Four-year-old Xiao Min attends kindergarten with 20 students in her class. She has been suffering from high fever, cough, runny nose and a sore throat for the past four days.

She has been absent from school for three days. She was brought to see a doctor twice.

The first time was on day one of her fever. She was prescribed medicine for her fever and charged RM50.

After two days of illness, the fever didn’t seem to subside and she remained weak. She only drank minimally and was less active than usual.

She was then brought to see a second doctor. This time she was given an antibiotic and other medicine for her cough, runny nose and sore throat.

This cost RM80. Her mother, who earns RM100 a day, had to take unpaid leave to take care of her.

Despite the medications, Xiao Min didn’t show any improvement.

Finally, she was brought to the hospital where she did a nasal swab rapid test. She was tested positive for Influenza B (the test cost RM220).

In view of her poor oral intake, she was warded for further treatment. She was finally discharged on day seven, by which time the total hospital bill had amounted to RM3,500.

Upon discharge, she was advised to be quarantined at home for another three days.

Her mother had to take another few days off to take care of her.

Worse still, her one-year-old younger brother started to have fever and cough. Her mother was scared that the nightmare would happen again.

influenza

Children with a common cold might just have low-grade fever and a runny nose, but still remain active. Photo: TNS

Message behind the scenario

Although this is not a real scenario, the message I want to impart is the burden of a disease to a family.

Recently, there has been an increasing number of respiratory virus-related illnesses, including influenza A and influenza B. I would like to share some information on influenza.

Generally, it is very difficult to differentiate between a common cold and the flu (influenza) without laboratory tests.

I will suspect a child to have influenza if she has a very high fever, sore throat, bad cough, symptoms of dehydration and lethargy.

Children with a common cold might just have low-grade fever and a runny nose, but still remain active.

Influenza viruses spread via droplets; when a patient coughs and sneezes, the droplets can travel a few meters and transmit the viruses to other people.

Hence, personal hygiene is important in order to contain the disease. Those with influenza-like illnesses (fever, cough, runny nose and sore throat) should wear a mask or rest at home.

Prevention is better than cure

There are a few types of influenza vaccines available on the market. The vaccine can be given to infants as young as six months old.

Those who are from the high risk group – young children, elderly, medical staff or those with underlying diseases such as asthma, heart diseases or other comorbidities – are advised to take the vaccine.

The influenza vaccine should be given on a yearly basis.

For those who are confirmed to have influenza, the doctor will usually prescribe a course of antiviral medication.

The treatment is most effective if it starts before 48 to 72 hours of the illness.

The current available test includes a nasal swab rapid test, but the specificity is up to 70% only, which means 30% can still be missed despite this fast and cheap test.

Other tests include nasal pharyngeal aspirate PCR test (accuracy up to 99%), which is very expensive.

Some doctors may offer those in close contact with influenza patients a course of antivirals, which we call prophylaxis (preventive treatment).

In conclusion, influenza can have a big negative impact on the family, society, and even country.

Maintain good personal hygiene habits, and getting vaccinated annually may be a good idea, especially for those in the high risk group.


Dr Lee Kok Fung is a consultant paediatrician. This article is courtesy of Columbia Asia Seremban. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.