The NICD (National Institute for Communicable Diseases) has now reported that we have already surpassed the number of cases expected for the flu season. The flu season is only expected to end in August /September, meaning there are many ill people around at present.
In my practice, I am swabbing 3 to 4 children per day who present with flu symptoms, and the results show that most of these children are suffering from Influenza A. Overall, these children are miserable with high fevers, congested noses, coughs and tummy upsets. This bout of Influenza is aggressive, and the symptoms have not been mild. They have been what my children call “lit”.
What is Influenza A?
Influenza A can be broken down into subgroups. The group that causes the most concern to parents is the H1N1 (swine flu). The more common variant is the H3N2. Influenza A is an acute illness, meaning that it comes on quickly and will run its course in a couple of days. Typically, the symptoms will include:
- Sudden onset of fever. The children I am seeing have fevers as high as 41®C
- Body aches and pains
- Noisy breathing
- Severe cough
- Sore throats
- Congestion
- Some with vomiting and diarrhoea
- Lethargy
How is Influenza A spread?
Influenza A is a respiratory illness that is spread when an infected person coughs or sneezes without covering their mouth and nose. The droplets containing the virus can spread for up to 1 meter from the person who is ill and infect anyone in that proximity.
A sick person may also spread the virus by touching surfaces without washing their hands. For this very reason, children in a school environment are most at risk.
This is followed closely by adults in open-plan work environments. Since Influenza A can be found in many species, including humans, birds and pigs, this sneaky virus has plenty of choices for hosts and is therefore most troublesome. Generally, a person is infectious from the day before symptoms arise and then for the next three to four days.
How is Influenza A diagnosed?
The only way to be sure is through a swab. Your doctor may swab the nose or throat and send the swab to the laboratory for a viral analysis. Once you know what type of virus you are dealing with, your doctor may recommend different treatment options. If your child isn’t too ill, the flu diagnosis may be made based on symptoms. 
Is there a treatment for Influenza A?
Since Influenza is a virus, there is no treatment that can be given to kill the virus. Instead, all treatment focuses on reducing the effects of the symptoms.
If the symptoms are severe, your doctor may prescribe an anti-viral agent, which will likely decrease the amount of time it takes for your child to get better. The anti-viral agent depends on the virus detected; this is where a swab is helpful. The anti-viral agents are most effective if started within the first 48 hours of the illness.
Decongestants and paracetamol help to alleviate the symptoms and are safe when used in the correct dose. Please remember not to use Aspirin on your child for fever. This can lead to serious complications. Over and above this, encourage your child to drink plenty of fluids.
Is there anything that I can do to prevent my child from getting Influenza A?
The flu vaccine is the best way to prevent your child from getting any form of flu. According to the American Journal of Paediatrics, the “Influenza vaccination is an important strategy for protecting children and the broader community, as well as reducing the overall burden of respiratory illnesses when other viruses, including severe acute respiratory syndrome and coronavirus 2, are cocirculating.”
I have heard the concerns of parents regarding the flu vaccine many times. These include:
- “The year I got the flu vaccine was the year I got the worst case of flu. “Each year the flu vaccination contains 4 of the most common flu variants for that season. If you got flu, it was most likely a variant not covered by the vaccine.
- “If my child has had a flu vaccine, why should it be repeated yearly?” The influenza virus changes slightly every year, so the vaccination has to be adapted accordingly.
Think of the flu vaccine as an investment. In the first year, you have a little in your investment fund. As the years go by and you add a sum annually, the investment grows. This is exactly the same with the flu vaccine. Each year you are broadening your child’s immunity to the various flu strains to give your child the best possible resistance when the flu season comes around.
- “Isn’t my child too young to receive the flu vaccine?” The flu vaccine is recommended from 6 months of age. In the first year, your child will receive two doses, one month apart. This is for all children under the age of 9 years.
- “What type of reaction can I expect from the flu vaccine?” The most common side effect is pain and redness at the vaccine site. The child may develop a slight fever or body aches in a few cases. Your child will not get the flu from the injection. It is a “killed vaccine”, which means the virus has been inactivated.
- “When is the ideal time to vaccinate?” Naturally, it would be ideal to vaccinate a child before the flu season begins. I recommend that my patients have the flu injection towards the end of March and the beginning of April. However, the Institute for Communicable Disease (NICB) has stated that a flu vaccination can still be given as late as August/ September as the current season continues to surge nationwide.
Mitigating the dangers
No parent wants to sit beside a child’s bed all night because the fevers keep spiking; they cough until they vomit and complain of pain and discomfort. This is made so much worse by you also feeling ill. Unfortunately, colds and flu go hand in hand with winter, so it is a factor of life, but a factor we can influence somewhat. In my house, everyone gets the flu vaccination in March.
My now son-in-law was terrified of needles when he started dating my daughter. It has become a family joke that he overcame his fear of needles just to stay around. Last week they became parents to a beautiful baby girl, but that was after the entire family received their flu injection. Most importantly, Mommy received her shot in her final trimester. The statistics show that the immunity a mother receives from the flu vaccine is passed to the baby in utero and during breastfeeding.
Based on what I am currently seeing in my practice, I am incredibly grateful for this vaccine. Influenza A is a nasty illness, especially for tiny tots, children with chronic diseases and people over 65.
Please ensure that you receive medical advice for any child under three months with flu-like symptoms. These children have not had time to develop much immunity, and their symptoms can progress very quickly. I am sure I can speak on behalf of many paediatric practices and say that this current flu situation is causing severe disease.
References:
https://publications.aap.org/pediatrics/article/150/4/e2022059274/189385/Recommendations-for-Prevention-and-Control-of?autologincheck=redirected
https://www.cdc.gov/flu/symptoms/testing.htm
https://www.cdc.gov/flu/professionals/diagnosis/labrolesprocedures
https://www.marchofdimes.org/find-support/topics/parenthood/influenza-flu-and-your-baby
https://www.nicd.ac.za/increase-in-flu-cases-across-the-country5-june-2023/
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