Flu Makes a Return

The flu is making a comeback after taking a backseat to COVID-19 in the latter half of 2020 and all of last year. Last week, 76 of the 558 patients tested for flu at Cook Children’s Medical Center were positive for flu A, and one was positive for flu B.

“On Friday, 60% of my sick patients were positive for flu A,” said Bianka Soria-Olmos, D.O., a physician at Cook Children’s Pediatrics Haslet. “Our health system’s numbers are still significantly lower for percent positivity compared to usual flu seasons but, as omicron comes down, it will be interesting to see what flu does.”

Symptoms of flu include fever, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches and tiredness. Vomiting and diarrhea with flu is more common in children than adults.

So how do you know if your child’s symptoms are the result of flu, COVID-19 or the common cold? A cold typically won’t come with fever and chills. As for flu versus COVID-19, Dr. Soria-Olmos said testing is the only way to tell.

“The hard part about this winter is that you have to have a high level of suspicion for both flu and COVID even though COVID numbers are coming down,” Dr. Soria-Olmos said. “Both still have to be on the list because there isn’t one symptom that tells either apart. That’s why we rely on testing to identify the virus.”

While there are no COVID treatments currently approved for kids younger than 12, there are treatments for flu, like Tamiflu. To get the full benefit, Tamiflu needs to be administered within 48 hours of the onset of symptoms.

“I want to tell the viruses apart because if you are flu positive and you're within the window of time, then Tamiflu is an option,” Dr. Soria-Olmos said. “But also, isolation guidelines for flu and COVID are a little bit different. So the reason I would want to know COVID from flu is not just treatment recommendations, but also isolation recommendations.”

Most children will recover from the flu in a few days with rest and lots of fluids, but anyone can develop a complication. Children under two or those with an underlying health condition like asthma, diabetes or heart disease are at higher risk for complications than others. Complications can include anything from a minor sinus or ear infection to a serious case of pneumonia. That’s why Dr. Soria-Olmos recommends the flu vaccine for children 6 months and older.

“You may still get the flu if you are vaccinated, but the likelihood that you’ll have severe illness will decrease,” Dr. Soria-Olmos said.

If your child is sick with the flu or a flu-like illness, the most important thing to do is keep them hydrated. Dr. Soria-Olmos said parents should watch the color of their child’s urine. If the urine is dark or decreasing in amount, that is a sign they may be dehydrated. Parents can use fever-reducing medication like acetaminophen and ibuprofen to manage fever and discomfort. But if your child’s fever lasts more than four to five days, they are struggling to breathe, their cough continues to worsen or they’re experiencing a lot of pain, they need to be seen by their physician.

Keep children home while they have symptoms. Kids should be fever-free for 24 hours without fever-reducing medications before returning to daycare, school and other activities.

Most importantly, remind your kids to wash their hands regularly and to catch their sneezes and coughs in a tissue. These simple tasks go a long way in preventing the spread of the flu bug and keeping kiddos healthy.