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Cold and Flu Med Shortage for Kids: What Parents Can Do

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More children are being sickened by RSV and flu this year than in recent years. PeopleImages/Getty Images
  • The FDA and manufacturers are reporting shortages of key medications for children this holiday season.
  • Flu and RSV has spiked in young children this winter.
  • Experts say there are steps parents can take to help young children even if they have difficulty finding medication at drugstores.

​As the holiday season has arrived, so have many winter illnesses like the common cold and seasonal flu.

And this rise in cases is hitting children especially hard.

The U.S. Food and Drug Administration (FDA) along with parents and pharmacists are reporting that medications to treat children’s ear infections, sore throats, influenza, and common upper respiratory illnesses are becoming hard to find.

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Experts believe that this problem is due to increased demand for medications as children have become ill earlier in cold and flu season than expected.

 

According to the U.S. Centers for Disease Control, influenza and RSV are likely the culprits for this recent rise in illness.

“We have had a record number of RSV and influenza hospitalizations nationwide this fall,” says Dr. James Antoon, Assistant Professor of Pediatrics, Divisions of Pediatric Hospital Medicine at Monroe Carell Jr. Children’s Hospital at Vanderbilt.

Antoon attributes the increase due to a dramatic decline in RSV, influenza, and other respiratory viruses during the COVID-19 pandemic.

“As a result, there are a large number of children less than three years old who have never been exposed to RSV and influenza, and the pool of susceptible children with no underlying natural immunity to these viruses is much larger this year than years past.”

CDC estimated that this season there have been 8.7 million illnesses due to influenza. The CDC also reports that in multiple US regions there has been an increase in RSV detection and emergency department visits. Historical data suggests that there are approximately 2.1 million outpatient visits due to RSV in children younger than 5 years old.

“Locally and nationally, pediatricians are experiencing a huge surge in upper respiratory infections – from a high amount of respiratory viruses including one of the worst influenza seasons we’ve seen in about a decade to the worst RSV surge in years,” says Dr. Alok Patel, Pediatrician at Stanford Children’s Health.

Patel says, “we’ve seen an overwhelming amount of upper respiratory infections in all levels, from outpatient cases to hospitalized children needing oxygen support to critically ill children in the ICU needing further intervention and neither I or my colleagues have ever seen such an early, rapid rise in RSV-associated hospitalizations in young infants and toddlers.”

 

 

According to prescribing data, Tamiflu, the prescription medication for treating influenza, is seeing an increase compared to previous years.

The current prescription fill rate for this medication through early December is already equivalent to the rate that is traditionally seen at the peak of the influenza season usually in later December and January. It is expected that the demand for this medication will continue to rise.

This increase in Tamiflu use is causing shortages in this medication, say experts.

This is a serious problem for young kids as Tamiflu is currently the only medication approved by the FDA for the treatment of influenza in children less than five years of age.

 

While antibiotics can’t treat a virus, they can help secondary bacterial infections that can develop after that initial illness.

This winter there are reports that common antibiotics, like amoxicillin, are in increased demand which has led to shortages of these vital medications, according to data from the FDA.

“Bacterial infections, such as ear infections and pneumonias, can occur during or after viral infections and given the large number of RSV and flu infections this season there is likely an increase in these secondary infections as well,” Antoon tells Healthline.

Experts stress that antibiotics should not be used to treat viruses since they will not help these conditions.

Patel reminds parents, “parents and caretakers should remember that the majority of upper respiratory infections are caused by viruses and resolve without the need for any antibiotics.”

 

 

Similarly, over-the-counter medications like Children’s Tylenol and Motrin are in short supply.

In a statement by Tylenol, company executives said they understand that consumer demand is high but they say they are doing everything they can to ensure that people have access to the products they need.

Understandably, parents worry about not being able to provide medication for their children, especially when they are sick. However, health experts say that parents should not be alarmed, and medications may be available with assistance from your healthcare provider.

 

One of the first things that parents can do to help their children is to get them tested if they have symptoms of the cold, flu or COVID-19.

Understanding if your child has influenza, RSV, COVID-19, or another virus can prevent you from needing prescription antibiotics to take care of an illness.

The unnecessary use of antibiotics not only leads to additional infections but can lead to antibiotic resistance as well.

Antoon encourages prevention as a way for avoiding the need for medications in the first place.

“The best way to protect your child from getting sick this winter season is prevention. Vaccination is the best way to prevent getting seriously ill from influenza and COVID. If your child hasn’t been vaccinated for flu or vaccinated and boosted for COVID, now is the time.”

There is no vaccine available for RSV.

 

Antoon says, “if the pharmacies in your area do not have the medicine, talk to your doctor about what alternative formulations, such as chewable or crushable tablets, or medications, such as second-line antibiotics, may be used.”

There are also remedies that parents can try that don’t include medications and may help relieve symptoms for sick kids.

While fevers should be controlled with anti-fever medications such as ibuprofen or acetaminophen, other symptoms can be treated with more natural remedies.

Using a humidifier or even steam from a shower can assist with nasal congestion. Some advocates recommend using warm therapy such as a bath to help with body aches, and thicker substance foods such as honey to help with sore throats.

Honey should not be given to any children under the age of 12 months.

 

 

Patel strongly advises against using smaller doses of adult medications on children.

“Parents should not try and give smaller adult doses or attempt to treat infections on their own with another antibiotic, a leftover supply, or a relative or friend’s antibiotic. Antibiotic misuse is, on its own, a widespread and dangerous problem that should be avoided,” he told Healthline.

