Flu Can Be Serious for Children with Asthma

Announcer
MemorialCare health system Excellence in Health Care presents weekly dose of wellness. Here's your host, Deborah Howell.

Deborah Howell
Welcome to the show, I am Deborah Howell, and today we'll be talking about asthma and the flu. Our guest today is Dr. Jen Jen Chen, a pediatric pulmonologist at Miller Children's and Women's Hospital in Long Beach. Welcome, Dr. Chen.

Jen Jen Chen, M.D.
Hi, Deborah. Thank you for having me.

Deborah Howell
Thank you for being on the show. So asthma triggers often are harmless to most people, but certain substances, like weather conditions or even other diseases like the flu can make life very, very difficult for a child with asthma. What can happen when a child with asthma gets a cold or the flu?

Jen Jen Chen, M.D.
So, I mean, when you and I have the flu, it kicks us probably pretty hard. And so you can imagine when a child, especially if a small child gets the flu on top of asthma. What asthma does. And this is just anecdotally to go into the little metaphor because my mom told me when I cook a patient report oil down the drain, right? Because it closed the pipe makes it sicker. And essentially, that's what happens when you get a cold or flu. Imagine your pipes as the airways. And so when you have an infection, any kind of respiratory infection, your airways will get sicker. So that's that coating. And on top of that, if you have an underlying asthma, what asthma is is very sensitive airways. It is a lot of inflammation, so very thick airways, you start off with sick the airways. And on top of that, you get more thicker airways because of the inflammation and at some point the air. It's very difficult for the air to get in and out of your lungs. And so that's that's what happens when a kid with asthma gets a cold or flu. On top of that.

Deborah Howell
Wow, that sounds tough. All right now, how can a cold or flu trigger an asthma attack?

Jen Jen Chen, M.D.
Well, it really has to do with your immune system, and I don't want to get in the nuts and bolts of it . But basically what happens is when you get a virus, usually a virus, respiratory infection, that virus will trigger a certain type of immune system, and it will release certain chemicals, so to speak, that will actually trigger an asthma attack. And so for an asthma attack, that's when your airways will, as I mentioned, become more inflamed. But on top of that, it can cause what we call bronchospasm, which are when your airways will shrink because they're so reactive. And so that leaves a child to have coughing, wheezing or complain they can't get air in very much.

Deborah Howell
Mm-Hmm. And what are some of the serious complications the flu can cause for kids with asthma and other respiratory conditions?

Jen Jen Chen, M.D.
Oh, here they actually just got off of being in the hospital and on it. It can hit very quickly and very hard. And I think the rapidness of how quickly this can escalate is probably the most worrisome part because when you're talking about a child and how small their airways are, they don't have a large caliber to work with. And on top of that, do you have the asthma that a child has? And when the diameter of your airways, it's small enough that the air can start getting out. It's pretty much like if you were taking a straw and putting it in your mouth and breathing in and out with a straw. And you can imagine that the complications can make anywhere from having an overlying pneumonia because of just a simple cold or flu to, you know, being in the ICU. And the reason for having more infection, like on top of the virus that have some kind of bacterial infection like a pneumonia is because when you have asthma, you have a cold, you have a lot of mucus in there like everybody knows, but that means its saved. And it's trapped by those smaller airways and it doesn't go anywhere. Usually, when we have a cold, we can cough it up pretty easily because you have a larger lungs than your average child. So what happens is when you have asthma, everything is trapped up in there. The musus is a perfect situation for bacteria to overpopulate and then and then you start getting pneumonia. And then with that, all the complications ad up to the point where you can end up in the ICU.

Deborah Howell
So terrible, so terrible. So let's talk about some of the ways that families can help prevent the flu.

Jen Jen Chen, M.D.
And a lot of it really is sort of the common sense that I know a lot of parents really know about their washing hands, things like that. But the most important thing I don't know about the flu is that it is transmitted by droplets in the air. So I suggest parents want to go out and take a look at that video where you look at someone who's coughing and see how far the droplets can spread. It's a little scary. It's quite a few feet, actually, so that the sneezing, the coughing that can all spread the flu so preventively, if you do have cold symptoms, it's great to wear masks and then vice versa. Hand-washing, just staying away from people who are coughing. And teaching kids about that would be the best.

