow, such as cough etiquette, proper hand washing and the use of hand sanitizers.
Other measures include wiping down commonly used objects and surfaces with soapy water or a disinfectant.
STOP THE SPREAD OF FLU
Teach and demonstrate good hygiene practices such as hand washing.
Keep sick children at home and return to school after fever drops below 100 without medications.
Teach children to avoid touching eyes, nose and mouth.
Clean and disinfect surfaces that are often touched.
Avoid close contact with others and isolate those who are sick.
Source: Centers for Disease Control and Prevention; Nancy Jones, Tyler ISD