Sniffles, snot and sneezes

Coughing, sneezing, wheezing and a runny nose – these are the common symptoms lumped under the generic term of ‘the flu’. However the difference between real ‘flu’ and a common cold is information that all parents should be familiar with.

Influenza

Influenza or ‘the flu’ is a serious and often debilitating illness which affects the whole body. Symptoms include fever, headaches, muscle aches and pains. In children, symptoms may also include nausea, vomiting and diarrhoea.

The majority of infections occur between July-September with the infection usually lasting for about five days. Fever and other symptoms usually disappear after that time but a cough and weakness may continue, with all symptoms usually gone within a week or two.

According to the Influenza Specialist Group (ISG), vaccination reduces the average person's chances of catching the flu by up to 80% during flu season. Vaccination isn't a guarantee against getting sick, but it generally reduces the severity of the symptoms and because flu strains vary from one year to the next vaccination is only good for the current year.

Influenza is highly contagious - the influenza virus can survive for an hour or more in the air in enclosed environments, such as child care centres and schools; for more than eight hours on hard surfaces such as stainless steel and plastic; and up to five minutes on hands after transfer from other surfaces.

Children are a major transmitter of the virus and are much more likely to contract influenza during any given season (20-50% of children compared with 10-30% in adults).

Healthy children under the age of five years are also more likely than adults to be hospitalised for influenza complications; mathematical modelling has shown that vaccinating children under five years could decrease the incidence of influenza in the total population by 22-38%.

Current immunisation guidelines recommend annual influenza vaccination for anyone who wishes to protect themselves including children aged six month and older.

Influenza cannot be treated by antibiotics, however antiviral medications available on prescription can limit the effects if taken early after the onset of symptoms (within two days).

The best treatment is bed rest, plenty of fluids and sleep, and paracetamol for pain relief. The flu often makes the patient cold one minute and hot the next so wearing layers of clothing makes it easy to add or subtract clothes as needed.

Call the doctor if your child:

• Has flu symptoms
• Has a high temperature
• Seems to get better, but then feels worse than before
• Has any trouble breathing, seems confused, or seems to be getting worse.

Common colds

Kids get as many as eight colds a year, causing a great deal of angst for the working parent as colds are the number one reason that children stay home from child care or school.

Despite what your mother may have told you, colds are not caused by going out without a jumper or with wet hair, or sitting on cold concrete! Most colds are caused by rhinoviruses that are in invisible droplets in the air we breathe, or the things we touch.

More than 100 different rhinoviruses can infiltrate the protective lining of the nose and throat, triggering an immune system reaction that can cause a sore throat and headache, followed by a runny or stuffy nose, and sneezing.

Kids with colds may also have a cough, mild fever, fatigue, muscle aches, and loss of appetite. Nasal discharge may change from watery to thick yellow or green.

Colds are most contagious during the first two to four days after symptoms appear, and may be contagious for up to three weeks. You can catch a cold from person-to-person contact or by breathing in virus particles spread through the air by sneezing or coughing. Touching the mouth or nose after touching skin or another surface contaminated with a rhinovirus can also spread a cold.

In the long run, keeping a child home from day care or school for a day or two is more responsible than sending them sick and contagious, which runs the risk of the infection becoming more severe, with your child taking many more days to recover.

Cold symptoms usually appear two or three days after exposure to a source of infection. Most clear up within a week, but some can last as long as a fortnight.

There is no vaccine to prevent colds and, according to The National Prescribing Service, the common cold needs common sense, not antibiotics, Make sure your child gets plenty of rest, and encourage them to drink as much as normal. Saline nose drops and steam vaporisers can help clear blocked noses, as well as good old-fashioned Vicks.

To prevent cold spreading to the rest of the family, encourage good hand washing habits in both adults and children – before and after eating, after using the toilet, after touching pets, and after blowing your nose, before handling food.

Anyone with a cold should cover their nose and mouth when coughing and sneezing; use tissues instead of hankies and avoid sharing towels or eating utensils. It also makes good sense to steer clear of anyone who has an obvious cold. If your child is under the age of two go to the doctor.

Call the doctor if your child has the following::

• coughing up a lot of mucus
• shortness of breath
• unusual lethargy/tiredness
• an inability to keep food or liquids down, or low fluid intake
• increasing headache or facial or throat pain
• severely painful sore throat that interferes with swallowing
• fever of 39.3 degrees or higher, or a fever of 38 degrees or higher that lasts for more than a day
• chest or stomach pain
• swollen glands in the neck
• earache
• is under the age of two

Publicity from the United States over the adverse affects of over-the-counter cough and cold medications found that they are open to misuse, error and accidental overdose. After review, Australia’s Therapeutic Goods Administration (TGA) issued the following advice to doctors, pharmacists and caregivers:

For babies and children under 2 years of age:

Do not give over-the-counter cough or cold medicines to children under 2 years of age.

For children 2 years of age and over:

• Always read and follow the instructions on the medicine label.
• Do not exceed the recommended dose, frequency of dosing or duration of use.
• Always use a medicine measuring spoon or medicine measure supplied with the product or obtained from a pharmacy to measure the dose. Do not use ordinary kitchen spoons as they are unsuitable for measuring medicines accurately and may lead to an unintended overdose.
• Do not give your child more than one medicine containing any of these ingredients at the same time unless your pharmacist or doctor has instructed you to do so.
• If you are unsure about the directions for use or have any difficulty in understanding the instructions on the medicine label seek advice from your pharmacist or doctor.

Source: Therapeutic Goods Administration

Symptoms Guide

To help determine whether your child's fighting the flu or combating a cold, review these guidelines:

Flu

• Onset of illness - Sudden
• Temperature - High fever
• Exhaustion Level - Severe
• Headache - pain
• Appetite - Decreased
• Muscles - ache
• Feel - chilled

Cold

• Onset of illness - slow
• Temperature - no (or mild) fever
• Exhaustion level - mild
• Headache - headache-free
• Appetite - normal
• Muscles - fine
• Feel - no chills

If most of your answers fell into the first category, chances are that your child has the flu. If your answers usually belonged in the second category, it's most likely a cold.

Source: adapted from Kids Health

Hand washing ... did you know?

Good hand washing is the best way to prevent infection and serious illness whether at home, day care or school. Kids don’t always listen when you tell them to wash their hands before eating, but it’s a message worth instilling so that it becomes a habit.

If your child is reluctant about hand washing try these tips:

• Use warm water and soap made in bright colours and shapes, or pump lotion bottles made especially for children
• Antibacterial soap is nice but unnecessary – any soap is fine.
• Lather up for about 10 to 15 seconds. Wash between the fingers, under nails and include wrists.
• Have your child sing a favourite song while lathering up.  Try this one (to the tune of row, row, row your boat).

     Wash, wash, wash, your hands
     Play our handy game
     Rub and scrub, scrub and rub
     Germs go down the drain HEY!

     Wash, wash, wash your hands
     Play our handy game
     Rub and scrub, scrub and rub
     Dirt goes down the drain HEY!

• By the time the tune is done, germs should be washed away.
• Rinse and dry well with a clean towel.

Hand washing is considered so important in the prevention of infection and disease that there is even a Global Hand Washing Day on October 15, 2009.

Resources

Influenza Specialist Group

National Prescribing Service

Kids Health

Therapeutic Goods Administration  

The information provided in this article is intended as a guide only. Always consult your doctor if you or your child is suffering any medical complaint. Any websites referred to by Australian Family contain information moderated by government and medical institutions or organisations.

This article was first published in Australian Family Magazine, May 2009. Updated July 2009.