With an escalating number of flu cases in the region, a local pediatrician is advising that there is a sweet spot for when to bring your child into the clinic after exhibiting common symptoms.
“You can actually bring them in too early, sometimes real early in the course; the test will not be positive,” Dr. William Barron, a longtime pediatrician at Dothan Pediatric Clinic, said. “If you come in just when there is coughing and nothing else, the likelihood that the flu test will come in positive is lower.”
On the other hand however, if a patient waits longer than 48 hours after exhibiting symptoms, the medicine used to treat the flu — Tamiflu — may not be as effective.
“If they have these symptoms and they have fever, and they’ve had it for at least 24 hours, then I think it’s probably worth being seen,” Barron said.
Although the window is brief, coming in at 24 to 48 hours is the best way to receive an accurate diagnosis and effective treatment.
Barron’s advice is timely considering southeastern healthcare providers are beginning to deal with a quickly escalating number of influenza cases.
According to a weekly report from the Alabama Department of Public Health, 6.1% of total outpatient visits in the southeastern district from Oct. 20 to Nov. 9 have been due to flu-like illness, a significantly higher percentage reported by other districts in the state.
In that time frame, three strains were identified in Alabama patients — influenza A/H3, influenza A/H1N1, and influenza B/Victoria.
Count of cases
From Nov. 1 to late Tuesday, the Dothan Pediatric Clinic has tested 350 positive flu cases, with 200 other cases confirmed in affiliate pediatric offices in Ozark, Enterprise, and Eufaula.
Barron, who has been a pediatrician for 36 years, said the Influenza B/Victoria strain has been prevalent so far this flu season, consistent with national reports from the Center for Disease Control.
“The last couple of weeks have really been lots of flu,” Barron said. “You never really know when it’s going to hit. In Dothan, we’ve probably been in it two or three weeks now, at least… some places like Enterprise have been in it longer than that.”
Though there are many different sub-types of the type B strain that differ in severity, patients Barron has diagnosed have not exhibited severe symptoms, he said.
“This year, I think the children don’t seem to be as sick, as a rule, as they are some years, so I don’t think this is going to be a really bad one,” Barron said, although it is still early in the season.
Prevalence of flu cases typically peak around January or February before quickly dissipating.
In children that have tested positive for influenza, the first noticeable symptom of flu is usually coughing, but high fever, aches, and sore throat can also exhibit first.
“They don’t seem to be as achy this year, and it seems like a lot of them don’t have quite as much fever,” he said.
Patients who are infected with the flu virus are typically the most contagious at the beginning of the course. Barron said the recommendation is to not return to school until 24 hours of being fever-free.
The most at-risk for complications related to the illness are children with underlying conditions like asthma, heart conditions, and diabetes — which can be worsened or become fatal — and babies.
So far, a total of three influenza-associated deaths have occurred in the United States, though none were in Alabama. The most recent death was associated with the type B/Victoria strain of the virus that occurred in the week ending on Nov. 2, according to data from the CDC.
Key to prevention
The best prevention method advised by Barron, along with the ADPH and CDC, is to get the vaccine, which can prevent contracting the virus or the risk of hospitalization.
Last year, the vaccine was 29% effective for all ages and 49% effective for children ages 6 months to 8 years old.
“It does seem like those who got the flu in spite of having the flu shot had an easier time with it; it was not as severe,” Barron said. “It usually does keep it from getting as bad as it could have been had you received nothing.”
He said the optimal time to get a flu shot is as early as you can, but it is never too late.
Barron also dispelled the myth that getting a flu shot will give patients the flu — something he says is not possible.
Other prevalent illnesses making the rounds are strep, which is characterized by fever and sore throat, and another unidentified flu-like virus, Barron said.
The key to preventing the flu and other infectious diseases is washing your hands regularly, keeping your hands away from your eyes, nose and mouth, and the “vampire cough” — coughing into the inner corner of one’s arm.