Treating the Cold/Flu

Typically, parents are told to just treat the symptoms of a cold or the flu and make their child comfortable, because these common infections are caused by viruses and there are no treatments. While symptomatic treatments are important to help your child feel better, this is not totally true anymore. There are many medications available now to help treat the flu.

Symptoms of a Cold

Cold symptoms are usually mild and develop 2-5 days after you are exposed to somebody else that is sick. Symptoms may include a fever, runny or stuffy nose, sneezing, sore throat, cough, headache and muscle aches. The runny nose typically begins with a clear runny nose, but after 2-3 days, it may become thick and green or yellow. Symptoms usually worsen over the first 3-5 days, and then slowly go away over 10-14 days.

Treating a Cold

Since it is caused by a virus, antibiotics do not work against the common cold. These types of upper respiratory infections go away on their own and taking antibiotics will not help your child get better any faster and will likely not prevent secondary bacterial infections, such as an ear infection or sinus infection. Although there is no cure for colds, that does not mean that you can't treat your child's symptoms to help him feel better. Extra fluids, a cool mist humidifier, and rest will likely help with some of his symptoms. Younger children, since they can't blow their nose, may benefit from using saline nasal drops and a bulb syringe to help keep their nasal passages clear. Over the counter medications that may help, depending on your child's symptoms, include a pain and fever reducer, such as acetaminophen or ibuprofen, and a cold medicine with a decongestant and/or cough suppressant.

Zinc lozenges, although commonly used by adults, have not been shown to be helpful for kids and are not always well tolerated and should probably be avoided.

Flu Symptoms

Although flu symptoms are similar to those caused by a cold, they are in general a lot worse. Children with the flu will usually have a rapid onset of a high fever, severe headache and muscle aches, and chills, in addition to a runny nose, nasal congestion, cough, sore throat, vomiting, nausea, and fatigue.

Flu Treatments

The flu, like the common cold, is caused by a virus, so antibiotics don't work against it. However, there are many antiviral medications that can be used to treat the flu and may help your child to get better a few days faster. In general, they are only effective if started within 1-2 days of your child's symptoms beginning. Flu medications include:

• Relenza (Zanamivir) - a Diskhaler that is given by inhalation to children over the age of seven years. It is effective against Influenza type A and B.

• Tamiflu (Oseltamivir) - available as a capsule or oral suspension and can be used as a flu treatment and prevention in children over the age of 1 years and adults. It is effective against Influenza type A and B.

• Symmetrel (Amantadine) - an older medication that is only effective against Influenza type A and can be used to prevent and treat the flu in children over 12 months of age
• Flumadine (Rimantadine) - also only effective against type A Influenza and it is only approved for use to prevent the flu in children under 10 years, and not as a flu treatment.

Because of problems with resistance, the CDC recommends that doctors not prescribe amantadine and rimantadine to prevent or treat flu any longer.

Symptomatic treatments, as described above, may also help your child feel better.

Flu Prevention

The best way to prevent your child from getting the flu is to get him a flu shot each year, especially if he is at high risk of having complications from getting the flu. Many of the flu medications described above, except Relenza, can also be used to prevent your child from getting the flu if he is exposed to someone that is sick with the flu. This year, Tamiflu, will be your best option for prophylaxis if your kids are exposed to the flu.

Is it a Cold or the Flu?

In the past, it really wasn't important to know if your child had a cold or the flu, since in both cases, you just treated the symptoms. But now, since treatments are available for the flu, it can be important to know for sure whether or not your child has the flu. The flu should be suspected if your child has typical flu symptoms as described above, especially if he has been exposed to someone else with the flu. Testing can be done in many doctors' offices from a throat or nasal swab, with results in about half an hour.

If your child tests positive for the flu, or if testing is unavailable, but the flu is strongly suspected, then he may be a candidate for one of the flu medications described above. Other family members and close contacts might also be a candidate for flu medications to prevent them from getting sick.

A.M. Vitals: Case Claiming Individual Mandate is Unconstitutional to Proceed

Case to Proceed: A federal judge says the assertion by 20 states that the health-care overhaul law’s individual coverage mandate is unconstitutional is “a plausible claim,” theWSJ reports. Judge Roger Vinson of U.S. District Court for the Northern District of Florida is permitting the states’ case to go forward. He was more skeptical about the claim that the expansion of Medicaid included in the bill is also unconstitutional, but permitted it to go forward as well. The case is likely to make it to the Supreme Court, the WSJ says.

Offering Suggestions: UnitedHealth Group suggests that to save money, health benefits for the nine million people eligible for both Medicare and Medicaid should be administered via managed-care plans, Bloomberg News reports. The insurer issued a report proposing several measures for Medicare and Medicaid it says can save $3.5 trillion over the next 25 years.

FDA Reversal: The FDA said it shouldn’t have allowed the Menaflex knee implant to reach the market because political influence affected the approval process, and is now revoking its approval of the device, the WSJ reports. As the paper wrote in 2009, the implant, made by ReGen Biologics, was approved following a lobbying campaign by four members of Congress — even after FDA staff questioned its safety and efficacy. ReGen says it’s weighing its options, which include an appeal of the decision.

Fighting Bacteria?: Chiquita Brands’ Fresh Express, which makes bagged salad mixes, says washing greens in a mixture of two organic acids — rather than the usual chlorine — is a more effective way to kill off potentially dangerous bacteria, the New York Times reports. The company will switch to the FreshRinse wash and will also license it to other producers; food-safety experts tell the NYT that without published data, it’s impossible to verify the wash’s effectiveness. Fresh Express has recalled packaged greens three times this year over bacterial contamination worries, the NYT says.

Study Suggests Electronic Medical Records Improve Adverse-Event Reporting

Digitized medical records and systems have been proposed as a remedy for a lot of problems, from the difficulty of deciphering a doctor’s handwriting to decentralized and inaccessible patient medical information to long ER wait times. (Whether electronic records can live up to all the hype is, of course, not clear.) 

Now a new Pfizer-sponsored study suggests digitized records may improve the reporting of adverse events associated with prescription drugs, the WSJ reports. (The paper also wrote about this project when it was in progress.)

Research suggests the vast majority of harmful drug-related side effects go unreported to the FDA. This small study — covering 26 physicians at two Boston hospitals over a five-month period — set out to see if incorporating reporting into the electronic medical record system could help change that. As the WSJ describes it: “When one of the doctors in the study recorded discontinuing a medicine because a patient experienced an adverse event, the hospital’s electronic patient record system generated an alert. The system asked the doctor whether the side effect was serious and submitted a report to regulators.”

The physicians in the study reported 217 side effects to regulators during the study period, compared to none the year before.

Only about 20% of the flagged side effects were serious, and the Brigham and Women’s Hospital internist who led the study tells the paper the system may need some rejiggering to reduce the number of reports of non-serious issues. A common complaint of physicians who use electronic medical records is that they issue so many automated alerts for things such as drug interactions that doctors end up ignoring many of the messages.