Deborah Howell
OK, and who actually should get a flu vaccination.

Jen Jen Chen, M.D.
The flu vaccination should really be received by everyone unless your doctor specifically otherwise says so based on your medical history. And there are certain types of flu vaccinations that are appropriate for those who have asthma and those who don't. For instance, we have a flu vaccination that injected, which is kind of the dead virus just to boost your immune system. And that's what kids with asthma should be getting. And then as opposed to the nasal administration of the flu virus, and that's just as same flu vaccine. But that's not going to cater for kids with asthma.

Deborah Howell
Got it. And what should parents do if their child with asthma catches the flu?

Jen Jen Chen, M.D.
I would ask if you had a fair shot at asthma and you and he or she got the flu. I would just give a quick call the doctor, just to let them know about the symptoms. Only because it can spiral so quickly and within a day or two, it could potentially get much worse. It's often difficult to find a doctor at night, and it's just too good to give your doctor a heads up that you know this is happening. And then on top of that, a lot of kids with asthma have something called albuterol, which is also known as a rescue inhaler. And if they do have albuterol on hand, I would start giving it earlier rather than later. It's really hard to play catch up when you're dealing with the flu and asthma. So if you give it earlier, it can kind of nip it in the bud, at least to prevent those bronchial spasms that, as I was talking about earlier,

Deborah Howell
I think that's just such a great idea to just call your doctor, give them a heads up because you're your kid is so sick and you don't know whether to transport them to the doctor and if that will make them worse. And you know, you just constantly second guessing,

Jen Jen Chen, M.D.
Right, its scarry. It's really scary when they when they have a flu and asthma and when it goes so quickly, at least your doctor can help you out. You know, you just don't want to deal with it at like 3:00 a.m. Yeah. Like, it always happens with kids.

Deborah Howell
That's always the thing. And I'm wondering, how can parents determine when it's time to call their child's doctor?

Jen Jen Chen, M.D.
Any time you're worried, I think parents have the best radar. Honestly, they know their kids the best. They have their gut instinct and any time that starts worrying otherwise, specifically, when your child has problems breathing in terms, it can be anything. Kids are different, so some kids will say, I can't, its like an elephant sitting on my chest, or some kids will say that I will be coughing throughout the night and they'll be struggling to breathe. I mean, at that point, it's it's definitely you should call your doctor, but again, call your doctor early. There's no problem with that. That's what we're here for.

Deborah Howell
Great. And is the cough. Does it sound different when the flu is involved?

Jen Jen Chen, M.D.
That is a really good question. So when the when first of all, there's not actually so much of a cough, you find more of cough, stuffy nose in a cold and flu, it's just they get hit hard in terms of you get tired. Very tired. Very fatigued. A lot of body aches. Very high fevers. The coughing can be an issue, especially they have asthma, but it's not that congested coughing that you see with cold.

Deborah Howell
OK, got it. And Dr. Chen working families go to find out more information about asthma management at treatment at Miller Children's.

Jen Jen Chen, M.D.
I think the best place to start would be our website because it really has a lot of information and contacts and resources. And that's at www.millerchildrenshospitallb.org, and then slash pulmonary.

Deborah Howell
Sounds good. And any final thoughts before we wrap up today?

Jen Jen Chen, M.D.
No, just take care of your kids, take care of yourselves and have a very healthy 2017

Deborah Howell
and get your vaccination right?

Jen Jen Chen, M.D.
Get your vaccination, Yes.

Deborah Howell
Well, thank you so much, Dr. Chen, for your time today. We really do appreciate you being on the show.

Jen Jen Chen, M.D.
Thanks for having me.

Deborah Howell
For information or to listen to a podcast of this show, please go to MemorialCare.org. That's MemorialCare.org. And that is all for this time. I am Deborah Howell. Thank you so much for listening and have yourself a terrific day and sleep well tonight.