Children's Emergency Department Experiencing Rise In Suspected Flu Cases

Over the past two weeks, Cape Fear Valley has seen a significant increase in the number of children presenting with flu symptoms at the Children’s Emergency Department.

The number of children with the chief complaint of fever was more than doubled from 106 Aug. 16-21 to 239 from Sept. 6-10. In addition, children whose chief complaint was respiratory symptoms jumped from 30 Aug. 16-21 to 127 Sept. 6-10, a four-fold increase.

“We feel it is associated with children going back to school,” said John Backus, Service Line Director for the Emergency Department.

What should a parent do if their child has a fever or respiratory symptoms and they think it might be 2009 H1N1, sometimes called “swine flu?”

R. David Smith, M.D., Medical Director of the Children’s Emergency Department, says most children should stay home. There is no need to go to the Emergency Department unless the child is having serious trouble breathing or shows signs of dehydration from repeated vomiting.

“The key here is whether the child is having respiratory difficulties. If the child just has a fever, cough or respiratory symptoms, he should stay home,” said Dr. Smith. “Bringing the child to the emergency department could expose other children to the flu.If the child turns out not to have flu, he or she may catch it from other children sitting in the waiting room.”

“Children who have underlying risk factors, such as severe asthma, cystic fibrosis or congenital heart disease, are at a much higher risk for complications from the flu. Those children should see a physician, and the best thing for them is to see their regular doctor.”

“A child with asthma who is on several medications to control his or her asthma would fall under this category. Likewise, a child who has had multiple hospitalizations for asthma or who has been undergoing chemotherapy would be high risk. Those are the ones I’d be concerned about.” 

For children, emergency warning signs that warrant a visit to the Children’s Emergency Department include:

• Fast breathing or difficulty breathing
• Bluish or gray skin color
• Dehydration: in babies or young children refusing fluids and a decrease in the number of wet diapers
• Severe or persistent vomiting
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Flu-like symptoms that improve but then return with fever and worse cough

Dr. Smith says that at present, physicians are reserving antiviral drugs for children with severe disease, for example hospitalized children, or those who have the potential for complications.

The symptoms of 2009 H1N1 flu virus include:

• Fever
• Cough
• Sore throat
• Runny or stuffy nose
• Body aches
• Headache
• Chills
• Fatigue.

A significant number of people who have been infected with this virus also have reported diarrhea and vomiting.

The Centers For Disease Control and Prevention (CDC) recommends children who are sick with flu-like illness stay home for at least 24 hours after the fever is gone except to get medical care. The child’s fever should be gone without the use of fever-reducing medicine, such as acetaminophen or ibuprofen.

To protect other persons in the home, it is best to keep the sick person in a room separate from the common areas of the home. If possible, the sick child should use a separate bathroom. This bathroom should be cleaned daily with household disinfectant.

If possible, have only one adult in the home take care of the sick person. People at increase risk of severe illness from flu should not be the designated caregiver, if at all possible.

For more information about 2009 H1N1, go to www.cdc.gov.