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EDUCATIONAL INSIGHTS: Pearls from a Practicing Pediatrician - “Influenza 2020 and Children – Latest Recommendations and a Look Back at 2019”

Posted: Nov 16, 2020
Comments: 0
Author: UCA Admin

Content provided by Thomas W. Tryon, MD, MBA, FAAP; UCA Pediatric Section Chair

Winter is coming or is here in many states across the country and along with the winter comes Influenza season.  This year will likely be one of the most challenging in my almost 30 years in healthcare as we are still dealing with COVID-19 and its implication on the health of children and the population in general.  To help us prepare for the upcoming influenza season, the American Academy of Pediatrics (AAP) and the Centers for Disease Control (CDC) have published updates and recommendations specifically impacting children. 

First, a look back at the 2019-2020 influenza season is worthwhile.  Here is what we know about how influenza impacted children and adults last year:

  1. CDC estimates that the burden of illness during the 2019–2020 season was moderate with an estimated 38 million people sick with flu, 18 million visits to a health care provider for flu, 400,000 hospitalizations for flu, and 22,000 flu deaths.  The CDC estimates include 12.5 million children under the age of 18 who were infected with influenza.
  2. The CDC reports that there were 188 confirmed deaths in children under the age of 18 due to influenza.  However, they believe that number is under-reported and mathematical models place the number at closer to 434. 
  3. Additionally, over 7,700 working age adults (between 18-65) died from influenza this past season.3 
  4. More than 52,000 hospitalizations occurred in children under 18 years of age. 
  5. The 2019–2020 season was of moderate severity, although 3 peaks of influenza-like illness activity and the highest hospitalization rates in children, 68.2 per 100 000 population overall, were reported this season.  The influenza peaks occurred in January, February and March, with the March influenza peak then co-existing with the SARS-CoV2 pandemic.

What can you do as parents, grandparents and caregivers of children as we head into this influenza season?  First and foremost, ensure that both you and your children or grandchildren are immunized for influenza.  Influenza is not a mild respiratory illness.  I have always told parents and children who were afflicted with influenza that they would “feel like death warmed over” for the next 5-7 days.  Even with medications that we can use to help treat influenza, most research shows that it only shortens the disease by 1-2 days.  As our parents and grandparents have always told us, “an ounce of prevention is worth a pound of cure”.  In this case, preventing influenza by being vaccinated is all important.  For those concerned that the vaccine can give you “the flu” (influenza), it can’t.  The vaccine can give you an “influenza-like illness” that is much milder than the actual influenza. 

Further, being vaccinated for influenza will decrease the risk that you may spread the infection to those most vulnerable such as infants under six months of age who are too young to be vaccinated or children or adults “in your bubble” who may have complex medical conditions, or the elderly with whom you come in contact who may not mount a great immune response to the vaccine. 

Last, children who are hospitalized for influenza-related complications but are vaccinated have a lower risk of death due to influenza.  The latest data from last year has shown that being vaccinated decreased the risk of death by 50% in hospitalized children who were considered high risk for influenza complications and decreased the risk of death by 75% in hospitalized children without high risk medical conditions.  Flu vaccination will also likely result in you or your child having a milder course if you do still get infected.

Second, as with any symptoms of COVID, it is important to stay at home and away from people if you or your child are ill.  Rest, lots of fluids, medications for fever or pain, and a prompt visit to your nearby urgent care or primary care provider is important if you believe your child may have influenza.  Early treatment is key in helping your child have a milder course and a quick return to normal. 

Last, again along the lines of an ounce of prevention is worth a pound of cure, social distancing where appropriate, wearing a mask and hand hygiene is going to be important in protecting your children from getting influenza or spreading the disease if they do become infected.  Best wishes for a safe and healthy Winter, 2020-2021 as we pray for an end to the Coronavirus pandemic and for a mild influenza season.   


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