A student post this as a discussion post, please reply with 1 up to date reference. Influenza A Influenza virus is categorized into three antigenic types: A, B, and C. Influenza epidemics occur mainly in the winter months with type A and B as the causative agents (Garzon Maaks et al., 2020). Transmission is through respiratory secretions produced through cough and sneeze. Incubation is from one to four days. (Munoz, 2021). Children shed the influenza virus longer than adults and therefore have a greater potential for transmission. Influenza affects approximately 30% of the pediatric population yearly and is particularly harmful in patients with chronic conditions (Alauzet et al., 2021). These conditions include respiratory diseases, neurological disorders, heart diseases, chromosomal abnormalities, and immunodeficiency. Clinical presentation of influenza varies and may include high fever, cough, chills, coryza, vertigo, pharyngitis, headache, dry cough, aches, vomiting and diarrhea (Garzon Maaks et al., 2020). Treatment is supportive care including rest, hydration, and antipyretic medication. Criteria for hospitalization of a child positive for influenza are dyspnea at rest, change in mental status, hypoxemia, dehydration, and serious complications (Munoz & Edwards, 2021). Antiviral agents such as neuraminidase inhibitors may be initiated within 48 hours of symptom onset; providers should be knowledgeable of recommended age and dosages for each approved antiviral (Munoz & Edwards, 2021). Yearly flu vaccination in children 6 months and older is the primary method of prevention. The CDC (2022) notes that flu vaccination reduces risk of severe flu in children by 78%. A study by Alauzet et al. (2021) notes the primary reason for lack of vaccination among pediatric patients is the absence of provider recommendation. It is vital to discuss vaccination prevention and concerns with parents and patients, especially during the flu season. Patient Encounter An 8-year-old male patient was seen in the primary care pediatric office complaining of headache and abdominal pain for one week. The patient’s caregiver reported fever for the past few days averaging 101°F. The patient also reported nasal congestion and cough but denied nausea and vomiting. The patient reported one episode of diarrhea one week ago. Patient reported adequate PO intake and fluids. The patient denied ear pain and rashes. Mom had been treating fever with Tylenol/Motrin. BP109/75, HR 109, RR 24, T . Physical examination was WNL. The patient had not received an annual flu vaccination. A rapid Influenza A test was performed with a positive result. The official diagnosis was Influenza A. Reassurance was given about viral illnesses. We discussed the natural course of the illness and when to return to clinic. We informed the patient and caregiver to return to the clinic for a fever >103 or for a fever greater than four consecutive days. Also counseled the patient and caregiver to return to the clinic for decreased urination (less than 4 voids per day), respiratory distress, a cough >1month, or for any other concerns or questions. We provided education regarding viral vs bacterial infections, fever as mechanism to fight infection, and usual course/length of influenza. We instructed the patient and caregiver to continue with antipyretics: Tylenol at 15mg/kg or Motrin at 10mg/kg PO as needed for high fevers. We also instructed the patient and caregiver to use nasal saline q2 q4-6 prn for congestion. We discussed supportive care such as encouraging fluids, using a humidifier, 1 tsp of honey for cough, and herbal medications if desired. We also educated the caregiver regarding the use of cold meds, lack of proven benefit, no cure, and possible unwanted side effects.
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