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Fight the Flu

Fight the Flu

Daily Dose

Cold & Flu Season

1:30 to read

Despite the fact that the weather is beautiful in most parts of the country, it is Fall which means more viral upper respiratory infections. This is especially true of the 12-15 month old children who are now getting their “first of many” colds.  Many of their parents are concerned as to why they are suddenly getting sick…as they have not been sick before?

 

Well, here is the deal. Last fall and winter these children were babies in arms, and were not crawling and walking which also means they were not exploring their environment and all of the germs that go with touching EVERYTHING!  During that first winter season (if a child is not not  in day care or school) and does not have siblings (to get them sick) they may luck out for the first 2 - 12 months without a runny nose or cough. 

 

But….those days come to an end once they become toddlers. This is not alarming at all, but just a fact of life.  Toddlers will catch a little bit of everything once they hit one. That means they may have a cold, cough or even a fever every month…for the next fall/winter/early spring months, (which is about the next 5-6 months).  As a parent of a new toddler this is really difficult to fathom!

 

Every parent wants to know how they can “avoid” these illnesses….short answer is it is impossible and you should actually look at each viral illness as a victory which primes the immune system, and helps develop antibodies to some of the viruses we are all exposed to every day.  With each viral illness your child’s immune system is actually getting stronger…and you will notice that around the age of three your child will not catch as many colds and coughs as they did when they were younger. I know that seems like such a long time!! Unfortunately, parents of toddlers also catch a few more illnesses as they too are “over exposed” by their child. 

 

Remember to always watch your child for any difficulty breathing by looking at their chest with their shirts off - you do not want to see them look like they are “working with their ribs to breathe”. You also need to make sure they are well oxygenated and should turn red with cough and never a dusky blue color…especially important in young infants. Any concerns call your doctor.

 

So…gear up for winter as peak upper respiratory season is not even here yet!!  Get those flu vaccines too. 

Daily Dose

Do Essential Oils Boost Immune System?

1:30 to read

Although it is still hot and officially summer, soon everyone will be heading back to school  and coughs and colds (and eventually flu, another topic) will be just around the corner. I had a patient ask me about the use of essential oils. Her 2 1/2 year old daughter is heading to preschool for the first time and she “had heard from her friends that essential oils help a child’s immunity during cold season”.

Unfortunately, there is very little data at all to confirm that statement. I only wish that rubbing a bit of lavender oil on would help prevent the common cold. While it may smell great and be relaxing....there is no data that I can find to show that there is any reproducible science to the claims that essential oils boost the immune system.  

While I was researching I found many sites stating that “eucalyptus oil is an anti-viral” and “peppermint oil is an anti-pyretic (fever reducer)”.  Tea tree oil is touted as being “both anti -bacterial and anti-fungal” (I don’t know of other drugs that can claim both!).  But, I just don’t see any data to support all of this. 

The word essential refers to the essence of the plant the oil is derived from, rather than being “essential” to your health. While in most cases essential oils (which are highly concentrated) used as aromatherapy are not harmful for adults, it may be a different story in children, especially those under the age of 6. While labels may say  “natural” it may not always mean safe.  Many oils are poisonous if ingested and there have been reports of accidental overdoses in children with several different oils. In one report tea tree oil and lavender oil applied topically have been shown to cause breast enlargement in boys.  Oil of eucalyptus and peppermint are high in menthol and cineole.  These substances may cause children to become drowsy have decreased respirations.  While there are articles stating that the use of menthol (Vicks) on a child’s feet may be helpful during a cold for reducing a cough, do not use this if child is young enough to put their feet in their mouths. 

I must say that I sometime use a few drops of eucalyptus oil in the shower when I have a cold as I think it smells great and seems to help “open up” my head. Whether this is in “my mind” or a response from my olfactory centers which sends calming messages to respiratory center is not clear. But, I am not ingesting it or using it topically. 

 

Daily Dose

Get Your Flu Shot!

