Influenza and antiviral treatment

Overview & Definition

Picture a three-year-old brought to the emergency department in mid-winter with a high fever, a dry cough and aching legs, who has been well until that morning. The suddenness is the clue — influenza does not creep in the way a common cold does, it arrives all at once. Recognising that pattern, and knowing when to escalate from reassurance to antiviral treatment, is the skill this topic builds. [2] [3]

Influenza is an acute infection of the respiratory tract caused by influenza A or B viruses (family Orthomyxoviridae), spread by respiratory droplets and by contact with contaminated surfaces. It causes recurrent seasonal winter epidemics and, periodically, pandemics. In older children and adults it is a self-limiting febrile illness; in infants and in children with chronic medical conditions it is a leading cause of hospitalisation, intensive-care admission and death. [2] [3]

The clinician's task has three parts. The first is to recognise influenza and triage severity — who can be managed at home and who is heading for the ward or the intensive-care unit. The second is to treat early with antivirals in the right patients, alongside supportive care and active management of complications. The third is prevention through annual vaccination, maternal vaccination and infection control, because the child who never reaches hospital is the child the immunisation programme has protected. [3] [10]