Dr. Rajiv Bahl, is an emergency medicine physician, board member of the Florida College of Emergency Physicians, and health writer. You can find him at RajivBahlMD.com.

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Deadly fungal infections a concern in patients post-COVID-19, flu | CTV News – CTV News Calgary

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While fungi are not about to start turning the human race into zombies, like in the HBO blockbuster series The Last of Us, the World Health Organization (WHO) says invasive fungal infections are an increasing threat to human health.

Aspergillosis is one fungal infection common in our environment but, in some circumstances, it can turn deadly. In an average day, most of us will inhale hundreds to thousands of Aspergillus spores with no adverse effects, but for people with weakened immune systems it can cause deadly infections. That includes people undergoing cancer treatments, or bone marrow transplants, but it is now recognized that some viral infections, like influenza (flu) and SARS-CoV-2 (COVID-19) increase the risk of deadly fungal infection even in otherwise healthy people.

“When these kinds of things happen in the ICU, it can be devastating because even advanced medicines still can’t treat these infections,” said Dr. Bryan Yipp, an intensive care physician and researcher at the University of Calgary.

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“Once many of these infections really get ingrained and take over, clearing them with medications alone, antifungal or anti microbials, can be very difficult.”

Dr.Yipp began studying Aspergillus — a type of fungus that is a common mould — and its connection to viral infections in 2019, following three deaths in intensive care units of patients initially admitted for influenza, but who subsequently died of the fungal infection.

“It was very much a surprise when people first started identifying the fungus in the lung.  There was a lot of discussion around the table of ICU doctors, infectious disease doctors, asking ‘Was Aspergillosis really the cause of death, or was this just a secondary finding?'” said Yipp. “The pathologists who looked at the samples and the autopsies, were convinced that it was Aspergillosis that was the main problem.”

UCalgary researchers have determined exposure to Aspergillus, a common fungal mould, can lead to a potentially dangerous Aspergillosis infection in people with weakened immune systems.

Working in Yipp’s lab, lead researcher Nicole Sarden, a PhD candidate, isolated the mechanism by which the immune system starts failing to prevent fungal infections.

“In healthy humans. specific immune cells, called B cells, produce molecules (antibodies) that basically tag invaders so that other cells in the immune system, called neutrophils, can recognize them, eat them, and clear the infection,” said Sarden

“But when you have infections with viruses, such as influenza, or if you get COVID, these molecules are no longer present, which means that the immune systems that are trying to eat, and clear the fungi cannot do it because they cannot see it.”

Working with both mice and human blood and tissue samples, the researchers discovered that following a viral infection, neutrophils could identify a fungal infection and surround it but did nothing to destroy it.  

“The virus kills the B cells, no messenger molecules exist, so the neutrophils that would normally attack, the fungus, are blinded. They sit there and don’t know what to do,” said Sarden.

The research team also discovered that reintroducing Aspergillosis reactive antibodies can protect infected mice, leading to hopes a similar treatment will be available in the near future for humans with Aspergillosis infections.

While Yipp and Sarden focused on Aspergillus, it is not the only fungus that can cause serious, or fatal infections. It is estimated fungal infections kill an estimated 1.5 million people worldwide every year. Most of those are due to four different fungi; Cryptococcus, Candida, Aspergillus, and Pneumocystis.  Since the advent of COVID, a previously rare infection of the fungus Mucormycosis has been increasing rapidly in India. It affects the sinuses, brains and lungs of its victims. The rise in Mucormycosis has also been seen in patients who are recovering or have recently recovered from COVID.

Yipp is hopeful the research being conducted at Calgary’s Cumming School of Medicine could lead to treatments for these infections as well.

“We have some hunches that that could be a similar mechanism to what we see here with what we have found.” said Yipp. “So we think that this could be applied to multiple different types of fungi around the world.”

The research team, led by Sarden, published their findings in the journal Science Translational Medicine.

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Barrie hospital declares COVID outbreak in transitional care unit – BarrieToday

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Royal Victoria Regional Health Centre (RVH), in collaboration with the Simcoe Muskoka District Health Unit, declared a COVID-19 outbreak in the Barrie hospital’s transitional care unit on Friday, Jan. 27.

According to RVH, eight patients have tested positive for COVID-19 and have been isolated.

“Enhanced cleaning measures are underway, as well as swabbing of patients and staff,” RVH said in a news release Monday afternoon. 

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Admissions to the unit are on hold at this time, and visitors are not permitted. However, RVH says some exceptions may apply.

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Guidance for diagnosing and managing migraine – News-Medical.Net

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Migraine is a major cause of disability, affecting about 12% of people. A 2-part series published in CMAJ (Canadian Medical Association Journal) on diagnosing and managing the condition with both acute and preventive therapy provides guidance for clinicians. https://www.cmaj.ca/lookup/doi/10.1503/cmaj.211969.

“The goal of treatment of migraine attacks is to provide rapid relief from pain and other migraine-related symptoms, to restore patient function and to prevent recurrence,” writes Dr. Tommy Chan, Department of Clinical Neurological Sciences, Western University, London, Ontario, with coauthors.

“A stratified approach to treatment that empowers patients to choose from different options, depending on attack symptoms and severity, and encourages them to combine medications from different classes (e.g., nonsteroidal anti-inflammatory drugs and triptans) for severe or prolonged attacks, is preferred.”

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Part 2 of the review, which will be published February 6, focuses on preventive treatment to reduce the frequency and severity of migraine attacks.

Journal reference:

Tzankova, V., et al. (2023) Diagnosis and acute management of migraine. Canadian Medical Association Journal. doi.org/10.1503/cmaj.211969.

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