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WHAT IS THE FLU? The flu is an illness caused by influenza viruses. The flu season generally peaks between late December and early March. Epidemics of flu are caused by influenza type A and type B. Epidemics of the flu usually last 4 to 8 weeks in a community. HOW DOES A PERSON GET THE FLU? The flu is spread from person to person by direct contact, through the air and by articles recently contaminated with secretions from the nose and throat of an infected person. People with the flu are contagious from the 24 hours before they become sick, and until their symptoms begin to resolve. The incubation period (time from exposure until symptoms of the illness begin) is 1 to 3 days. WHAT ARE THE SYMPTOMS OF THE FLU? Typical flu illness is characterized by sudden onset of fever, often associated with chills, muscle aches, sore throat and a dry cough. In some cases complications such as bronchitis and pneumonia may occur. Some people are at risk for developing serious complications that may require hospitalization. WHAT CAN BE DONE TO AVOID THE FLU? Getting the flu shot each year before the flu season begins is currently the most effective way to reduce the impact and the incidence of the flu. A percentage of people who receive the flu shot may still develop the flu, however, the illness may be milder and they may be protected from developing pneumonia and other complications. WHO SHOULD GET THE FLU SHOT? Yearly flu shots are recommended for children six months of age and older with one or more of the following risk factors: 1. Children with asthma and other chronic pulmonary diseases 2. Children with significant heart disease 3. Children with sickle cell anemia and other hemoglobinopathies 4. Children receiving immunosuppressive drugs (ie-children being treated for cancer or who are receiving prolonged courses of steroids) 5. Children with HIV infection 6. Children with diabetes and other chronic metabolic diseases 7. Children with chronic renal diseases 8. Children on long-term aspirin therapy 9. Close contacts of high-risk patients. Immunization of persons who are in close contact with high- risk children may be an important means of protection for these children, especially for infants younger than 6 months of age for whom the flu vaccine is not recommended. Household contacts, including siblings and primary caretakers of high-risk children, should be immunized. At a parent's request the flu vaccine is also available for children who are not in a high-risk group. (If there is an unusually high demand for the flu vaccine, we may need to reserve it for children in high-risk groups.) WHAT SHOULD I KNOW ABOUT THE FLU VACCINE? Current influenza vaccines are produced in chicken embryos. The vaccine contains different subtypes of the influenza virus. Periodically the composition of the vaccine is changed as the prevalence of different strains of the influenza virus changes from year to year. Influenza vaccine should be given in the fall before the start of the flu season which is usually December or later (in some years the flu has hit earlier). Yearly immunization is recommended to boost the child's immunity and because the composition of the vaccine is usually changed from year to year. DOSAGE, REACTIONS AND ADVERSE EFFECTS In children ages 6 months through 8 years who are receiving flu vaccine for the first time, two doses are given 1 month apart. Thereafter these children require only 1 shot a year. Children ages 9 years and above require only 1 shot a year (both the first year it is given and in subsequent years). Fever and local reactions (redness, swelling and tenderness at the injection site) may occur but are infrequent. Unlike the 1976-77 swine flu vaccine, subsequent vaccines prepared from different strains of the influenza virus have not been clearly associated with an increased risk of Guillain-Barre Syndrome (GBS). Even if GBS were a true side effect, the very low risk of GBS is less than that of severe influenza that could be prevented by immunization. In addition, GBS has not been associated with influenza immunization in children. WHO SHOULD NOT RECEIVE INFLUENZA VACCINE? Children who have severe, life-threatening allergies to eggs or chicken can, on rare occasions, have a similar type reaction to influenza vaccine. Generally such children should not receive influenza vaccine due to the risks of reactions and the likely need for yearly vaccination. If your child is at high risk for severe influenza and also has a severe egg allergy, we can discuss this further with you. VINELAND PEDIATRICS, P.A. October 13, 1994
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