Q : Are there any treatments for influenza that children can take?
A: There has been a lot of press about the double threat of influenza and COVID-19 as we head into influenza season (November to April in New Mexico).
It is natural to worry that the effects of the two viruses together might be overwhelming for any child, and to wonder what we can do to minimize the risk.
The first thing we are all trying to do to protect our children is to get them vaccinated with the flu vaccine. Any child 6 months or older is eligible. The vaccine does not ensure complete protection from getting sick with influenza, rather it significantly improves the chances of have a milder illness, should the child fall ill with influenza.
Each year, a new influenza vaccine is manufactured, made to target the strains most likely to be prevalent in the current influenza season. Last season was unusual in that the overall effectiveness of the vaccines in preventing infection was approximately 39%. This was much lower than in years past.
Nonetheless, immunization was estimated to have prevented more than 4 million illnesses and more than 55,000 hospitalizations. Every year children get admitted to hospital intensive care units with a diagnosis of respiratory failure, due to influenza bronchiolitis or influenza pneumonia.
For those children, having a less severe disease course would have made a world of difference.
In addition to vaccines, there are a few medications that we use to treat children who become ill with influenza. They are called antiviral drugs.
Antiviral therapy is recommended for children who are hospitalized, have severe illness or are at increased risk for complications from illness. Early antiviral treatment can shorten the duration of fever and reduce the risk of complications such as otitis media, dehydration, sinus problems, pneumonia and worsening of chronic medical problems like asthma or heart disease.
Antiviral treatment is most likely to be beneficial if started within 48 hours of symptom onset.
The antiviral medication most commonly used in children is called Tamiflu (oseltamivir). It can be given to children as young as 14 days, and older.
If a child’s symptoms are consistent with influenza, treatment with Tamiflu should be started immediately, even if test results are not yet back. Early treatment within the first 48 hours of symptoms can shorten the duration of fever and reduce the risk of complications.
Another oral antiviral agent available to treat children 12 years and older is Xofluza (baloxavir). Clinical trials have shown that one dose of baloxavir is equivalent to five days of oseltamivir. A third antiviral available for use in children called Rapivab (peramivir). Peramivir is available in an intravenous formulation only. It is approved for use in children 2 years and older, who have been symptomatic for 2 days or less.
Although there are a number of medications approved to treat influenza, for children, they are not a substitute for yearly vaccination.
The Centers for Disease Control recommends that every child 6 months and older get a seasonal flu vaccine each year by the end of October. However, as long as flu viruses are circulating, vaccination should continue throughout flu season, even in January or later if your child has not yet been vaccinated for this current season.
Some children 6 months to 8 years old require two doses of flu vaccine for adequate protection from flu, spaced at least 4 weeks apart. If your child needs the two doses, begin the process early. This will ensure that your child is protected before flu starts circulating in your community. It usually takes about two weeks after the second dose for protection against flu to begin.
In addition to vaccination, sticking to tried and true good hygiene habits will provide additional protection against contracting the flu. These habits include avoiding close contact with other children who are sick, encouraging children to cover their nose and mouth when sneezing or coughing and making an effort to minimize touching their eyes, nose or mouth.
Last but not least, don’t forget to role-model frequent hand-washing. The best way to teach children these lifelong protective measures is to employ them yourself, and demonstrate these simple but effective habits through example, so your children start doing them without even thinking about it!
Anjali Subbaswamy is a Pediatric Intensive Care Physician at UNM. Please send your questions to asubbaswamy@salud.unm.edu
