“Mommy, Mommy, make it stop!”
“Make what stop?”
“It’s loud. They’re yelling!”
“Shhhhh, sweetie, no one is yelling.”
“Stop, stop, aaaaaaaaaaaahhhhhh.”
It’s 7 a.m. and, after I spent the night treating her high fevers, Marissa is finally feeling better but is suddenly terrified by what she’s hearing.
Most parents would be similarly terrified while seeing their child in such distress; flailing, yelling and confused. Not me. As an emergency doctor I have seen many other kids hallucinating these last few weeks while sick with Influenza A.
Our emergency department has been visited by children hearing loud sounds, seeing objects as too large or too far away, and feeling scared that someone or something is trying to hurt them.
These young patients have all been influenza positive.
How to manage your child’s fever
I wanted to warn other parents, but also provide reassurance that your little one will be okay. Thankfully, these episodes of delirium are brief and do not require treatment. As long as Marissa wasn’t confused or scared between these episodes, there was nothing I could do other than offer cuddles.
While I may have prevented the illness by booking her influenza vaccine sooner (she was booked for the next day) the best you can do during the illness itself is offer hydration and help to control the fever. Kids with fevers often look really, really sick, but remember that the fever itself is not dangerous, and alternating Advil and Tylenol every three hours works well to bring the fever down.
With the recent shortage of liquid medication, here are links to how to use regular adult tablets to safely manage fevers:
How to get your child vaccinated against influenza
Marissa is back to her feisty self, and her siblings successfully got protected with their flu shots. There’s still time to get your child vaccinated - find out how and where.
Visit our immunization clinics page
Most kids get up to 10 respiratory viruses every year from September to April. This year we are seeing a particularly nasty combination of influenza, COVID-19, and RSV (respiratory syncytial virus) in kids less than three years old, as well as common colds. While it’s hard to see your child sick so frequently, almost all of these viruses can be managed at home with fluids, Advil/Tylenol, and some TLC.
When to take your child to emergency
Is it an emergency? With our emergency departments busy, here are some guidelines for when to worry or have your child assessed.
Emergency
- Respiratory distress (working hard to breathe or breathing much faster than normal)
- Unusually pale, whitish or blue lips
- Asthma or wheezing not responding to prescribed medications
Not an emergency
- Nasal congestion and cough (even if it interrupts sleep)
- Symptoms of the 'common cold'
- Mild asthma or wheezing that responds to usual puffers
Emergency
- In a child less than 3 months old
- With immune or complex chronic health problems
- Difficult to wake up
- For more than 5 days in a child any age
Not an emergency
- In healthy and vaccinated babies
- In children who appear generally well (particularly after treating the fever)
Emergency
- Fever with a rash that looks like either blisters or bruises that don't turn white or fade when you push on them
Not an emergency
- Recurring rashes or skin problems
- Rashes with cough and cold symptoms, if the child looks well
- Mild hives that respond to antihistamines without difficulty breathing or throat/tongue swelling
What you can do to help prevent the spread of influenza
- Keep your child home when they’re unwell, waiting at least 24 - 48 hours after the end of their fever before returning to school
- Practice good handwashing, and wear masks in crowded indoor spaces
- Get your child protected with influenza and COVID-19 vaccines to prevent them from getting ill
Marissa makes a full recovery
I'm glad that I knew enough about this year’s Influenza A delirium to not have to bring Marissa to the emergency department, but I wouldn’t hesitate to bring her in for excellent care if she was exhibiting the symptoms outlined in this post. For now, we are back to playing in the snow and hearing no voices other than the shrieks of laughter of healthy kids.
Stay safe friends.
Dr. Kathryn MacKinlay is a Pediatrician in Vernon
Learn more from the BCCDC
Fever can make a child look unwell. Using children’s acetaminophen (Tylenol) or ibuprofen (Advil) can help bring down the fever. If you are having trouble finding fever-reducing medication, the Public Health Agency of Canada provides information on what parents can do:
- Only buy what you need so others have access to the medications they need.
- Keep your child comfortable:
- Use cold compresses and have them drink plenty of fluids
- Luke warm baths
- Do not use adult fever and pain medications on children under 12 years of age without consulting a health care professional as there is a risk of serious harm and overdose.
- Speak to a pharmacist who can help choose the right alternate product and dose, or who may be able to prepare an appropriate and safe medication for your child.
- If you have any questions or concerns that your child may have taken or been given too much of a pain or fever-reducing medicine, please contact the BC Drug and Poison Information Centre at 1-800-567-8911 or 604-682-5050.
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