Posted on 12/11/2003 4:46:53 AM PST by BSunday
''Worried well'' may be making themselves sick
NORFOLK — Doctors at Children’s Hospital of The King’s Daughters tried Wednesday to head off more flu infections by urging parents not to rush children with run-of-the-mill illnesses to emergency rooms, where they are exposed to more serious viruses.
The hospital began seeing a surge of patients in its ER early this week, not only flu-sickened children, but also the “worried well” – those with colds and other minor respiratory illnesses.
Not all of those who have come to the ER this week needed hospital treatment, officials said, and some would have been better-served had parents called for doctors’ advice first, or even treated the children at home. As part of its education campaign, the hospital posted guidelines on its Web site for when children need medical treatment.
Parents have been responding to a very real flu outbreak – cases in Virginia recently reached widespread status – but also to media reports of severe, life-threatening flu outbreaks in other parts of the country, such as Colorado and Texas.
Dr. Albert Finch, executive medical director of CHKD, said on a typical day, the emergency room serves about 125 children. On Monday the ER treated 208 and on Tuesday, 219. The numbers showed no sign of decreasing Wednesday.
The roughly 70 percent increase has led to waits of three to four hours for those children with the least-severe symptoms.
The hospital’s pediatric practices also have been flooded with calls and patients.
“It’s only those people with complications that need the help of a physician,’’ Finch said. “I can promise you that if you bring a child that has not been exposed to the flu, that they will be exposed sitting in the waiting room. I don’t think that’s what people want.”
He said that while flu season has started earlier this year – about half the children tested so far have been positive for the flu – the symptoms and severity have not been worse than previous seasons. “We do not have a situation around here that is anywhere near what they are experiencing in Colorado and Texas,’’ he said.
In Colorado, six children have died from the flu. That state, along with Texas, California and several others, has also reported high numbers of children who have been hospitalized with severe flu complications.
So far, that is not happening in Hampton Roads. Finch said most children can be treated for the flu at home with over-the-counter medications.
The hospital has set up a “Flu Facts” set of guidelines on its Web site, www.chkd.org, with the information about when parents should seek the advice of a doctor or other health-care provider.
In particular, parents of children with these symptoms or characteristics should seek medical advice:
A high fever that does not respond to over-the-counter fever medications, such as Tylenol and ibuprofen. Parents should call if the fever lasts more than three to five days, which is normal for the flu, or if the fever goes away and returns.
If the child is listless or has no interest in playing or other activities, especially after Tylenol or ibuprofen brings the fever down.
If the child is inconsolable, irritable and cannot be calmed down.
If the child is not drinking fluids or not keeping down fluids. Poor fluid intake and diarrhea can lead to dehydration.
If the child has difficulty breathing, or exhibits fast, hard breathing. If the child is working hard to breathe, a health-care provider will need to assess the situation.
Children with chronic illnesses, such as cystic fibrosis, asthma, diabetes, heart and lung disease and children under 1 year old also warrant a call to a health-care provider for advice if symptoms are severe.
The local flu outbreak comes at a time when the supply of flu vaccine is drying up throughout the community and nation.
The two major manufacturers of the flu vaccine announced Friday that they had sent their last shipments and would not be able to meet demand spurred by severe outbreaks. The flu vaccine takes months to manufacture.
Two South Hampton Roads health departments, Suffolk and Virginia Beach, no longer have vaccine available.
Chesapeake ran out last week but expects more doses to arrive today. Norfolk and Portsmouth are reporting limited amounts and advise people to call before heading to a clinic for a vaccine.
Dr. Randall Fisher, a CHKD pediatric infectious-disease doctor, said the hospital and many of the CHKD practices have run out of the flu vaccine, but there are other ways to avoid the flu.
He said parents should teach their children to clean their hands often with soap and water, and to cover their noses and mouths with tissues when they cough or sneeze. If they don’t have a tissue, they should sneeze into their sleeves, rather than their hands.
Fisher said sick children should be kept home from school, a sentiment echoed by officials of the Virginia Beach school system, which reported an earlier-than-normal spike in flu-related absences. Suffolk was the other South Hampton Roads school division to report an increase in such absences.
Children under age 9 who receive the flu shot are supposed to have two doses, one month apart. However, Fisher said, some children were able to get only one of the shots before the vaccine ran out. But he said one dose is better than none at all. FluMist nasal spray is still available nationally for the first time this season, but many doctors and practices don’t stock it here.
Unlike the injected vaccines, the FluMist contains a live, weakened virus, and can be used only by healthy people who are 5 to 49 years old. FluMist also is more expensive — $60 to $70 — and is usually not covered by insurance.
Finch said the fact that a record number of people received the flu vaccine this year – in part because of outbreaks elsewhere and also because of lingering concerns about a cluster of child flu deaths locally in February – should help reduce the severity of this year’s flu season.
This year’s vaccine was made with strains that are slightly different from the virus that is circulating. That means even vaccinated people might get the flu, but health officials hope the flu shot will lessen the impact.
Finch said it’s still too soon to gauge how serious this flu season will be in Hampton Roads. He said CHKD inpatient admissions are not out of the ordinary so far.
“We don’t know that this flu season is worse,” Finch said. “The principal difference is it’s earlier.”
Staff writers Deirdre Fernandes, Matthew Bowers and Mike Gruss contributed to this report.
I got the flu vaccine the week it was available at the local branch medical clinic. Fat lot of good it did me. I can't remember the last time I was this sick. And naturally I hit the Murphy's Law of sick kids-first they're BOTH sick, then one gets better while the other gets worse. *shakes head* Stuff like this NEVER fails to happen when my husband's on deployment...
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