1:30 to read

I just had my flu vaccine!  Guess what - my arm didn’t even hurt this year.  I have also been reminding all of the pregnant mothers that I see to get their flu vaccines as well.  The current recommendation is that pregnant women receive influenza vaccine as soon as possible beginning after their 28th week of pregnancy (3rd trimester). 

When a pregnant woman receives her flu vaccine she is not only protecting herself, but also her baby.  Infants cannot receive a flu vaccine until they are 6 months of age…and for babies born during the fall and winter season, that means they will not be vaccinated until the following year. But when a mother has received a flu vaccine the infant is also getting protection via antibody that the mother passes to her baby across the placenta. 

In a 2014 study, the authors reported that “immunization of pregnant women with trivalent inactivated influenza vaccine (IIV3) was safe, immunogenic, and partially protected the women with a vaccine efficacy of 50% and their infants with a vaccine efficacy of 49% against laboratory-confirmed influenza illness during a 6-month follow-up post delivery ”. In other words, the infants in the study had just as much protection as the mother.

In a more recent study the authors now looked at how long the immunity lasted in the infants born to the flu vaccinated mothers. Surprisingly, the immunity was not as long lived as had been thought. The infants involved in the study were born an average of 81 days after their mothers were vaccinated with flu vaccine, and were monitored for influenza infection for about 172 days after birth.

Infants born to mothers who had a longer interval between vaccination and delivery had higher antibody titers. The infants’ antibody levels did drop off after birth and by 8 weeks of age the babies did not have significant antibody. Ideally, In order for babies to have better protection a mother would be vaccinated even earlier in her pregnancy, and studies are being done to look at this possibility.

Infants are especially susceptible to influenza and have a higher rate of complications as well as hospitalizations.  While the current recommendations for vaccinating pregnant women may not confer as much immunity to the newborn as was previously thought , there is very high protection for the first 8 weeks after birth. Any protection is preferable to none!.

Get your flu vaccine and if you are pregnant ask your doctor to give it to you as soon as you are in your 28th week.  The longer the baby is getting placental antibody the better!!

 

 

 

 

 

Daily Dose

Flu is Here!

1.15 to read

Somehow I knew that flu would finally arrive! I kept telling my patients that during my 27 years of practice, I could not remember having a year go by that there was not some sort of flu season.  I thought maybe this was going to be the year, but as you know with many things in life, “never say never.” Guess what, flu season seems to have arrived in the U.S., albeit quietly. 

The CDC is reporting that for the last 2 weeks flu activity in the country has picked up and that about 15% of tests at different surveillance sites around the country are positive for influenza. So....don’t you feel good that you have gotten your flu vaccine? 

Despite it being a relatively “quiet” flu season, the good news is that the influenza strains that are being reported are “in” this year’s flu vaccine (in other words it is a good match).  It also appears that the flu strains are not resistant to the antiviral drugs that are typically used, which is a concern during each year’s flu season. 

The flu is typically heralded by fever, body aches  cough, sore throat, fatigue and just feeling terribly for anywhere from 3-10 days. Some years the fever seemed to last for a week, but the few cases I have seen this year the fever is only lasting 2-4 days. That is a good thing as well. 

Fortunately, there have only been 3 pediatric deaths reported for the 2011-2012 flu season. I can only hope that this will continue to be the trend as in several recent years there were over 200 deaths in the pediatric population due to flu. 

So, is it too late to get a flu vaccine? The answer is a very loud NO!  No one can predict how long the flu season will last and whether there will continue to be an increase in flu activity across the country. If you don’t want flu to interfere with March spring breaks, or Easter in early April I would suggest getting vaccinated now. It takes a couple of weeks for the vaccine to work as well, so you need to get it sooner than later to be protected. 

Don’t assume that just because the season is quiet that you can dodge the flu. Remember about airborne illnesses and how easily a cough can spread the flu. 

I am still immunizing my 6 month old patients in hopes of providing them protection this season too.  There is plenty of vaccine available this year so rather than let it “go to waste” as some does every year, let’s take advantage of the late flu season and get vaccinated now!   

