Children’s colds and flu are treated differently.

In daily life, parents tend to confuse children’s common cold with influenza. In fact, there are great differences between them in pathogen, infectivity, symptoms and medication. Parents should carefully distinguish whether their children are suffering from the common cold or the flu, and take medicine according to the symptoms.

Common cold

The common cold is mainly caused by viruses, and children will have symptoms such as stuffy nose, runny nose, sneezing, coughing and fever. The common cold is often a mild self-limiting disease, which can be gradually relieved without taking medicine.

In infants and young children, the symptoms of the common cold are usually more serious on the second to third day, and gradually relieved on the tenth to fourteenth day. A few children may cough for 3-4 weeks. Older children and adolescents generally have cold symptoms gradually subsided in 5-7 days, and children with basic lung diseases may last longer.

There is no specific medicine for the common cold. Taking medicine is mainly to relieve symptoms and make children feel less uncomfortable. The commonly used therapeutic drugs for relieving cold symptoms are shown in Table 1.

It should be noted that children should not be given cold medicine containing codeine. Although codeine has a strong antitussive effect, long-term use may cause physiological dependence and addiction. National Medical Products Administration’s announcement on revising the instructions for cold medicines containing codeine clearly points out that it is forbidden for children under 18 to use cold medicines containing codeine. Then, how to relieve the mild cold symptoms of children?

When the body temperature caused by fever is above 38.2℃, children over 2 months old can use acetaminophen to reduce fever, and children over 6 months old can use acetaminophen or ibuprofen to reduce fever. For the symptoms of nasal congestion and runny nose, it is suggested to relieve the symptoms by dripping salt water into the nose, spraying nose, nasal irrigation, etc. Children under 6 years old are generally not recommended to use drugs (such as compound cold medicine) to relieve the nasal symptoms, because these symptoms will generally gradually relieve themselves, and adverse reactions may occur when using drugs. If you have a cold accompanied by cough, you can replenish water appropriately, which will help to dilute sputum and relieve respiratory mucosa. Children over 1 year old with common cold can take honey or honey water to relieve their cough. Honey has a mild cough relieving effect on night cough. It should be noted that children under 1 year old should not take honey, because it will increase the risk of botulinum poisoning.

Parents need to pay special attention to that children need to seek medical attention as soon as possible in the following situations: infants less than 3 months old have symptoms such as fever and cough; After taking antipyretics, the fever still persists or persists for 3 days; Persistent nasal symptoms, such as stuffy nose, runny nose, sneezing, etc., have lasted for more than the course or degree of the common cold; Abnormal conditions such as dyspnea, confusion and ear pain occur.

So, how to prevent children from catching a cold? The most important thing to prevent colds is to wash your hands frequently. It is best to use running water when washing your hands, and tell your child to rub it with hand sanitizer or soap for at least 20 seconds. In addition, we should pay attention to indoor ventilation, take children to crowded public places less, and try to wear masks when going out. If parents catch a cold, they should be isolated and reduce contact with their children. Pay attention to the combination of meat and vegetables in diet, ensure nutrition, take children to exercise more and ensure enough sleep time to enhance their physique and improve their immunity.

Common medication problems of common cold

Q: Can antipyretics and compound cold medicines be taken together?

A: no. Compound cold medicine usually contains antipyretic ingredients, which can easily lead to repeated medication and toxic and side effects when taken together with antipyretics. It is best for parents to choose a single ingredient medicine for their children. If you use a compound cold medicine, you must read the instructions carefully before using it, especially the ingredients, to know whether there are repeated drugs.

Q: Do Chinese patent medicines have any side effects?

A: Chinese patent medicines also have side effects. Although the adverse reactions written in the instructions of many Chinese patent medicines are unclear, this does not mean that they have no adverse reactions, and Chinese patent medicines are not necessarily safer than western medicines.

Q: Do children need antibiotics for their common cold?

A: no need. Common cold is caused by virus infection, and antibacterial drugs are mainly aimed at bacterial infection. The use of antibacterial drugs is not only ineffective for common cold, but also may cause bacterial resistance. Therefore, the common cold does not need antibiotics, unless the doctor clearly diagnosed bacterial infection or secondary bacterial infection.

Q: Can children take oseltamivir for a common cold?

A: no. The common cold is mainly caused by rhinovirus and coronavirus, while oseltamivir is aimed at influenza viruses, including influenza A and influenza B viruses, so oseltamivir is not symptomatic for treating common cold.

flu

Influenza is an acute respiratory infectious disease caused by influenza virus, which can be divided into four types: A, B, C and D. The most common type of influenza is seasonal influenza, which occurs in autumn and winter and is mainly caused by influenza A and B viruses.

