Children with asthma, like those we treat at the Respiratory Center for Children at Goryeb Children’s Hospital, have inflamed airways, which increase their sensitivity. The influenza virus causes increased airway inflammation, leading to greater sensitivity and narrowing of the airways, which makes it more difficult to get air into the lungs. This increases the risk of acute respiratory failure and pneumonia in asthmatics. Most respiratory viral infections can worsen asthma symptoms of cough, wheezing and breathlessness. However, the influenza virus is an especially strong trigger of worsening asthma symptoms, requiring greater amounts of medication to maintain asthma control, and an increased risk of hospitalization.
Children and the elderly are especially susceptible to complications from the flu. Generally every child older than 6 months should receive the flu shot. Children younger than 5 years old and all children with long-term health issues like asthma and other chronic lung diseases, arthritis, diabetes, immune problems, seizures and developmental problems are at high risk for serious complications from the flu, and therefore are most in need of the vaccination. All close contacts such as family members and care givers of high-risk groups should also receive the flu shot.
The typical side effects may include soreness, redness and swelling at the injection site, low-grade fever, and muscle aches. The flu shot does not “cause the flu.” Most flu vaccines contain a minute amount of egg protein. However, most egg-allergic children can safely receive the flu vaccine without problems, but it needs to be administered under close observation in a doctor’s office for at least 30 minutes so that if a reaction does occur, it can be treated.
For many children older than 2 years, a nasal flu vaccine (Flumist) spray can be used. However, this vaccine is a live-virus vaccine and should not be given to children with asthma and other lung diseases, and immune problems. The live virus in the nasal spray causes inflammation in the nasal passages and the airway lining, leading to swelling, which can worsen asthma symptoms in asthmatics. Therefore, asthmatics should only receive the flu vaccination as an injection. If a child with or without asthma develops the flu, an oral antiviral medication (Tamiflu) can be given in the first 48 hours of the onset of symptoms to decrease the severity of symptoms.
A common-sense approach to avoiding contact and association with sick people or those having symptoms of illness is an important step in limiting exposure to the flu. Thorough and frequent hand-washing during the cold and flu season is also a very important method to help decrease infection. Healthy eating, plenty of fluids and adequate sleep are also needed to maintain good health and a strong resistance to getting sick. If your asthmatic child does catch the flu, controlling the fever with ibuprofen or Tylenol and increasing fluids helps maintain ease of breathing. Continuing asthma medication and increasing rescue medication, as prescribed by your doctor, can minimize worsening asthma symptoms.
Parents should always consult with their child’s pediatrician with any questions or concerns about their child’s health.
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