Flu and RSV: What Parents Need to Know

TulsaKids is partnering with The Children’s Hospital at Saint Francis to bring you information that you need to know about children’s health. Dr. John Lukeman with Warren Clinic Pediatrics spoke with us about flu and RSV. Watch the video below; the transcription follows.

Q: Let’s start with flu. What is it, and what are the symptoms we should look for?

A: The flu is a virus that causes typically upper respiratory-type symptoms. Most commonly in our pediatric patients we’ll see fever, headache, sore throat and cough. Sometimes with flu we’ll see vomiting and diarrhea as well.

Q: And we should take them to the doctor if we see those symptoms?

A: Yes, we will quickly do flu testing, and potentially other testing to verify it’s not another virus or illness, as there can be overlap of symptoms between different types of viruses.

Q: How can we prevent the flu?

A: Probably one of the best ways to prevent the flu is washing your hands. Washing your hands  can prevent the spread of a lot of different types of sicknesses and viruses. However, flu can also be spread by respiratory droplets. When we talk, cough or sneeze, we spread droplets into the air, and those droplets stay in the air. I know nobody’s excited about wearing masks these days but wearing masks can actually prevent the spread of flu, and that is one of the reasons over the last couple years we’ve seen a decrease in flu.

Q: Let’s talk about the flu vaccine. Who can get it, at what ages and when can they get it?

A: The flu vaccine is a great preventative measure. It can sometimes help prevent getting flu but, more than anything – and what I really like to stress to my patients – is that the flu vaccine prevents serious illness from the flu. And, in most cases it prevents death from the flu. The flu vaccine can be started with infants at 6 months old, so anyone age 6 months and older can get the flu vaccine. The vaccine can be given at the doctor’s office or many pharmacies.

Q: Do infants really need a flu vaccine?

A: Flu is one of those viruses that it really affects the very young and the very old, so sometimes I’ll have families say, “Well, I don’t want to do the flu shot in my 6-month-old, so maybe next year we’ll do it,” and I actually say, “Really, this is the time you want that flu vaccine because it’s the little babies that I see that are really ill with flu, and the ones that don’t have the flu vaccine, I can tell. They are just way sicker.”

Q: Can I get my flu vaccine and a covid vaccine/booster at the same time?

A: Absolutely. That was something that was a little bit unclear early on whenever we were giving the COVID vaccine, but now we’re saying that, yes, those can be given together without any complication.

Q: Some people may say, “I got my flu shot and I still got flu, so I’m not going to get it this year!” What would you say to them?

A: My immediate response – and I try to say this as kindly as possible – is, “Yeah, you got the flu, but you didn’t die from the flu.” And who knows if something worse would have happened, and, God forbid, it wouldn’t have. The flu shot prevents those serious illnesses that can come along with flu, can prevent those comorbid conditions worsening your flu symptoms and can prevent death from the flu.

Q: What is RSV and what are the symptoms?

A: RSV is respiratory syncytial virus. It’s a virus that is somewhat similar to the flu in that it spreads throughout communities. We also worry about the very young and very old with RSV, but it’s one that classically effects babies. Our babies that are coming in, especially under 6 months that have a cough, runny nose and difficulties breathing, those can all be signs of RSV. And, again, we worry when they’re less than 6 months old that they may have significant difficulties breathing. When they’re starting to have low oxygen levels, they can sometimes need oxygen support or other treatment to help them get through that sickness.

Q: It sounds like some of those symptoms you mentioned are similar to a cold. How do you know if your child has a cold or RSV?

A: That’s a question I get every day in my office. Many times, for children that are two years old and above and adults, RSV will be a cold. That’s exactly what it is. But the younger patients, when they get RSV, they tend to have copious amounts of secretion, so a whole lot of snot. And parents will say, “I suction it out and five minutes later it’s everywhere again.” And that’s kind of one of those key features to RSV that we can look across the room and say, “Yeah, that’s RSV,” because you’ll see that congestion and mucus everywhere, and a lot of times the baby will be working hard to breathe, where they’re taking these big breaths and their whole body is moving because there are so many secretions.

Q: So, if we’re seeing these symptoms, we need to get the infant to the physician?

A: Absolutely.

Q: Is there an RSV vaccine?

A: There is an RSV vaccine that exists. It is incredibly expensive and reserved for patients that have serious health conditions otherwise. It is not available to the general public.

Q: Are preventive measures the same for the flu and other viruses? Washing hands, masking?

A: Absolutely.

Q: You mentioned that RSV can be dangerous for infants. Is there a season for RSV that we may need to be aware of?

A: RSV is typically seasonal, and it’s typically similar to what people think of as flu season, so those fall and winter months. Interestingly, ever since we’ve had COVID-19 in the picture, our RSV season have been a bit skewed. So, we had an RSV season last summer, which I’d never seen before. I’m anticipating this year we’ll have an RSV season in the winter months again. But we’ll see.

Q: Should I ask my family and friends to wear a mask around my infant?

A: It certainly wouldn’t hurt anything if you have a baby under 6 months old for family and friends who are around the baby to wear a mask. Not only can that help prevent the flu and RSV but also the spread of COVID.

Q: What else should we know about flu and RSV? And the complicating factor of COVID still circulating? What other advice do you have for parents? They’re all viruses, correct?

A: Most viruses tend to last about five days where they’re at their worst, and then should improve for an additional 5 days. If your child is just getting more and more sick each of those days and if it’s worsening after five days, it tells me something else could be wrong. That’s certainly the point you would want to go in and see your pediatrician for a good physical exam, potentially getting an x-ray, to make sure we’re not dealing with bacterial pneumonia, or something else in addition to the original virus.

Q: This sounds like it can be a little confusing and complicated. So, if you have a question or are unsure what your child is dealing with, call your doctor.

A: It can absolutely be confusing. It’s confusing even for the physicians when we can’t always tell you exactly what illness your child has, but we can do testing to come up with the answer, and we can also give a whole lot of reassurance like, “We need to see this kid back in one or two days,” or “We think you’re going to be good, so we’re going to just give this a few days to watch it, and your child should get better.” So absolutely, if you’re having any concerns, your doctor wants to see you.