I hope you'll join us tomorrow, 2/21 for #KidsDrChat on twitter 9-10:00 p.m. ET!

Daily Dose

Pregnant? Get Your Flu Shot

1.45 to read

If you are pregnant, know someone that is pregnant, or are even thinking about becoming pregnant, you need a flu vaccine!!  (That is not to say that we all need to be thinking about flu vaccine’s right now!)

A study out of Duke University showed that of 1,600 women who delivered during the 2009-2010 flu season, those that had received a dose of flu vaccine delivered more term babies and also delivered babies who had higher birth weights. Women who received at least one flu vaccine during the season were also less likely to require a doctor’s visit for flu prior to delivery and they had lower hospitalization rates.

Another study out of Wake Forest University which was recently published in the Journal of Obstetrics and Gynecology looked at women who had received flu vaccine during their pregnancy.  This study showed that infants born to mothers who received flu vaccine while pregnant were 50% less likely to be hospitalized with flu than infants born to mothers who had not received flu vaccine. This was a study conducted over the years 2002-2009 (before H1N1) Impressive!

Flu vaccine is recommended for everyone 6 months of age and older. Infants 6 months of age and younger have the highest rate of hospitalization for flu related illness among all children.  The only reason that flu vaccine it is not given to younger infants is that the vaccine is not effective. How do we protect those babies, by protecting the mothers who are carrying the child? 

So…bottom line, pregnant women who get their flu vaccines not only protect themselves, they are protecting their newborn infants as well. A mother’s job of protecting her children is life long, but it begins even with a baby in utero. Go get that vaccine, as flu season is upon us!  

That’s your daily dose for today.  We’ll chat again tomorrow.

Daily Dose

Flu Vaccine

1:30 to read

Even though the temperatures are topping out in the high 90’s around many parts of the country, it is still the time of year that pediatric offices are just receiving their flu vaccines for the 2017-2018 season.  Our office received our first shipments about 10 days ago and we have already started immunizing. This includes “my” precious 6 month old babies - all the way through to my college patients. 

 

There are 2 questions on parents and their kids minds:

 

#1 Is it too early to get a flu vaccine?

#2 Is there “flu-mist” available this year? 

 

I bet you can guess who is asking question #1 and who wants to know about question #2.

 

So here you go:

 

#1  It is NOT too early to start getting your flu vaccine. Once you receive the vaccine it takes several weeks to develop antibody levels and these antibodies have been shown to last throughout the flu season. Flu season is also temperamental….in that it sometimes decides to arrive sooner than is typical- which means you want to be prepared in case of an early influenza season. So, if you are in your pediatrician’s office, go ahead and opt in for the vaccine…and then you save yourself a trip back later in flu season…and in many cases another co-payment!

 

#2  Sorry kids and parents (and doctors too), there is not going to be a nasal mist influenza vaccine again this year.  The studies of the live attenuated influenza vaccine (FluMist) from the 2015-2016 flu season found that FluMist was only 5% effective in children ages 2-17, compared with 60% effectiveness for the inactivated (shot) flu vaccine.  While no one wants tears - pediatricians do want to give a vaccine that has been found to work - which means a shot.

 

Just to clarify…as parents often ask…”if the flu vaccine is not always 92-99% effective like our routine childhood vaccines, why should we get a shot?”.  My short answer, “would you buy a lottery ticket if you had a 60% chance of winning, rather than .000000001% chance?”. If you don’t get a flu vaccine it is guaranteed that you didn’t get any flu protection…I would rather go with the odds of it working (and winning the lottery which I would buy a ticket for with better odds).  We also have data that shows that those children who received flu vaccine had less chance of complications and hospitalization than those who were not vaccinated. 

 

Start scheduling your family's flu vaccine today.

 

 

 

 

 

 

 

 

  

Daily Dose

Thimerosal In Flu Vaccines

Confusion about thimerosal in flu vaccinesI received an email from a reader who “had a problem with my statement about vaccines being thimerosal free”.  Since 2001 all vaccines given to children under the age of 6 are thimerosal free, with the exception of the influenza vaccine.

