Think your child has the flu? Stay home, including from the emergency room

Your kid starts feeling crummy, aches all over, starts getting a fever. You think it could be the flu. Should you taken him to the emergency room or to see the doctor right away?

The answer, this year especially, might be no.

Dell Children’s Medical Center of Central Texas has seen a bump in emergency room visits and it’s all flu cases. Daulton Venglar/AMERICAN-STATESMAN

Dell Children’s Medical Center of Central Texas has seen its emergency room fill up in recent weeks. Monday last week the emergency room had about 370 kids come through, compared with the normal for 225 to 250 kids in a day. “It’s all flu,” says Dr. Eric Higginbotham, medical director of Dell Children’s emergency department.

Dell Children’s opened up an area with eight additional patient beds to the emergency department, though it hasn’t been as bad there since that day last week.

If you take your child to the emergency room for flu, what will doctors do for them? They will make sure your child is not dehydrated or having breathing problems, has good vital signs and send you home.

Doctors at Dell Children’s aren’t even testing for the flu in most kids. The test is pretty scarce right now, Higginbotham says, and the treatment would be the same for most kids whether they have the flu or another virus. Right now, there’s also an upper respiratory virus with some of the same symptoms as the flu as well as a stomach virus. If you came into the emergency room or doctor’s office thinking it’s the flu and it’s not, you could end up being exposed to the flu or another virus. If it is the flu, you could be exposed to another strain of it.

Doctors at Dell Children’s are saving flu tests and antiviral medications for kids who have pre-existing conditions that would make the flu more dangerous.

Those include:

  • Being younger than age 2
  • Having a chronic medical condition, especially asthma
  • Being born prematurely

Higginbotham wants you to call your primary care physician and talk to the triage nurse there first before coming to the emergency room. Parents might have been skipping that step as doctors’ offices often don’t have appointments available right now. They should still call the office and talk to a nurse to see if a visit to the emergency room is recommended.

Parents should look for these warning signs that would necessitate medical attention:

  • Dehydration — not drinking fluids, not wetting at least three diapers a day or going to the bathroom
  • Not behaving right — there appears to be more there than just a kid with the typical aches and tiredness that comes with the flu.

A high fever is not a warning sign. Higginbotham doesn’t worry about fevers that are lower than 105 degrees. The worry about a fever higher than that is a febrile seizure.

Here’s what you should be doing:

  • Push liquids to avoid dehydration. They won’t be hungry, but they need to drink liquids anyway.
  • Alternate Tylenol and Motrin to prevent the fever getting too high.
  • Stay home for at least 24 hours after having a fever. (And that 24 hours doesn’t count until you stop giving Tylenol and Motrin).

It might feel like this is the worst flu season ever. It is and it isn’t. As far as the number of cases, it’s the most since 2009, when the H1N1 virus swept the United States that summer. The 2018 flu season is actually now an epidemic, according to the Centers for Disease Control and Prevention.

It’s also not just one flu. There are three types: Type A subtype H1N1, Type A subtype H3N2 and Type B. Sometimes you can get more than one at a time, or you might get one, and then later get another one. That H3N2 type is the one that the flu shot wasn’t very good at matching, with it being only about 10 percent to 15 percent effective. 

It’s not the worst flu season as far as deaths, though, especially among children. This time last year 110 kids had died from the flu in the United States, compared with 63 this flu season.

Dell Children’s has not had any kids die because of flu, but a few have been in intensive care.

What it is is very contagious, and you’re contagious about 24 hours before a fever hits. That’s why it’s able to spread so rapidly in the schools, Higginbotham says. Kids feel fine but are spreading the virus before they feel sick.


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