Description of Disease

Influenza (flu) is a contagious respiratory illness caused by several different influenza viruses. It can cause mild to severe illness. Serious outcomes of flu infection can result in hospitalization or death. Some people, such as older people, young children, and people with certain health conditions (such as asthma, cystic fibrosis and diabetes), are at high risk for serious flu complications.

 

The flu can present with the following symptoms: fever, cough, sore throat, runny nose, body aches, headaches, fatigue, vomiting and diarrhea. The symptoms tend to be much more severe than the common cold with higher fevers and more rapid onset.

 

Flu is unpredictable and how severe it is can vary widely from one season to the next and from one person to the next. Complications of flu can include bacterial pneumonia, ear infections, sinus infections, dehydration, and worsening of chronic medical conditions, such as asthma. Flu seasons are unpredictable and can be severe. Over a period of 30 years, between 1976 and 2006, estimates of flu-associated deaths in the United States range from a low of about 3,000 to a high of about 49,000 people. Most deaths occur in the elderly, but last year there were 149 pediatric deaths caused by the flu, with an average age of 8 years. Half of the children who died from the flu had chronic underlying health conditions, but the other half were normal healthy children.

 

Effectiveness of Vaccine

The flu vaccine will protect against the influenza viruses that research indicates will be most common during the season. This includes an influenza A (H1N1) virus, an influenza A (H3N2) virus, and one or two influenza B viruses, depending on which flu vaccine you receive. The CDC estimates that the flu vaccine last year prevented approximately 6.6 million influenza cases that would have required medical attention and 79,000 hospitalizations. Last year fewer than 50 percent of people over the age of 6 months were vaccinated, so even more illness could have been prevented.

 

There are several types of flu vaccines available this year including tri-valent (which protects against 3 strains of flu) injectable vaccine, quadrivalent (4 strains) injectable vaccine, and the quadrivalent inhaled (nasal) flu vaccine. All are equally effective, although the quadrivalent vaccines have broader protection.

 

Risks of Vaccine

As with any vaccine there are risks and side effects associated with the vaccine. Millions of seasonal flu vaccines have been given safely. CDC expects that any serious side effects following vaccination with the 2013-2014 flu vaccine would be very rare.

 

The flu shot:

 

 

The nasal spray (also called LAIV): The viruses in the nasal-spray vaccine are weakened and do not cause the severe symptoms that are often associated with influenza illness. In children, side effects from LAIV can include: runny nose, wheezing, headaches, vomiting, muscle aches, and fever.

 

Serious adverse affects can rarely occur including allergic reactions. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, swelling around the eyes or lips, hives, paleness, weakness, a fast heart beat or dizziness. In addition, after the vaccination you should look for any unusual condition, such as a high fever or behavior changes.

 

Recommendation

Everyone who is at least 6 months of age should get a flu vaccine this season. While everyone should get a flu vaccine this season, it's especially important for some people to get vaccinated, including:

• People who are at high risk of developing serious complications (like pneumonia) if they get sick with the flu.
• People who have certain medical conditions including asthma, diabetes, and chronic lung disease.
• Pregnant women.
• People younger than 5 years (and especially those younger than 2), and people 65 years and older.
• People who live with or care for others who are at high risk of developing serious complications (see list above).
• Household contacts and caregivers of people with certain medical conditions including asthma, diabetes, and chronic lung disease.
• Household contacts and caregivers of infants less than 6 months old.
• Health care personnel.

If your child has not yet been vaccinated please call us right away, we still have flu vaccine available. If adults in the family have not yet been vaccinated, please contact your physician or visit a drug store or urgent care clinic to get a flu shot.

The American Academy of Pediatrics (AAP) published an article in June on swaddling infants. The focus was on safe swaddling; ensuring that infants are comfortable without being at risk due to the constraints of swaddling. The article recommended swaddling infants only up to 2 months of age as this is before most infants intentionally begin to try to roll over. Studies have shown an increased risk of SIDS and accidental suffocation when babies are swaddled if they are placed on their stomach to sleep, or if they roll onto their stomach.

 

While there are the above concerns for swaddling in general, swaddling immediately following vaccines can offer a safe and effective technique to help reduce your child's discomfort. An April 2012 story featured on NPR highlighted a pediatrician in Virginia who studied 230 infants and parents who followed the "5 S's" technique:

1. Swaddling the baby
2. putting the baby on her Stomach
3. gently Swinging her
4. Shushing into her ear
5. offering a pacifier to Suck on

The 5 S's stopped crying much sooner than those who received general comfort care from parents. Their pain scores, as measured by flailing arms and facial grimaces, were also significantly less.

 

How To Swaddle:

• Spread the blanket out flat, with one corner folded down.
• Lay the baby face-up on the blanket, with her head above the folded corner.
• Straighten her left arm, and wrap the left corner of the blanket over her body and tuck it between her right arm and the right side of her body.
• Then tuck the right arm down, and fold the right corner of the blanket over her body and under her left side.
• Fold or twist the bottom of the blanket loosely and tuck it under one side of the baby.
• Make sure her hips can move and that the blanket is not too tight. A good rule of thumb is to make sure you can fit 2-3 fingers between your infant and the blanket.

 

Visit healthchildren.org (the AAP parent website) for more helpful information about swaddling.