Kansas City,
09:21 PM

Kansas City Star: What's a parent to do about this record-setting flu?

By Andy Marso

The country is in the grips of the worst outbreak of influenza since the 2009 swine flu pandemic.

Mary Anne Jackson is at the center of the Kansas City area’s medical response as chief of the pediatric infectious diseases section at Children’s Mercy.

“This is, what I have told pediatricians, a bad winter season that we’re having right now,” Jackson said. “We’ve had some record census days here in our hospital at Children’s Mercy and we’ve set some records in our urgent care in terms of number of children that have been seen.”

The Star sat down with Jackson for a question and answer session about what parents should know to protect their kids. It has been edited for length and clarity.

Question? Is this year’s flu considered an epidemic or a pandemic and what does that mean?

Answer: It is an epidemic, and epidemics of influenza occur every single year. It’s something we can count on. A pandemic means it’s a major change in the antigen, in the germ itself. So, for instance, 2009 was a pandemic with a brand new strain nobody had seen before. This is not a pandemic year, but it is an epidemic year.

Q: If I haven’t gotten my child vaccinated yet, should I?

A: It’s really important to continue to vaccinate, especially during this season. The reason for it is this: There is not just one strain of influenza that’s circulating, and in fact there’s not just one strain of influenza that is causing serious disease, including death, particularly in the pediatric population I deal with. So even in children who have influenza right now, who are sick with the flu, if they have not been immunized we are recommending that they be immunized because the worst thing that could happen is for them to get a second bout of influenza due to a second strain. And then certainly for people who are un-immunized, we are recommending influenza vaccine. Consider this: the projected vaccine effectiveness right now is about 35 percent. But 35 percent is pretty darn good. If I told you there was a 35 percent chance you’d win the lottery if you buy a ticket, you’d buy a ticket. I say buy a ticket and get your flu shot.

Q: Is the Influenza A strain the one that should be more worrying than others?

A: Certainly it’s true that in Influenza A H3N2 years, we tend to see more serious disease. This year reminds me a lot of our 2012 to 13 season in terms of the H3N2 predominance, the high peak of disease and the severity of disease. But having said that, Influenza B is a bad virus, not only in the adult population (it’s one that has been associated with heart attacks in adults), but also in the pediatric population. A third of pediatric deaths so far are related to Influenza B. Here’s the important thing about that: in terms of the vaccine’s effectiveness, it’s better for Influenza B than it is for this H3N2 strain.

Q: You mentioned pediatric deaths. How worried should parents be?

A: Since 2004, the CDC (Centers for Disease Control) has tracked pediatric influenza mortality, or childhood deaths due to influenza. On average there are 100 per year. At this point, and we’re still pretty early in the season, there have been 30 deaths and that hasn’t been updated by the CDC since Jan. 13. The vaccine will modify (lessen) disease, prevent hospitalization and prevent death in children. For those who are not immunized, antivirals treat influenza. So, I don’t want parents to think, “Oh, my child is going to die if they get the flu.” Most children do not.

Q: We want to take kids to the right care at the right time. So what are the symptoms people should worry about? When should they go to urgent care? When should they go to the ER?

A: I think the first thing you have to do is look at your child and whether or not there are underlying conditions or other issues where the child is at higher risk for complications from the flu. So, children under 2 are at higher risk for complications, and those with underlying conditions (like) heart disease, lung disease, metabolic diseases, cancer, transplant, all the immuno-compromising conditions. And one condition some parents may not think about, but pediatricians do, is children who have underlying neurologic diseases, particularly neuro-muscular diseases or diseases where they have difficulty swallowing. For those children, when they get influenza, they have a particularly difficult time.

Secondly, what should you look for? In most infections fever is a good indicator. So we say, in general, fever over 101 (degrees) is worth noting. And then looking at other symptoms. It’s usually respiratory symptoms we’re talking about and the ability to eat, drink, sleep and play. If your child has no fever but they’re unable to drink, they’re not having wet diapers or they have labored breathing, they need to be seen. For children with high fever, who are continuing to be able to eat, drink and play at intervals, if it’s an older child, you can check in with your pediatrician’s office and ask them if this child should be seen. Certainly you want to access an urgent care where you know they have pediatric expertise. I think that’s really important. For a child who’s listless or has labored breathing, or certainly if they have any changes in their coloring, if they have gray or bluish tints, those children shouldn’t go to urgent care. They should be seen in an emergency room.”


Read the full article and see the video via the Kansas City Star.

Learn more about services provided through the Division of Infectious Diseases at Children's Mercy.