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Wellness Center

Toddler Flu- Please Respond Immediately

11/07/2009

Question:

I have a 3 year old son. We just moved to Uk from USA. My son started going to preschool from last monday. Today he came back witha very bad fever (39.9 c). He is so sick that he is not able to eat or drink. He doesn`t even have the energy to cry. Today I took him to the doctor and she said he has fever and ear infection as well. She prescribed pracetamol. She said incase the fever doesn`t go down by tommorow we need to give him Tamiflu. She said she is not sure if he has swine flu or it is just the normal fever. Now I am concerned. Can we just give tamiflu to a child just suspecting swine flu? What are the side effects of the tamiflu? What precautions should I take for my son. We live in a village so we dont have access to other doctors for second opinion. Please respond immeiately as I am concerned about my son. Please respond with all the information you can give me as I was not satisfied with the doctor visit today. Thanks!

Answer:

Hello! What a scary start to life in England! I strongly recommend that you start the Tamiflu immediately. It is an effective antiviral for both seasonal flu and Swine flu, shortneing the length of time a person is ill as well as the severity of the illness. As a young child, your son is more vulnerable to the complications of Swine flu as well as seasonal flu. Given his significant fever, it is better to be safe than sorry.

Tamiflu, oseltamivir, is usually very well-tolerated. The most common side effects are nausea and vomiting, which generally occur in the first 2 days of taking the medication, and can be lessened by giving the medication with food. Occasionally a rash may occur. If any signs of allergy to the medication occur such as swelling of the face, lips or mouth, hives or problems breathing occur, stop the medication and call for medical help right away.

Tamiflu should not be given sooner than 2 weeks after the child receives the Flumist intranasal vaccine, and the vaccine should not be given within 48 hours of a dose of Tamiflu. You can store the liquid form in the refrigerator but not the freezer. Liquid Tamiflu should be discarded 10 days after opening it. If you have capsules to use, you can open the capsules and sprinkle them into applesauce or ice cream to help the medicine go down easily if capsules are a problem for swallowing.

If :
 
1.) your son has difficulty breathing and is making wheezing or strident sounds with breathing,

2.) the skin below his lungs over his collar bones tugs in with breathing, or

3.) he is breathing more than 60 breaths per minute at rest,

he needs to be at the hospital.

Don't worry if your son does not eat, worry about keeping fluids going down often and well. Popsicles, Pedialyte or similar fluids, water, ginger ale, jello, or any uncaffeinated beverage will do. If his mouth and lips are dry, he is seldom or never urinating, is listless and unresponsive to you, he needs to be at the hospital. Keeping tylenol or paracetamol going round the clock at no more than five, weight-appropriate doses per day will help him feel better enough to drink and cooperate with taking his medication.

I hope he feels better soon!

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University