The Flu and You

by Michelle Place, CRNP-P
Flu season is reaching it’s peak in nearly 45 states this month and it has hit our community like a mack truck. The CDC is reporting 14,000 new cases of flu diagnosed each week. Schools and daycare centers are empty and our waiting room is full. With all of the mucus flying around, how can you tell if your child has the flu or just one of the million or so cold and flu-like viruses that are going around?
The biggest difference is the speed at which the symptoms present. Colds, even really yucky ones, start out gradually. Think back to your last cold…first you may have noticed a little tickle in your throat which eventually started feeling scratchy or sore.The next day you were filled with nasal congestion. After another day or two this stuffiness started to run, profusely. Next the cough kicked in. A fever may have raged for a few days. You may have sounded hoarse or lost your voice.
The same thing happens to your kids. In addition, they often feel tired because of interrupted sleep from cough or nasal congestion. This tiredness leads to extra crankiness. Usually kids feel well enough to play or attend school despite their cold symptoms. The average length of a cold is 7-10 days although it can take 2 weeks or more for all coughing and nasal congestion to resolve.
Important public service announcement about mucus: the mucus from a cold can be thick, thin, clear, yellow, green or white and can change from one to the other, all during the same illness. The color of the mucus does NOT tell you if your child needs an antibiotic and does not help differentiate between a cold and the flu.
By contrast, when you have the flu, honest to goodness influenza, you feel like you have been hit by a train. Symptoms of the flu are similar to the common cold but they last longer and tend to be worse. Seasonal Influenza is characterized by a sudden onset of fever of 101 or higher (it typically runs 102-103), cough (usually dry), headache, muscle and joint pain, severe malaise (feeling unwell), sore throat, lots of nasal congestion and often the sensation that your eyes are burning. Fever with flu can last 5-7 days. The cough can be severe and last 2 or more weeks. Most people recover from fever and other symptoms within a week without requiring medical attention.
Children, more often than adults, will occasionally vomit and have diarrhea along with their respiratory symptoms but, contrary to popular belief, there is no such thing as the stomach “flu.” Influenza is a viral infection that attacks your respiratory system – your nose, throat and lungs. It is not the same as stomach viruses that cause diarrhea and vomiting.
There are three different influenza virus families: A, B and C. Influenza types A and B are the most severe of the flu viruses. The viruses change constantly and different strains circulate around the world every year. The body’s natural defenses cannot keep up with these changes. Type C causes either a very mild illness, or has no symptoms at all. It does not cause epidemics and does not have the severe public health impact that influenza types A and B do.
An infected person can spread influenza virus in discharges from their nose and throat starting 24 hours before the onset of their illness until 3-5 days after symptoms begin. Young children and people with a weakened immune system can spread the virus for 7 days or longer. In general, once your child has been fever-free for 24 hours without the help of tylenol or motrin, they can return to school or daycare.
In summary, cold symptoms happen over time but with the flu all the symptoms come at once. There is nothing gradual about coming down with the flu, one minute you feel fine then suddenly you do not. So, if your child has a runny nose and cough, but is drinking well, playing well, sleeping well, does not have a fever and the symptoms have been around for a few days, the illness is unlikely to “turn into the flu.”