Oh No it's the Flu Monster

Routine annual flu vaccination is recommended for all patients over the age of 6 months. Ideally, all patients should receive the vaccine prior to the onset of flu season (Late November to March).

“The flu” is cause by the influenza virus. Unlike the common cold, influenza can cause severe illness (particularly under the age of 2). Symptoms often come on quickly including fever, cough, sore throat, runny or congested nose, muscle aches, headache and fatigue. Most people recover in days however, symptoms may last up to 2 weeks.

The flu season is unpredictable from year-to-year and the severity each year depends on multiple factors (which virus is spreading, how much and when flu vaccine is available and how many people get vaccinated). People at high risk for severe flu include young children, pregnant women, those with chronic medical conditions (asthma, diabetes etc) and adults over the age of 65.

The flu is spread mainly by droplets made when people with the flu cough. Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching their own mouth, eyes or  nose. You may be able to spread the flu to someone else before you know you are sick, as well as while you are sick. Most children may be able to infect others beginning 1 day before symptoms develop and up to 5 to 7 days after becoming sick.

A number of flu tests are available to detect influenza viruses. The most common are called “rapid influenza diagnostic tests.” These tests can provide results in 30 minutes or less. Unfortunately, the ability of these tests to detect the flu can vary greatly. Therefore, you could still have the flu, even though your rapid test result is negative. Most people with flu symptoms do not require testing because the test results usually do not change how you are treated.

The best way to treat the flu is to prevent it and the single best way to prevent the flu is to get a flu vaccine each season. There are two types of flu vaccines:

“Flu shots” — inactivated vaccines (containing killed virus) that are given with a needle. There are three flu shots being produced for the United States market now. It has been used for decades and is approved for use in people 6 months of age and older. Some minor side effects that could occur are: Soreness, redness, or swelling where the shot was given, fever (low grade), and aches. If these problems occur, they begin soon after the shot and usually last 1 to 2 days.

The nasal-spray flu vaccine — a vaccine made with live, weakened flu viruses that is given as a nasal spray. The viruses in the nasal spray vaccine do not cause the flu. The intranasal vaccine is approved for use in healthy people 2 to 49 years of age. In children, the most common side effects include runny nose, wheezing, headache, vomiting, muscle aches and fever.

Children 6 months through 8 years of age who did not receive at least one dose of the 2010-2011 vaccine, or whom it is not certain whether the 2010-2011 was received, should receive 2 doses of the 2011-2012 seasonal vaccine.

The first dose should be given as soon as vaccine becomes available, and the second dose should be given 28 more days after the first dose. The first dose “primes” the immune system; the second dose provides immune protection. Children who only get one dose but need two doses can have reduced or no protection from a single dose of flu vaccine.

About two weeks after vaccination, antibodies develop that protect against influenza virus infection. Flu vaccines will not protect against flu-like illnesses caused by non-influenza viruses.

Quick note on Flu vaccine and egg allergy: All licensed and recommended influenza vaccines in the US are made using egg-based manufacturing processes. Only contraindication is prior history of anaphylaxis to egg. Individuals with less severe reactions (hives) may receive the vaccine (shot only) and may be watched for 30 minutes after receiving the vaccine. 

Once you have the flu it can be treated. If you get the flu, antiviral drugs are a treatment option. However, not everyone requires antiviral therapy and the medications do not cure the flu just lessen the symptoms. Therefore, only a select population is recommended to receive therapy (<2yo and those with chronic medical conditions). Antiviral drugs are prescription medicines that fight against the flu in your body. When used for treatment, antiviral drugs can lessen symptoms and shorten the time you are sick by 1 or 2 days. They also may prevent serious flu complications.

Always remember basic illness prevention. Cover your nose and mouth with a tissue when you cough or sneeze. Wash your hands often with soap and water. Avoid touching your eyes, nose and mouth. Try to avoid close contact with sick people. If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care.

At Belliacres Pediatrics we pride ourselves in being up-to-date with the current CDC recommendations and ordering our flu vaccines as soon as they are available. Please contact the office if you have any questions and check our twitter feed often (@belliacrespeds) for updates on flu vaccine availability. 

RSV...That Pesky Winter Time Virus

Respiratory Syncytial Virus (RSV)

RSV may cause illness in any age, however, the course of illness and severity of symptoms varies with age. RSV has a seasonal pattern presenting in Maryland anywhere between November and April and peaking in January or February. Almost all children will have an illness caused by RSV by 2 years of age and re-infection is common. In children under the age of one year RSV is the most common cause of bronchiolitis (a viral infection of the lungs causing wheezing, cough or respiratory distress). Those at higher risk or more severe illness include:

• Children under the age of 6 months
• Infants born prior to 35 weeks gestation (prematurity)
• Infants with underlying heart or lung disease
• Infants exposed to second hand smoke

RSV is spread from hand-to-hand contact. Once on your hands, the virus is introduced to the body through your nose or eyes when you touch your face (therefore the key for prevention is regular washing of hands with soap and warm water). RSV may stay on your hands for several hours.