Children’s influenza often starts suddenly, the main symptom is fever, and the highest body temperature can reach 39~40℃, often accompanied by chills and chills. Children will also have headaches, muscle aches, fatigue, loss of appetite and other manifestations. Cough, sore throat, runny nose and stuffy nose may also occur, and a small number may have digestive tract symptoms, such as nausea, vomiting and diarrhea. The symptoms of influenza in infants and young children are often not as typical as those in children, and may only be fever and cough. Newborn influenza is relatively rare, but complications often occur, such as pneumonia and dyspnea.

Mild influenza is often similar to the common cold, but its fever and systemic symptoms are more obvious. Severe children will have viral pneumonia, secondary bacterial pneumonia, acute respiratory distress syndrome, shock, disseminated intravascular coagulation, cardiovascular and nervous system and other extrapulmonary manifestations and various complications.

Influenza patients and recessive infected people are the main sources of seasonal influenza infection, mainly through droplets of respiratory secretions, but also through direct or indirect contact with oral cavity, nasal cavity, eyes and other mucosa. Influenza virus is easy to produce new mutant strains, so it can spread widely among people, causing repeated infections and diseases. Therefore, we must pay attention to it and do our best to prevent it.

Different from the common cold, influenza has a "nemesis", that is, neuraminidase inhibitors. At present, the drugs listed in China include oseltamivir, zanamivir and palamivir. Among them, oseltamivir is the most widely used anti-influenza drug for adults and children at present, and its best administration time is within 48 hours after the onset of flu symptoms, and it is also effective after 96 hours after the onset of flu symptoms. Specific therapeutic and preventive doses can be found in Table 2. Although vaccination is the best way to prevent influenza virus infection, oseltamivir can be recommended for people who cannot be prevented by vaccine and the following key children in the outbreak of influenza.

The recommended drug prevention population includes: high-risk children who cannot be vaccinated with influenza vaccine, or children with immune abnormalities who do not respond to the vaccine; High-risk children within 2 weeks of vaccination; Family members or caregivers who are in close contact with non-immunized high-risk children or infants younger than 24 months; In order to control the outbreak of influenza, it is used in children who have not been immunized or in children’s gathering places (such as kindergartens); Prevention after exposure of family members; Prevention of patients with high risk of influenza complications and close contact with influenza.

Vaccination against influenza can significantly reduce the probability of influenza in children and the risk of serious complications. Therefore, parents are advised to take their children to get the flu vaccine in time every year. Generally, it is planted indirectly from September to December every year, and it is best to complete immunization before the end of October. Children aged 9 and over are advised to take one dose in one flu season. For children aged 6 months to 8 years, it is recommended to vaccinate two doses for the first time, with an interval of one month. But not all children are suitable for vaccination, and infants less than 6 months old or children who are allergic to any component of the vaccine are not suitable for vaccination. In addition, if the child suffers from mild to moderate acute diseases, it is recommended to vaccinate after the symptoms subside.

When the child has the following situations, he should pay attention to seek medical attention in time: dyspnea or shortness of breath, which can not be relieved after cleaning the nasal cavity; Crying low, crying less, not having good eye contact with parents, poor spirit and listlessness; Drink less water, or there are signs of dehydration, such as no tears when crying, decreased urine output (dry diapers), dry mucous membranes such as lips, tongue and eyes, and skin like dough, which cannot be quickly recovered after gently pinching the skin; Severe or persistent vomiting; Poor appetite, significantly reduced eating; Persistent fever, with or without convulsions; Fever with rash.

Common drug use problems of influenza

Q: Can infants under 1 year old take oseltamivir granules?

A: Although the minimum age of the population suitable for oseltamivir granules is 1 year old, the US Food and Drug Administration has approved that oseltamivir can be used for infants over 2 weeks old. The British Ministry of Public Health guidelines also suggest that infants under 1 year old can use it. China’s "Expert Consensus on Diagnosis and Treatment of Children’s Influenza (2015 Edition)" puts forward that oseltamivir can be used for influenza treatment in children of all ages and influenza prevention in children over 3 months old. According to the above evidence, infants younger than one year old can take oseltamivir granules, but it is an over-the-counter drug in China at present.

Q: The child’s condition has improved after taking the medicine for 3 days. Can he stop taking the medicine?

A: Due to individual differences, some children may feel better after two or three days of medication, but they are not sure whether their illness will recur. It is suggested that they should take medication according to the course of treatment for five days.

Q: Can oseltamivir take the place of influenza vaccine to prevent influenza?

A: Drug prevention is generally only used as an emergency temporary preventive measure and cannot replace vaccine prevention. Vaccination against influenza is the first choice to prevent influenza.

Q: Can I treat the flu with antibacterial drugs?

A: no. Antibacterials only kill or inhibit bacteria, but have no effect on influenza virus.