The Children's Hospital at Monmouth Medical Center

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Physicians at The Children’s Hospital at Monmouth Medical Center Offer Updated Prevention and Treatment Tips
for Seasonal Flu

Long Branch, N.J.-- A study in the Journal of Infectious Diseases showed that immunization of 85 percent of all schoolchildren in Tecumseh, Michigan against influenza resulted in a 3-fold reduction in the infection rate in other age groups. Despite this, national vaccination rates among children at increased risk for influenza complications remain low. Coverage among children aged 2-17 years with asthma for the 2004-05 influenza season was estimated to be 29 percent.

Most Americans have had some experience with seasonal flu, a respiratory illness that strikes annually. Seasonal flu is not a benign illness -- it kills about 36,000 and hospitalizes over 200,000 people in the United States every year. It poses an important threat to the unvaccinated, especially young children.

“Children are inherently more at risk because they congregate in groups,” reports Margaret Fisher, M.D., FAAP, Chair of the Department of Pediatrics at The Children’s Hospital at Monmouth Medical Center. “They like to ‘share’ their secretions. They won’t share their toys, but are happy to share their germs. We can expect them to become infected—and to infect others.” 

Flu Prevention
Federal health officials have expanded the age range for recommended seasonal flu vaccination of children. Currently, the Center for Disease Control (CDC) recommends that all children between the ages of 6-59 months of age receive the annual flu vaccine and that previously unvaccinated children less than  8 years of age receive 2 doses of vaccine the first time they are vaccinated.

Children younger than 2 years old, even if they are otherwise healthy, are more likely than older children to be hospitalized with serious complications if they become ill with influenza. These complications can include pneumonia, dehydration, and other bacterial infections. In some cases, complications can lead to death. Each year in the U.S., there are more than 20,000 children age five and younger hospitalized due to flu.

Treating Seasonal Influenza
According to the American Academy of Pediatrics, there are four drugs available to treat and/or prevent seasonal influenza. These are: amantadine, rimantadine, zanamivir (Relenza) and oseltamivir (Tamiflu). The Food and Drug Administration has approved all of them to treat, and most of them to prevent, flu caused by influenza A, while only zanamavir and oseltamivir are able to treat and prevent flu caused by influenza B.

However, during recent flu seasons -- and for the 2007-2008 flu season – the CDC has recommended against using amantadine and rimantadine for seasonal flu because influenza A viruses are becoming increasingly resistant to both drugs. CDC has urged that these two drugs not be used again until influenza A viruses once again become susceptible to them.

The FDA has approved oseltamivir to treat children one year and older and prevent influenza among children 13 years and older. Zanamivir is licensed to treat children 7 years of age and older, but is not licensed for the prevention of influenza.
All of the drugs except zanamivir are taken orally in pill or suspension form. Zanamivir comes in a dry powder and is inhaled using a device known as a “Diskhaler.”

On average, the drugs reduce the duration of flu symptoms by about one day if taken within the first 48 hours after illness begins. As a preventive, antivirals significantly reduce the chances of becoming ill during a flu outbreak.

Limiting the Spread of Flu
Studies have indicated that school children are the population group most responsible for transmission of contagious respiratory viruses. They have a high attack rate of influenza infection because they have limited pre-existing immunity and once infected, transmit influenza viruses to many others even before they have symptoms.

Children gather in groups-- in school, in daycare settings, on playgrounds, in households -- and often are unintentionally careless when it comes to their personal hygiene. While it is challenging to try to teach very young children to cough into their sleeves and to get them to wash their hands frequently, these efforts are the best method preventing transmission of germs.  Covering your mouth with a tissue is appropriate but few children or adults have tissues at hand.  It is much better to cough into your elbow (or sleeve) than to cough onto your hand since your hands will spread the virus to other surfaces and other children whereas your sleeve and elbow aren’t likely to touch others.

CONTACT: Beth Salamon
Public Relations
(973) 322-4926, esalamon@sbhcs.com

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