She is correct in pointing out that influenza vaccines may contain a minimal amount of thimerosal (a mercury based preservative), but influenza vaccines are also available thimerasol free.  The LAIV (live nasal vaccine/flumist), is also thimerasol free and is available for use in children 2 and older.

Although injectable influenza vaccines may contain a minimal amount of thimerosal, the amount is negligible and is deemed safe by both the FDA and the CDC. Infants are not receiving a series of vaccines containing thimerasol, and at most would receive 2 influenza vaccines after they are 6 months of age during the first season that they are vaccinated, and subsequently would receive one dose per year thereafter.  There are also thimerasol free influenza vaccines available (this year both seasonal and “swine flu” vaccines) for use. By the time a child is 2 years of age, they would at most have received 3 doses of an influenza vaccine that had  0.01% thimerasol or less which would be between <1 mcg – 25 mcg/0.5ml vaccine dose. (Do you know how much mercury is in the fish you eat or other products you consume daily?)  After the age of 2 parents may choose to have their child immunized for influenza with the LAIV nasal vaccine that is also thimerasol free. As with many things in life one must weigh the risk benefit ratio, in this case of giving a vaccine that contains minimal thimerasol. In my opinion the science has quite eloquently proven that there is not a link between the preservative thimerasol and autism. With that being said,  I also believe that the risk of an infant developing flu and having complications from their infection, far outweighs any hypothetical or anecdotal concern about thimerasol. As I have said before, we know what does not cause autism and it was not thimerasol in vaccines. In fact the rate of diagnosis of autism has gone up, rather than down, since thimerasol was removed from vaccines. We need to continue to devote research dollars to finding the cause of autism. In the meantime, I stand corrected and wanted to give all of you more detailed information about thimerasol and influenza vaccines. That's your daily dose.  We'll chat again tomorrow! Send your question to Dr. Sue! (click here)

Daily Dose

Do Essential Oils Boost Immune System?

1.30 to read

Although it is still hot and officially summer, soon everyone will be heading back to school  and coughs and colds (and eventually flu, another topic) will be just around the corner. I had a patient ask me about the use of essential oils. Her 2 1/2 year old daughter is heading to preschool for the first time and she “had heard from her friends that essential oils help a child’s immunity during cold season”.

Unfortunately, there is very little data at all to confirm that statement. I only wish that rubbing a bit of lavender oil on would help prevent the common cold. While it may smell great and be relaxing....there is no data that I can find to show that there is any reproducible science to the claims that essential oils boost the immune system.  

While I was researching I found many sites stating that “eucalyptus oil is an anti-viral” and “peppermint oil is an anti-pyretic (fever reducer)”.  Tea tree oil is touted as being “both anti -bacterial and anti-fungal” (I don’t know of other drugs that can claim both!).  But, I just don’t see any data to support all of this. 

The word essential refers to the essence of the plant the oil is derived from, rather than being “essential” to your health. While in most cases essential oils (which are highly concentrated) used as aromatherapy are not harmful for adults, it may be a different story in children, especially those under the age of 6. While labels may say  “natural” it may not always mean safe.  Many oils are poisonous if ingested and there have been reports of accidental overdoses in children with several different oils. In one report tea tree oil and lavender oil applied topically have been shown to cause breast enlargement in boys.  Oil of eucalyptus and peppermint are high in menthol and cineole.  These substances may cause children to become drowsy have decreased respirations.  While there are articles stating that the use of menthol (Vicks) on a child’s feet may be helpful during a cold for reducing a cough, do not use this if child is young enough to put their feet in their mouths. 

I must say that I sometime use a few drops of eucalyptus oil in the shower when I have a cold as I think it smells great and seems to help “open up” my head. Whether this is in “my mind” or a response from my olfactory centers which sends calming messages to respiratory center is not clear. But, I am not ingesting it or using it topically. 

 

 

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