RSV may cause a variety of symptoms depending on age. Older children (>1yo) and adults symptoms will often be limited to congestion, runny nose, cough and fever. However, in infants , we will often see an increased rate of breathing, decreased appetite, wheezing on exam and a cough that can last up to 2-3 weeks. Symptoms will peak usually on day 3-4 of illness.

So, Why do infants have more severe symptoms than older children?. Infants are small (duh Dr. Schneider we all know that) therefore, their lungs are small. When RSV gets into the airway it causes swelling and increased production of mucus. In older children and adults, coughing may move this mucus up and out of the airway. In young infants, they are not able to produce enough force to remove the mucus and over time as the infection progresses this mucus may plug up some of the smaller airways (bronchioles, thus bronchiolitis) making it harder for the child to breath.

Call 9-1-1 for an ambulance if your child:

·         Stops breathing

·         Starts to turn blue or very pale

Or Call our office or the covering physician if your child:

·         Has a very hard time breathing

·         Starts grunting

·         Looks like he or she is getting tired of having to work so hard to breathe

·         The skin and muscles between your child’s ribs or below your child’s ribcage look like they are caving in

·         Your child’s nostrils flare (get bigger) when he or she takes a breath

·         Your infant younger than 3 months has a fever (temperature greater than 100.4ºF or 38ºC)

·         Your child older than 3 months has a fever (temperature greater than 100.4ºF or 38ºC) for more than 3 days

·         Your infant has fewer wet diapers than normal

Diagnosis of RSV is made by your physician and is usually a clinical diagnosis (made on the presenting symptoms, time of year and overall picture of the patient). However, in some cases a nasal swab may be used to diagnosis RSV in the office. Results can be obtained within 30 minutes. However, the swab is not a 100% accurate and may miss some true infections with RSV.

Is there anything I can do on my own to help my child feel better?.

You can:

·         Make sure your child gets enough fluids

·         Use a cool mist humidifier in your child's bedroom

·         Treat your child's fever with acetaminophen (Tylenol) or Ibuprofen (Advil or Motrin as long as over the age of 6 months). Never give aspirin to a child younger than 18 years old.

·         Suction the mucus from your child’s nose with a suction bulb if it is interfering with sucking or breathing.

·         Do not allow anyone to smoke near your child

If your child is older than 12 months:

·         Feed warm, clear liquids to soothe the throat and to help loosen mucus

·         Prop your child's head up on pillows or with the help of a car seat.

Is there any medicine that my child can get prescribed to treat or prevent RSV?  -- Yes and No

Occasionally, we will try a breathing treatment in the office to help patients with significant breathing difficulty. Not all children require these treatments and most children will have little to no benefit from the treatment.

There is a medicine called Synagis that has been shown when used preventatively  to decrease hospital admission and severity of symptoms in a select group of infants. If your child is under the age of 1 and was born significantly premature, has chronic lung disease or congenital heart disease he or she may qualify for this treatment. Please ask our office staff for further information if you think your child meets these criteria.

In general, treatment is time. Since RSV is a virus your child’s body will fight off the infection. Our role as caretakers is to support your child through this process and allow their bodies the best chance to succeed. 

Welcome

The Schneiders of BelliAcres Pediatrics

At BelliAcres Pediatrics, we have always been proud of our record of continuous, competent and personal care that we provide our patients.  We continue to offer unprecedented access to your pediatric provider for the individual care and development of relationships that promote the health of children.

In that tradition, we are proud to announce the arrival of our new pediatrician:

Zachary Richard Schneider, MD

 Dr Schneider earned his Bachelors of Science Degree from Hobart College and his Medical Degree from George Washington University.   He completed his pediatric residency at the Levine Children’s Hospital in Charlotte, North Carolina.  

Dr Schneider grew up in our community, in fact, just a few steps from our office.   It was there that he developed the interest and passion for pediatric primary care and looks forward to those relationships that make us unique in our practice of pediatrics.  He and his wife, Anne, also a local native of Severna Park, are excited about their return to our community.

Yes, as you may have already guessed, Dr Schneider is the son of Dr Donald Schneider.  While they look forward to re-uniting as a family, it is with even greater excitement that they anticipate their new professional relationship.  They hope to, both, provide many years of outstanding and compassionate care to the families of our community.

Please, welcome Dr Zach to BelliAcres Pediatrics.