The flu and COVID-19 are affecting children. How can we protect the little ones?

The close contact between children in preschools and schools, combined with the fall and winter seasons, contributes to the spread of bacterial and viral upper respiratory tract infections—including the flu—as well as pneumococcal infections. It also turns out that in Europe and the U.S., the rising number of coronavirus infections among the youngest children is becoming an increasingly serious problem. How can you protect your child from getting sick, especially after returning to in-person learning?

The World Health Organization estimates that 5–15% of the population gets the flu each year. The flu virus is most commonly spread by children, and it is the youngest children (ages 5–9) who most frequently contract the disease. At the same time, coronavirus infections among children are causing growing concern. This is due to the Delta variant, which is highly contagious, contributes to a higher number of hospitalizations, and more frequently causes post-COVID syndrome (PIMS—pediatric inflammatory multisystem syndrome), which is even associated with severe lung damage. Will we face a simultaneous flu epidemic and coronavirus pandemic among the youngest?

5 million children who could become infected

To date, 1.4 million SARS-CoV-2 vaccinations have been administered in the 12–17 age group, meaning that a maximum of 0.7 million children and adolescents have received two doses. This represents less than 32% of the age group, which totals 2.2 million people. There are nearly 3.6 million children aged 3–11 in Poland—that is, those who, according to the recommendations of the European Medicines Agency (EMA), are not vaccinated against COVID-19. In total, this amounts to a group of over 5 million unvaccinated children, constituting a sort of reservoir for the SARS-CoV-2 virus.

At the same time, children are one of the most mobile social groups—in schools and preschools, they come into contact with many peers, and later they return home and visit their grandparents. The SARS-CoV-2 virus therefore has considerable scope for transmission precisely because of the youngest members of society. In this way, it can affect children and adolescents as well as their unvaccinated parents and grandparents. But will we only encounter the coronavirus this season?

Will the flu strike this season?

The first flu pandemic likely broke out in 1580, and until recently, the disease was referred to as “the last uncontrolled plague of humanity”4. The flu virus itself changes over time—it mutates, which means that each season brings new variants of the disease that differ from previous ones. Although people of all ages get the flu, in recent years a particularly high incidence rate has been recorded among children—according to the WHO, it reached as high as 20–30%. According to data from the National Influenza Control Program in Poland, as many as 45% of all infections are recorded among children under 14 years of age. The fall-winter season also favors other bacterial and viral upper respiratory tract infections among the youngest.

Infection with the influenza virus occurs through droplets—when a child sneezes, they release the virus into the air, infecting others. The virus can also settle on surfaces, such as toys in preschools, school desks, supplies, or doorknobs to classrooms and restrooms, and then—when a child touches an infected surface and the area around their mouth, nose, or eyes—enter the body. It doesn’t take much for a young child—who is in contact with peers and public spaces in kindergarten or school—to catch the flu, for example. This is especially true since some children are asymptomatic and can infect others during this time—it is estimated that they remain contagious for up to about 10 days (unlike adults, who are contagious for five days). The course of the illness in a child is difficult to predict—some children are asymptomatic, while others develop pneumonia as a result of the flu.

Last year, however, the National Institute of Public Health observed a positive downward trend—the incidence of the flu in Poland across all age groups decreased by nearly 34% compared to 2019. From January 1 to December 31, 2020, 3,164,446 Poles contracted the flu, while 4,790,033 cases were recorded during the same period in 2019. Whether this downward trend in cases will continue—including among the youngest—depends largely on us. What can we do?

Your Child’s Safety ABCs

One of the most effective methods for preventing the spread of viruses—including both the coronavirus and the flu virus—is vaccination. Flu vaccinations should be repeated every season due to the emergence of new virus variants. As indicated by specialists from the National Influenza Control Program, vaccinating children contributes to a 84% reduction in the occurrence of flu-like symptoms and indirectly protects members of other age groups as well. When it comes to the coronavirus, however, the vaccine’s effectiveness in the 12–15 age group and among those aged 16 and older is very high, reaching as much as 97% six months after vaccination. The more people who are vaccinated, the safer those who, for various reasons, cannot receive the vaccine—including children aged 3–11—become.

In addition to vaccinations, we should not forget about other preventive measures. As epidemiologists point out, last year it was precisely social distancing and the practice of hygiene—handwashing and hand sanitizing—that contributed to the reduction in the incidence of the flu and other infectious diseases. These measures are what break the chain of transmission of pathogens from one person to another. We also have the example of Israel, where, after a significant portion of the population was vaccinated, adherence to sanitary rules was enforced to a lesser extent. The number of cases then began to skyrocket, and outbreaks occurred, including one at a school where a student who had previously been in contact with a person infected with COVID-19 subsequently infected 20 other children.

Let’s explain to our child in simple terms how important it is to follow hygiene rules in the context of the spread of germs that can cause illness. Covering the mouth and nose with the inside of the elbow when sneezing, avoiding touching the mouth, nose, and eyes with your hands, and washing and disinfecting your hands are the basic methods for preventing infectious diseases.

Removing transient microflora from the hands with soap is the simplest way to stay healthy if a child has access to running water. Before eating, after playing, or after using the restroom—these are just a few examples of situations in which our little ones should reach for soap. For toddlers who can’t focus on a task for very long, foam soap works well—it’s easier to use than traditional bar or liquid soap and has a pleasant texture. The foam rinses off the hands much more easily than other types of soap, making the handwashing process quicker. It’s a good idea to show your child how to wash their hands to remove dangerous germs.

When a child cannot wash their hands, such as before eating outdoors or while commuting to school on public transportation, we should provide them with an effective and safe hand sanitizer and explain how to use it (apply directly to the hands to avoid getting it in the eyes) and how to spread it (don’t skip the spaces between the fingers and the thumb). For children, disinfectant wipes work well in addition to sprays, as they are easier to use. The key here is to choose high-quality products that are not only effective but also safe for children’s skin. Selecting a good sanitizer is made easier by a few simple guidelines found on the packaging of sanitizing products. It is important to ensure that the label of the selected sanitizing product includes: the marketing authorization number issued by the Office for Registration of Biocidal Products, Medical Devices, and Medicinal Products; the ingredients; information on which microorganisms the product is effective against; and instructions for use — that is, information on how much liquid to use and for how long to effectively disinfect your hands, e.g., rub 6 ml of liquid in for 30 seconds.

What products should you avoid? If you see the word “antibacterial” on the packaging, a red flag should go up. Such products are usually cosmetics that have not been tested for effectiveness and do not demonstrate virucidal activity. They also lack proven data on the time or amount of product needed to inactivate disease-causing pathogens. Another clue is a strong alcohol smell—besides being off-putting to young children, it also indicates an underdeveloped product formulation, which can negatively affect a child’s skin. Meanwhile, medical-grade disinfectants are made with high-quality alcohol. They also undergo dermatological testing—which is how we know they are safe for the skin and do not cause allergies, skin irritation, or dryness, thanks to the inclusion of skin-care ingredients in their formulation.

For more information on infection prevention, visit www.medisept.pl