A year ago Covid was the hot topic, 365 days later, however, there is nothing but talk of “Australiana”. A particularly tedious strain of flu that kept adults and children under the covers and with a thermometer in hand even on Christmas days. It is no coincidence that – except for holiday closures – the telephones of pediatric studies are hot. Nurseries and nursery schools are empty.
But is it the flu that is more aggressive? Or are we the weakest? We talked about it with Valentina Paolucci, known on Instagram as “The children’s doctor”. A pediatrician who publishes very useful pills for parents on her profile and who has returned several times to the subject of flu in recent weeks.
It’s been weeks now in which we hear from children, but also adults, who are sick. Cough, very high fever, persistent cold. What is happening?
We are going through a real train of viral infections, which is why many children, but also many adults, are getting too sick compared to the norm. We are paying the price of two years of lack of immunity due to Covid.
Have two years of masks weakened us?
Absolutely. Nothing has been seen in the previous two years apart from Covid and now we are paying the consequences. The viruses that normally circulate at this time of year are more aggressive because they have found more fertile ground. A bit as if we hadn’t gone to the gym for two years, now that we’re starting to train again we feel the fatigue more.
The flu arrived even earlier than in past years…
A series of respiratory infections began already in October, mainly laryngitis, therefore infections of the upper airways, barking cough which, however, left its aftermath on the children even for 3-4 weeks. The flu arrived in November, much earlier than we expected. The vaccination season had just begun and only the first vaccinated partially enjoyed coverage, for many it was late. So many families have become infected, including adults.
What is this Australian flu?
It is none other than a strain of type A influenza, characterized by a very high fever which somewhat displaced doctors and paediatricians; usually a fever duration of 3-4 days is expected, however in this case the high fever can continue even for 5-6 full days, accompanied by rhinitis, cough mainly with laryngeal timbre, therefore high; the presence of children with bronchitis was observed sporadically, therefore infections of the lower areas of the lung, which required the prescription of the antibiotic which is not typical in the case of seasonal flu.
But if the flu arrived early, can we now feel safe for the rest of the winter?
Unfortunately not. Indeed, it seems that a new peak will occur in January. Even if we’ve been through the November-December flu, we’re not actually safe because we could be catching another flu strain. We navigate on sight however, Covid has taught us not to make precise predictions because the trend of infections has changed in recent years precisely due to the lack of stimulation of immunity.
So does it still make sense to get vaccinated?
Since Covid and, especially this year with this challenging flu, the vaccine has been extended to a much larger slice of children and adults. As far as the little ones are concerned, according to the guidelines it is recommended from 0 to 6 years, but from the management point of view of pediatricians it has been recommended to everyone, even pre-adolescents and adolescents without particular pathologies. The advantage obtained from a vaccine compared to a week of high fever, malaise and diffusion in the family is remarkable. The risk of the vaccine is almost nil compared to the benefits.
Are there any symptoms that can help us distinguish Aussie from Covid?
A precise distinction cannot be made, in some subjects there may be an overlap of symptoms, let’s say that roughly Covid in recent weeks is presenting itself with a fever that lasts less, accompanied by gastrointestinal symptoms, nausea, abdominal pain, vomiting, the flu instead it is characterized by a prolonged rise in temperature and a persistent cough. The real distinction, however, can be made by the swab. There are antigenic and molecular swabs that can diagnose Covid and flu strains.
As a pediatrician, visiting many children, what data do you have on Covid? Are there still many cases?
I can say that many patients who enter the studio with fever who I have swabbed have tested positive for Covid. Let’s not forget it because unfortunately Covid is still there.
Spikes of high fever often alarm parents. What’s to be done?
As a parent I understand that high fever is an alarming event, also because in particular cases it can lead to hallucinations and convulsions, but generally the body implements this mechanism to cure us, because at those temperatures the germs are unable to duplicate and survive. We must not have the anxiety of high fever. We must not appease the fever, but the malaise. If a child is 39 but apparently doing well, the antiepiretic can be avoided. Conversely, if a child even with 38.2 is tired, exhausted, has a headache, is tired, the antiepiretic can be given even earlier.
When should you worry?
Let’s say that, once the antiepiretic has been given, if the fever goes down and the child is back to normal, there is no cause for alarm. If, on the other hand, this does not happen, there could be another more important infection in circulation and, in this case, it is good to hear from the pediatrician. A cough that increases, fever, loss of appetite, weakness are other symptoms to communicate to the child’s doctor. There may be an infection that needs to be treated with antibiotics even before 5 days.
Aerosol yes, aerosol no. In case of cough and cold, what should be done?
The aerosol must be prescribed by the pediatrician after he has auscultated the chest, you cannot choose the aerosol do-it-yourself or after a phone call, this is the first thing. There are, however, cases in which it is not possible to access the pediatric visit in a short time, in these cases let’s evaluate where the cough stimulus comes from: a very cold child with a mucus discharge is likely to have retronasal mucus and therefore it is useful to do a nasal wash or a nasal shower and evaluate if this is sufficient. You can thus stall until the visit which, in any case, is essential. In the case of a dry, dry cough that does not present phlegm, then the aerosol can make sense, cortisone can be nebulized – always under the advice of the pediatrician – to act on the larynx and trachea.
What if the cough still persists? Should we be alarmed?
Let’s say that going to the pediatrician is always the first thing to do. Cough shouldn’t be underestimated, on the contrary it should be treated with the right therapies, but let’s keep in mind that the flu form of this period brings with it a cough that can last up to 2-3 weeks.