Doctors are starting to see a lot of flu coming their way. It appears our flu season might be hitting earlier. In fact, according to the Centers for Disease Control and Prevention, Texas is one of seven states in the high range for flu incidents, and that’s just people who have been tested for it.


The holidays are also great spreaders of the flu because people travel from one area of the country to another, bringing the flu with them.


What should you do if you think you might have the flu?


Call your doctor; don’t go to the emergency room.


The last time we had a serious outbreak in 2018, Eric Higginbotham, medical director of Dell Children’s emergency department, told us that doctors at Dell Children’s weren’t even testing for the flu in most kids.


Instead, they made sure the kids were not dehydrated or having breathing problems, and had good vital signs. Then they sent them home.


When we start having outbreaks, doctors save the tests and the antiviral medications for the people who are at the most risk for dying from the flu: people who have pre-existing conditions such as asthma, kids who are younger than age 2 and the very old.


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As well, they warn that going to the emergency room during an outbreak could cause you to get a different strain of the flu, or if you just have a virus and not the flu, you could then get the flu.


Instead of heading to the ER, call your primary care physician and talk to the triage nurse there first before coming to the emergency room.


Parents should look for these warning signs that would necessitate medical attention:


Dehydration — not drinking fluids, not wetting at least three diapers a day or going to the bathroom


Not behaving right — there appears to be more there than just a kid with the typical aches and tiredness that comes with the flu.


A high fever is not a warning sign. Higginbotham doesn’t worry about fevers that are lower than 105 degrees. The worry about a fever higher than that is a febrile seizure.


Here’s what you should be doing:


Push liquids to avoid dehydration. They won’t be hungry, but they need to drink liquids anyway.


Alternate Tylenol and Motrin to prevent the fever getting too high.


Stay home for at least 24 hours after having a fever. (And that 24 hours doesn’t count until you stop giving Tylenol and Motrin).


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It’s not too late to get the flu shot. While the Centers for Disease Control and Prevention recommends getting your flu shot by Halloween because it takes two weeks to reach full immunity, you can still start protecting yourself now to be ready for Christmas break and January and February, when flu typically peaks.


Dr. Leighton Ellis, pediatric department chair for St. David’s Children’s Hospital, explained earlier this year what is different about this year’s flu shots and CDC recommendations:


There are two manufacturers of the shot that have lowered how old you have to be to use that flu shot and/or changed the dosing levels.


The Afluria Quadrivalent shot was previously only for people who are 5 years or older. Now it can be used for anyone age 6 months or older. Kids who are age 6 months to 3 get a smaller dose (0.25 milliliter). At age 3 and up, it’s the standard dose (0.5 milliliter).


The Fluzone Quadrivalent can now be given to children ages 6 months and older at the full dose (0.5 milliliter). Previously it was given as a half dose until age 3.


What does this mean for flu shot providers and patients? It means that there’s less of a chance clinics will run out of shots for the youngest recipients because these kiddos have more flu shot options and can even take a full dose of the Fluzone.


Flu shots are recommended for most people ages 6 months and older, but especially for anyone for whom getting the flu would be more likely to become life-threatening. That includes the elderly, anyone who has asthma, diabetes or an immune deficiency, pregnant women, anyone who is morbidly obese, as well as anyone who is caring for someone with these conditions. If there is a vaccine shortage, these are the people who will be given priority to receive the vaccine, Ellis says.


The CDC continues to recommend that kids younger than age 9 receive two shots to build up their immunity. Once they have had two shots, they don’t need to get a second shot, even if one shot was given in one season and a second in a different season. People ages 9 and up don’t need to get two shots even if they’ve never had a flu shot before, Ellis says, because the CDC assumes that at some point they’ve been exposed to the flu and have some natural immunity to it if they’ve made it to age 9.


What about the FluMist? It went away for a few seasons when it was found to not be as effective as the flu shot but was back last year. Ellis reserves it for patients who absolutely won’t do a shot, but sometimes getting a kid to let someone squirt something in their nose can be more difficult for the nurses than giving the shot. FluMist is not for kids younger than age 2 or anyone 50 or older, anyone pregnant or with asthma or a compromised immune system.


Ellis doesn’t recommend the FluMist for teens and adults because what’s she’s noticed is that anecdotally it doesn’t work as well for them as it does for kids. The advantage of the FluMist is it could potentially keep you from getting the flu, she says, because it stops the virus from spreading past the nose.


With a flu shot, you can still get the flu, but it will be a shorter period of illness, and it will be less severe.


Just like there are special recommendations for flu shots for young kids, there are special recommendations for seniors. People ages 65 or older should get the high-dose version of the flu shot to increase their immunity. The reason? Their immunity starts to wane quicker, usually around six months. Kids’ immunity lasts 12 to 18 months, and typical adults usually have about 18 months of immunity. (That doesn’t mean adults should skip the shot one flu season because strains of the flu change each year and the shot is for that year’s strains.)


Ellis says there aren’t many reasons a person couldn’t get a flu shot. Even people who are allergic to eggs can get one, but they’ll want to do it in their doctor’s office and wait 15 minutes to make sure there isn’t a reaction. If you’re not sure whether you should get a flu shot, ask your doctor.


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