Ah-choo! Yep, it’s that time of year again! The start of the school year and cooler temperatures mark the unofficial start of Cold and Flu Season! Boo! In fact, I just tested my youngest daughter for flu… came back positive for Influenza A. YUCK!!!
Although viruses cause both “colds” and “flu”, these two viruses are not created equal!
Rhinovirus, the nasty little guy that causes most of the symptoms we refer to as the “common cold”, is definitely the nicer of the two ugly step sisters! This virus is a fickle little bugger, and in fact has more than 100 similar versions of himself known to cause cold symptoms. Oy vey! That’s one reason why adults can get 2 – 3 colds per year, and children more than 8 to 12 cold per year! The flu, or influenza virus, only has two real alter-egos that affect humans: Flu A or Flu B. Here’s another fun fact: Children are the major reservoir and vectors for rhinovirus and influenza! Ick!
Although both Rhinovirus and Influenza are generally acute, self-limited, and usually uncomplicated diseases in healthy children, influenza has been associated with severe morbidity and mortality. Certain groups of children such as those with chronic medical conditions or very young infants have an increased risk for severe or complicated influenza infection. And, just because you had it once, doesn’t mean you can’t get it again (same with the common cold!). That’s why we recommend an annual flu shot for everyone over the age of 6 months.
How do I know if my child has a cold or the flu?
It can be difficult to tell if your child has a cold or the flu – many times the symptoms are very similar: nasal congestion, runny nose, sore throat, fever, headache, nausea, and cough – but flu symptoms tend to come on faster and more severe and also tend to include whole body aches and pains. Like I mentioned earlier, both illnesses are usually self limited and the mainstay of treatment is symptomatic care.
Here are my cold and flu treatment recommendations:
- Rest, rest, and more rest! Keeping your child home from daycare or school is important for more than just infection control!
- Manage your child’s fever – Tylenol or Ibuprofen (for kids over 6 months) can go a long way to making your child feel better. Find the correct dosage for your child, or print our Tylenol and Ibuprofen Dosing Information sheet to keep on your refrigerator!
- Chicken noodle soup, warm tea, ice-pops, and ginger ale – more than old wives tales! All can be extremely soothing and help maintain hydration.
- Hydration – extra fluids are important to help keep secretions thin, soothe the airways, and general well-being. Extra fluids are especially important if your child has a fever.
- Humidifier – cold air or warm – anything that puts extra humidity in the air will make your child feel better.
- Honey for cough – I suggest honey as an option for treating cough in children ≥1 year with the common cold. The honey (2.5 to 5 mL [0.5 to 1 teaspoon]) can be given straight or diluted in liquid. If you don’t have honey, corn syrup can be a good substitute. Honey has a modest beneficial effect on nocturnal cough and is unlikely to be harmful in children older than one year of age. Avoid honey for children younger than one year because of the risk of botulism.
- Warm baths and steamy showers can help loosen nasal and chest congestion.
- Saline nasal drops or nasal spray can also go a long way for making your child comfortable. This is especially important for young babies and is usually used along with gentle suction.
- We don’t recommend using over-the-counter cold preparations for children younger than 12 years.
Expected course of illness
You can expect your child to feel pretty crumby for the first 2 to 3 days – this is when both illnesses tend to peak. Symptoms should then gradually improve and resolve within 7 – 10 days (depending on the child’s age — give or take a few days). Coughs can take a bit longer to resolve but should not last longer than 2 weeks without medical evaluation. And that brings me to my next point 🙂
When to make an appointment
Most children will make it through several acute viral illnesses each year with nothing more than a few annoying symptoms or missed days of school. However, up to 30% of children with a viral illness will develop a secondary bacterial infection: ear infection, sinus infection, or pneumonia. Schedule an evaluation for your child if they have ear pain, or nasal drainage or cough that is lingering more than 2 weeks. You should call for an appointment if your child’s symptoms are getting worse instead of better, seemed to be getting better, then worsened, or of course if your child is having trouble breathing, a change in behavior or lethargy, or if they are not able to keep any thing down. I also encourage parents to call or bring their child in anytime they are worried! Parents have great intuition!
Prevention is the best medicine- especially in cold and flu season!
Well, there are measures we all can take to minimize our chances (and our kids chances) of getting sick. Good hand washing is the number one way to protect ourselves! Teaching your children how to wash their hands is so important! You and your child should wash your hands frequently during cold and flu season. Cold viruses pass from your hands to objects and to other people — and vice versa. Remind children to cough into a tissue or the crook of their elbow rather than into their hands. Throw away used tissues!
Many parents ask me if Vit C, D or Zinc can help, or herbal supplements. Well, the jury is still out on that one and some herbal remedies can be dangerous in children. In reality, good nutrition is very important all year round. Especially during cold and flu season!
Can my child still go to school or daycare?
Most children with colds need not stay home from day care or school because transmission is likely to have occurred before the child became symptomatic. You can decrease the risk of spread by following common sense prevention measures, discussed in the sections above. If you think or know that your child has the flu, I recommend they stay home from day care or school until they are fever-free and feeling better.
What about immunizations?
There is not an immunization to prevent the common cold. However, we recommend a yearly influenza immunization for all adults and children older than six months of age.
Please call us if you have any questions or concerns! Schedule an appointment if you’re concerned about your child.