Hello NAP Families,
As you are likely aware, the “flu” (influenza virus) has hit the Pioneer Valley with full force! We are getting many calls about children with flu-like illnesses and our nurses are doing their best keeping up with your questions. We want to provide some information here about NAP’s policies regarding flu testing and treatment, school notes, and also some basic home care advice. Of course, the best way to prevent the flu is by getting your annual flu vaccine and practicing good hand hygiene. On average, the flu vaccine decreases a child’s chance of getting the flu by over 50%, and even if a child does get the flu after receiving the vaccine they are MUCH less sick and typically need to be out of school for fewer days. If you have not yet gotten the flu vaccine for your family, please consider doing so as soon as possible.
Flu-like symptoms (not to be confused with the “stomach flu” aka gastroenteritis):
- high fevers
- body aches
- headache
- sore throat
- nasal congestion and cough
- occasionally vomiting/diarrhea
Most children only need supportive care for these symptoms which we will describe in detail below. However, symptoms can become more serious and require a visit with a provider. If any of these symptoms develop, call our office right away to discuss scheduling an appointment:
- difficulty breathing
- chest pain
- dehydration
- change in mental status (confusion, hallucinations, not waking up when roused)
For a child who does not need a hands-on appointment with a provider but is in need of a medical excuse note for missing school, we offer the following options:
- Do an at home flu test! These tests are now readily available at all area pharmacies. If you test positive at home for the flu, you can send this result to us via the portal and we will be able to provide a school excuse note for the duration of the illness. The same policy applies to at home COVID tests.
- Schedule a virtual visit with a provider! NAP offers some limited virtual visit availability each day for children who do not need a visit in the office and can then provide school excuse notes as indicated.
- Let the school know your child is sick and see if they truly need a doctor’s note. Did you know most schools allow 9 days each semester of “unexcused” absences? These are to account for when a child is sick enough to be out of school but not requiring medical attention.
Home care guidance for the flu:
- Rest at home, limit physical activity or exertion.
- Use ibuprofen (if 6 months and older) or Tylenol as needed for pain or fever.
- Keep well hydrated. Offer small frequent sips of fluids throughout the day. Monitor for dehydration. Fluids are more important than food when ill. Offer bland foods with salt as tolerated: broth, saltine crackers, etc.
- Use steam to open nasal passages and encourage frequent nose blowing to clear sinuses and prevent post-nasal drip.
- Sleep with the head elevated to alleviate pressure in the head and ears and allow gravity to assist with nighttime nasal drainage so your child doesn’t wake up coughing and choking on mucous all night.
- If over 1 year of age, use honey for cough and sore throat: directly on a spoon or mixed into warm water or lemonade. Cough, cold, and flu medicines do not work and often cause side effects in children!
- Wash hands well to prevent spread.
Most influenza infections last 5-7 days, although children who have received the annual flu vaccine typically have a shorter, less severe course.
Your child may return to school or daycare when they have been fever free for 24 hours without the use of fever reducing medication, and their other symptoms have started to improve.
If your child has the flu and their symptoms have been present for less than 48 hours, they may be eligible to take a medication called Tamiflu. This is an antiviral that helps limit the spread of the virus and decreases symptom duration by an average of 1-2 days. It is not effective after 48 hours as the virus is already widespread by that time. We recommend children who are “high risk” take Tamiflu if diagnosed within 48 hours of symptom onset – children under the age of 2, patients with asthma, or patients who are significantly medically complex/immunocompromised. For other children, Tamiflu could still be an option but there are some uncomfortable side effects (ex. Vomiting and diarrhea) that can occur about 10% of the time so if a child is not high risk and is otherwise managing the illness ok, it may not make sense to start them on Tamiflu. If you are interested in getting a Tamiflu prescription, a provider in our office would help make that decision and send the prescription if indicated. Because this medication is time sensitive, we ask that you call the office to speak to a nurse if your child has a positive flu test, has been sick less than 48 hours, and you would like them to start Tamiflu.
We wish everyone the best as we muscle through another New England flu season!
Northampton Area Pediatrics