Shoo flu (don’t bother me!)

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By ERIN ANDERSEN / Lincoln Journal Star and wire services

To date only one case of influenza has been confirmed in Lincoln.

But more cases are inevitable, doctors warn.

And they encourage parents to get their children vaccinated — now.

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All children age 6 months to 19 years should receive the flu shot, according to newly revised recommendations by the Centers for Disease Control and Prevention. (MCT)

All children age 6 months to 19 years should receive the flu shot, according to newly revised recommendations by the Centers for Disease Control and Prevention. (MCT)

No one knows how bad this year’s strain of influenza may or may not be.

Regardless, all children age 6 months to 19 years should receive the flu shot, according to newly revised recommendations by the Centers for Disease Control and Prevention.

According to the CDC, vaccinating children will protect not only them, but everyone else they interact with — especially in school and day care settings. Everyone knows that children, who do not have the best hygiene, are great little germ carriers.

Over the past decade, public health officials have been expanding the recommendations on which age groups of children should get the flu shot. This year marks the first time that flu vaccination is recommended for everyone age 19 and younger, with the exception of infants 6 months old and younger.

The main question is: Will parents go for it?

Dr. Stacie Bleicher, of Capital City Pediatrics in Lincoln, said her office has had to reorder the flu vaccine. She estimates about half of the parents are coming in requesting the flu shot for their children because they heard of the new recommendations; and the other half are being told when they bring their children in for routine doctor visits. And office staff is making sure to bring up the recommendations with parents who bring in babies for their 6-month checkup.

Kathy Carter, nurse practitioner with Doctors of Children in Lincoln, said many parents of kids ages 2 and older are opting for the FluMist vaccine, rather than the shot.

“The kids love it, they don’t have to get a shot,” Carter said. Unlike the shot, FluMist contains the live flu virus; it can be given earlier in the season, and indications are that it lasts longer than the shot, Carter said. It also costs a little bit more.

Once upon a time, that was a big drawback, said Dr. William Swisher of Lincoln Pediatric Group. But today, the difference in price is minimal.

“And the kids sure like it better (than a shot),” Swisher said.

Medical professionals have worked to get the word out about the new vaccination recommendations, said the Lincoln doctors.

Not only is the flu something awful to experience, but many children develop secondary illnesses, such as sinus infections, bronchitis and pneumonia, which can double the length of time kids are sick and out of school or day care to two weeks.

When asked about flu shots, Lincoln Public Schools tells parents the vaccine is “highly recommended,” but has not sent home any notices to parents regarding flu vaccinations.

New focus this year

For years, adults have been the target for flu shots. This year, the emphasis has shifted from reducing deaths in the elderly to stopping the spread among kids.

Physicians hope that vaccinating kids en masse not only will spare thousands of them from the aches and pains of flu, missed school days and hospitalizations but also will hinder the spread of illness throughout the rest of society — parents, grandparents, baby sitters, neighbors, teachers, coaches, office workers, health-care personnel, bus drivers and on and on.

“The flu is so contagious,” Carter said. “It is spread respiratory-wise through coughing and sneezing — kids are the perfect avenue to spread it.”

Dr. Stephen C. Aronoff, chairman of the department of pediatrics at Temple University in Philadelphia calls the new approach “the concept of herd immunity.”

“The more people you vaccinate, the less likely you are to see infection in people who are not vaccinated,” he said.

Flu vaccination guidelines made by the federal Centers for Disease Control and Prevention have undergone major revisions over the past 20 years as more evidence points to children as carriers of the disease. In 2004, a recommendation was added that babies age 6 months to 23 months be vaccinated. According to CDC statistics, severe flu complications are most common in children younger than 2.

 In 2005, the CDC tacked on vaccination for ages 24 to 59 months (with the exception of some children with illnesses, such as reactive breathing disorders).

The recommendation to add youths ages 5 through 18, announced earlier this year, is based primarily on the fact that children suffer disproportionately from flu.

Roughly 1 in 100 kids with flu is hospitalized, and 75 to 150 children die each year of the disease. Death rates are much higher among those 65 and older, but the rates of hospitalization for children 2 and younger match those of the elderly, and children 2 to 5 have the highest rates of seeing a doctor or visiting the emergency room because of the flu. And overall, young people ages 5 to 18 have the highest rates of infection.

“There is a higher rate of infection with influenza in school-age children — what we call the highest attack rate,” says Dr. Jeanne Santoli, deputy director of the Immunization Services Division of the National Center for Immunization and Respiratory Diseases at the CDC. “We know the vaccine is effective in this age group, and we know it’s safe. So the recommendation is based on the direct benefit to these children. But there’s another reason, too. What does it mean to the community if we vaccinate these children?”

Vaccinating children could mean less flu all around, research suggests. From 1962 through 1987, most schoolchildren in Japan were vaccinated, and flu rates and deaths dropped significantly throughout the Japanese population.

In another example, officials in a small town in Michigan vaccinated schoolchildren at the start of the 1968 flu pandemic. The town had one-third the number of flu cases overall of nearby towns where children were not vaccinated.

Studies show that children are especially potent transmitters of the flu, says John Talarico, interim chief of immunization at the California Department of Health Services. Adults transmit flu germs for three to five days after symptoms first appear; children, about 10 days.

Expanding the pool of vaccine recipients is probably only part of the solution to curbing flu outbreaks, says Dr. Peter Szilagyi, a pediatrician and expert in child immunizations at the University of Rochester Medical Center in Rochester, N.Y.

“We also need more effective vaccines. I think the combination of those two things will really help.”

In the meantime, the CDC will be monitoring outbreaks over the next several years to determine whether its push to immunize children reduces the nation’s flu load.

If it does, you may see more states, school districts and day care centers including influenza among their mandated immunizations.

“We’re going to wait and see what the specifics show in the states that are mandating,” Zabel said. “If it really does make a difference in attendance and scores, something (ruling) might come down.”

Reach Erin Andersen at 473-7217 or eandersen@journalstar.com.