Children are suffering in this year’s flu season, which has arrived earlier and with a difficult strain that has proven deadly.
Kids have been flooding Toronto’s emergency departments, while Ottawa health units confirmed three children, between the ages of five and nine, have died from “influenza A-related complications.”
It all comes back to H3N2, a new mutated strain of influenza A, that causes more severe infections and has been called a possible “mismatch” to this year’s flu vaccine.
Here’s what you need to know about this year’s mutated strain and how to protect those most vulnerable near you.
Who should be worried about influenza?
Everyone is at risk for the flu, but children under five, pregnant people, people over 65 and those with underlying health conditions are more likely to be affected, according to the Public Health Agency of Canada’s website.
“H3N2 is completely nonprejudicial in hosts,” said Dr. Allison McGeer, an infectious disease specialist at Sinai Health System. “It makes everybody miserable.”
For young children, Matthew Miller, director of the DeGroote Institute for Infectious Disease Research at McMaster University, said influenza tends to cause more severe illness than physicians typically see with “run-of-the-mill common colds.”
“It’s much more common to have persistent fever, muscle aches and extreme fatigue, things like night sweats,” he said.
This can also lead to “more severe manifestations” of the illness and children can experience pneumonia or secondary infections, such as an ear or sinus infections, which can prolong a child’s recovery time.
Why are children more vulnerable?
Children, including school-age kids, are more vulnerable because of the dominance of the H3N2 strain subtype this flu season.
“They’ve had less exposure to influenza, so some of them will have never encountered some of the different types or subtypes of viruses, making them … perhaps more susceptible than older children and adults in general for infection,” said Jesse Papenburg, a pediatric infectious disease specialist at Montreal Children’s Hospital.
A child’s first influenza infection leaves an “imprint” on their immune system to have better responses and protection against infections. Most children would have been imprinted with the H1N1 — another variant of influenza A — and are encountering H3N2 for the first time.
“It’s kind of like their immune system is not as ready to fight it off compared to if it had been an H1N1 strain,” Papenburg said.
While it’s not usual to see “high attack rates” in kids at the beginning of flu seasons, Papenburg said those numbers are “really, really high” right now.
From Nov. 30 to Dec. 6, nearly 64 per cent of children who were tested, ages five to 11, and around 55 per cent of youth, ages 12 to 19, were positive for influenza, according to Public Health Ontario.
“H3N2 was more common than H1N1 this week and season to date,” the website read.
How can you protect yourself and your child?
There are several methods to help protect yourself from illness, even though Miller said the flu vaccine remains the “best medical intervention we have.” Flu vaccines are available and recommended for kids as young as six months old, according to Toronto Public Health’s website.
In busy, indoor environments where there is more risk for illness exposure, masking can be helpful and effective for children, alongside reminders of proper hand hygiene.
It’s more effective to wash your hands before eating and avoid spreading bacteria all over your mouth and face.
Another measure is using humidifiers in bedrooms and living spaces, Miller said, since the heat indoors during the winter can dry out the mucus and saliva that line our respiratory tracts and make it easier for the virus to infect our airways.
“Things like humidifiers can keep the air moist and prevent some of that drying out from happening and then maintain some of those protective barriers that essentially evaporate when there’s not enough humidity,” he said.
From a prevention standpoint, Miller said it’s important to make sure children aren’t getting “too run down,” are getting a good night’s sleep and have healthy eating habits.
“The healthier you are in general, the better your body’s ability is to fight off infections and prevent those infections from becoming severe,” Miller said. “When it comes to looking after children, what’s most important is for parents to watch how their child’s behaving.”
When should you visit the ER?
In the first three months of a child’s life, Papenburg said that fevers, which can be a sign of a severe infection. As a child gets older, signs such as difficulty breathing, dehydration and lethargy are also “dangerous.”
The Canadian Pediatric Society also lists vomiting, loss of appetite, diarrhea and chest pain as worrying symptoms. If a child still has a fever after five days, suddenly develops a new fever after feeling better or has a chronic illness, they should head to the emergency department.
All of these symptoms should be brought to medical attention, and depending on a person’s access to care, can vary from the emergency department to a primary care physician.
“There are gradients within these things in terms of how severe (symptoms) might be so the more severe and the more concerned a parent is, they should go to an emergency department,” Papenburg said.
