"H1N1" is coming, parents should know these

This is the 4721st article of Da Yi Xiao Hu

1. What is influenza A?

Influenza A, the full name of which is influenza A, is an acute respiratory disease caused by influenza A virus (or influenza A virus). Unlike the common cold, it is highly contagious and has seasonal epidemics. It is more common in winter and spring, and people with poor resistance, such as children, the elderly, or "fragile" young and middle-aged people are generally susceptible.

2. What symptoms are highly suspicious of influenza A?

The fever caused by influenza A is generally high, which can reach 39℃ or even 40℃, and may be accompanied by chills and shivering, and is often accompanied by systemic symptoms such as headache, muscle aches, fatigue, loss of appetite, cough, sore throat, runny or stuffy nose, nausea, vomiting, diarrhea, etc.

Some parents bring their children to the hospital for treatment. The test shows that the influenza A antigen is negative, which cannot completely rule out influenza A. The test result is related to the low viral load in the nasopharynx at the early stage of the disease, or the fact that the sampler did not collect saliva containing the virus during the test. However, if the high fever persists, and there is no significant improvement after taking antipyretics, or there is a history of contact with a confirmed influenza A patient, it is recommended to visit the hospital for re-testing.

3. How to use medicine for influenza A?

The first choice of effective drug is oseltamivir, which currently has two dosage forms on the market: granules or capsules. Children weighing less than 40 kg generally choose granules, which are easy to take and can be taken with boiled water. In addition, for older children weighing more than 40 kg who can swallow capsules, capsules can be chosen.

Specific method of use

Weight ≤ 15 kg: 30 mg each time;

＞15-23 kg: 45 mg each time;

＞23-40 kg: 60 mg each time;

＞40 kg, 75 mg each time, twice a day, for 5 days.

If my fever has subsided after taking oseltamivir for one or two days, do I need to continue taking it?

It is recommended to take it for 5 days, because the mechanism of action of oseltamivir is to inhibit the release of influenza A virus in the body. If the drug is stopped immediately after the fever subsides, the influenza A virus may resurface.

Do I need to take another dose of oseltamivir after vomiting?

Generally, if vomiting or diarrhea occurs during the first use, you can choose to take it with food or after meals to reduce gastrointestinal irritation. Whether to take it again depends on two points:

① Dosage form;

②Time

Capsules: If you spit out the capsule shell, you need to take it again, otherwise you don’t need to take it

Granules: Vomited right after taking, need to take more

If you vomit within 15-30 minutes, take half the dose

＞30 minutes, no need to take a supplement

4.Can children take Sufuda?

In the past two years, a new type of anti-influenza drug, Mabasaclovir (trade name: Sufuda), has been introduced into China. Compared with oseltamivir, Sufuda has been favored by some parents because it is taken less frequently (only a single dose is needed) and for fewer days (only one day). However, it also depends on the age of the child. It was previously recommended for children over 12 years old, but the latest instructions have relaxed the recommendation to children over 5 years old.

It should be noted that Sufoda may have greater side effects than oseltamivir, and has greater liver and kidney toxicity, so parents are advised to fully communicate with their doctors and choose the drug as appropriate based on their child's physical condition and medical history.

5. Does a high fever caused by influenza A require intravenous drip to be cured?

Important things must be said twice: influenza A does not require intravenous drip! Influenza A does not require intravenous drip! In the minds of some parents, especially some elderly people, if a child has a high fever, they must be given intravenous drip or antipyretic injections to get better. Perhaps doctors in their era did deal with it in this way. But with the advancement of medical care, some concepts should be changed! For children, oral administration instead of intramuscular injection is better, intramuscular injection instead of fluid replacement is better, and oral administration can solve the problem without injection! In clinical practice, we have also encountered parents with very tough attitudes. Even intravenous drips cannot lower the body temperature, and they "keep silent after being hung up." The key is to find the cause of the fever. Only by treating the cause will it be effective quickly. Please follow the doctor's advice on whether intravenous drips are needed.

6.Why can’t I go to school if I have influenza A?

Some parents don't understand why children with influenza A cannot go to school. Isn't it just a cold? It is not a common cold. At present, influenza A is a Class C infectious disease stipulated by the state (managed as Class B). Once diagnosed, you need to cooperate with the doctor to fill out the "Communicable Disease Reporting Card of the People's Republic of China", which requires the guardian's name, home address, telephone number, school and other detailed information to be registered and reported to the local CDC. So for the health of yourself and other children, don't go to school for the time being, and have a good rest at home for a few days!

What should we pay attention to during home quarantine?

The diet should be light and easy to digest, and sufficient protein, vitamins and other nutrients should be supplemented to promote the body's recovery; the tableware used during the illness should also be avoided from being mixed with others, and the tableware of the sick child should be boiled and disinfected in time. For families with many children or the elderly living together, wash hands frequently, open windows for ventilation regularly, keep the indoor air fresh, and avoid excessive reproduction of indoor viruses. In addition, it is not recommended that other family members living together take oral anti-influenza drugs in advance for prevention, and we still rely on our own resistance!

7. How long will it take before I can go to school?

Generally speaking, most children with influenza will feel better in about 3-7 days. After they have no fever or other symptoms, they can go to a hospital or medical institution near their home to have their nasal or throat swab tested for influenza A antigen. If the result is negative, they can return to school and resume their studies.

8. How to prevent influenza A?

Children should eat a healthy and balanced diet, not be picky about food, drink plenty of water, wash hands frequently, and pay attention to hygiene. They should open windows at home more often to allow fresh air to circulate. They should also strengthen physical exercise on a daily basis to increase their ability to resist disease.

In addition, influenza A is not a lifelong immune disease that will prevent reinfection once infected. The influenza virus mutates every year and different subtypes become prevalent, so arranging for children to receive influenza vaccinations before the flu season is also a good preventive measure.

I hope all the children can smoothly get through the peak of the flu season and grow up healthy and happy!

Author : Lv Jiajia, attending physician, Department of Pediatrics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine. Research direction: Diagnosis and treatment of respiratory and digestive system diseases in children using traditional Chinese and Western medicine.

Article reviewer and column editor : Shen Jian, director of the Department of Pediatrics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, academic leader, chief physician, doctor of medicine, master's supervisor. National TCM inheritance and innovation "hundreds of thousands" talents of the Central Administration. Vice President of the Child Development and Behavioral Science Committee of the World Federation of Chinese Medicine Societies, Vice President of the Prescription and Drug Efficacy Research Branch of the Chinese Society of Ethnic Medicine, and Standing Committee Member of the Pediatric Professional Committee of the Shanghai Society of Integrated Traditional Chinese and Western Medicine.