September Newsletter

 Flu Season: Section written by Dr. Ashley Cox, MD. As we enter fall, the upcoming flu season is on the horizon. With most people returning to in-person school and work, and with what we experienced with respiratory viruses this summer, we may have a more typical flu season this year as compared to last winter. For the 2021-2022 flu season, the American Academy of Pediatrics (AAP) recommends a flu vaccine for all children aged 6 months and older. “Influenza vaccination is particularly important to protect vulnerable populations and reduce the burden of respiratory illnesses during circulation of SARS-CoV2.” The AAP is also recommending that all flu vaccines ideally be given before the end of October. For children under the age of 9 years who are receiving the flu vaccine for the first time or who have only ever had one dose prior to July 2021, a series of 2 doses given 4 weeks apart will be needed. Ideally all doses would be completed by the end of October. All influenza vaccines this year are quadrivalent, meaning they help protect against 2 strains of influenza A and 2 strains of influenza B. The 2 strains of influenza A in the 2021-2022 flu vaccine are different from the 2020-2021 vaccine. This means that even if your child received last season’s flu vaccine in spring of 2021, we do recommend getting this season’s flu vaccine this fall. The AAP also states that children with egg allergy can receive the flu vaccine without any additional precautions beyond those recommended for all vaccines. Families can schedule flu shots with Beansprout Pediatrics using the link below. Section 2: What are we seeing in our community right now? The following are some illnesses we are seeing this season. Rhinovirus ("Common Cold") Parainfluenza viruses (Croup viruses) RSV COVID-19 Stomach Viruses Hand Foot Mouth Virus Strep Throat Environmental Allergies- Ragweed, Tree Pollen, Grass Pollen, Mold Section 3: What to do if exposed to Covid? Adapted from Cook Children's Checkup Newsroom, August 31, 2021. By Diane Arnaout, M.D. What does the CDC consider a “direct or close” exposure to COVID-19? Being within 6 ft of someone infected for more than 15 minutes. The CDC does not consider it a “close exposure” in a classroom if both children are masked and more than 3 feet apart. What should I do if my child is directly exposed to COVID-19? Keep your child home for 10-14 days after exposure to the positive person. Make sure your child wears a mask in any indoor setting for 14 days, if over age 2. Incubation period can be up to 14 days– but if you get to day 10 and there are no symptoms, most of the time it is OK to end quarantine. Sometimes a negative test on Days 5-7 will allow return to school on Day 7 of quarantine if no symptoms appear. What if my child has been vaccinated and then exposed? Do they have to quarantine? Nope. If they are symptom-free, they do not have to quarantine. The CDC reccomends a COVID-19 test 3-5 days after exposure Your child should wear a mask indoors for a minimum of 14 days after the exposure, even if vaccinated. What should I do if someone in my house tests positive for COVID-19? Try to keep the individual who tested positive in their room as much as possible and have them use their own bathroom. If they are older than 2 years old, have them wear a mask in shared spaces. Do not share towels, cups, utensils or bathroom supplies. Wash your hands a lot. What if my kid has symptoms, but I don’t know of any positive contacts. What do I do? Typically if a child is showing symptoms of COVID-19 (which can look like a whole lot of other viruses and seasonal allergies), and they have no known exposures, Beansprout still recommends COVID testing. If it is negative, they can go back to school as long as fever-free for 24 hours and symptoms are improving. What if someone in my home tests positive for COVID? Can my child go to school? If your child is VACCINATED and has no symptoms, yes. Get a COVID test 3-5 days after the last close exposure to that person. Regardless of vaccine status, have the child wear a mask in indoor spaces for at least 14 days If unvaccinated, they need to quarantine for 10 days after their last exposure to that person. If the person with COVID cannot isolate (say a parent who must help with childcare), the child must quarantine for 24 days (14 days they could potentially catch it, and 10 days to become non-infectious if they do have it). Again, these times could be shortened with negative testing and no symptoms, as discussed above. Recommend COVID testing 5-7 days post exposure or at any time if COVID like symptoms develop. My child has been in close contact with someone who was positive for COVID, and is starting to show symptoms. What do I do? Don’t panic. Most of the time, COVID-19 is mild in children. Get your child a test for COVID. If the test is negative, consider another test in 24-48 hours (or if it was a rapid, consider a PCR). The child must isolate at home for at least 14 days from exposure. Have the child mask indoors for at least 10 days, if over age 2. My child tested positive for COVID-19, but has no symptoms. What do we do? Your child is infected and needs to be in isolation from others even though they don't have any symptoms. You may end your child’s isolation if 10 days pass after the positive test with no symptoms. If over age 2, have them mask in indoor spaces for at least 10 days. Section 4: Return to Sports After Covid-19. Return to play exam/clearance can be provided by Beansprout providers following mild cases of COVID. Growing evidence suggests a possibility for long term health effects following an infection with SARS-CoV-2. To help keep our patients safe, the following guidelines for sports clearance have been adapted from the American Academy of Pediatrics. The following is a flow chart of information regarding symptom severity and how to proceed with each level. Symptom severity. Asymptomatic or mildly symptomatic (Fewer than 4 days of fever, short duration of myalgia/chills/lethargy). Does your child have normal exam results & have no complicated medical history? If yes- 7 day gradual return to play if 10 days have passed from positive test and symptom free x 24 hrs. If no- Child will need to receive an ECG and cardiology referral before return to play. Moderately symptomatic (4 or more days of fever; myalgia, chills or lethargy; non-ICU hospital stay and no evidence of MIS-C. Children with moderately severe symptoms will need to receive an ECG and may need to receive clearance by a cardiologist. Severely symptomatic (ICU stay and/or intubation) OR MIS-C. Children with severe symptoms will need exercise restriction for 3-6 months and child will need to receive clearance by a cardiologist.