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What's Your Cold and Flu IQ?

child taking medication

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1. It's tough to tell whether your child has influenza or just a bad cold, but it's probably flu if...

A. she had a sore, scratchy throat a few days ago and now she has a drippy nose and a cough.
B. she's a mucus machine.
C. she was fine when you picked her up at school, but by dinner she had a fever, a bad headache, and was too wiped out to play.

2. Are you getting the flu vaccine?

A. Yes -- and so is your whole family.
B. You're skipping it because you got one last year.
C. You'll get it, but your kids won't. They're healthy and can fight off whatever's going around.

3. When should you call the doctor about a fever?

A. If your baby is under 3 months old and has a temperature higher than 100.4?F
B. If your child seems sicker about an hour after being given acetaminophen or ibuprofen (for babies older than 6 months)
C. If your child develops a gasping, wheezing, or whooping cough

4. You can tell when your child needs an antibiotic because...

A. her phlegm is clear and watery.
B. her phlegm is thick and more of a yellow-green shade.
C. it's been a week and she seems to be getting worse.

5. Your child has a runny nose and a bit of a cough but otherwise seems fine, and you really have to be at work today. You should...

A. send him to day care as long as he doesn't have a fever.
B. drop him off and pray the phone doesn't ring in the next hour.
C. keep him home.

6. Your 5-year-old's cough has been keeping her up every night. She desperately needs a good night's sleep -- and so does the rest of the family. That's why you're planning to...

A. give her half the dose of the OTC cough medicine that you give your 12-year-old.
B. rub her chest with Vicks VapoRub.
C. give her an antihistamine that'll make her drowsy. (Okay, so it's not the best thing to do, but it's only for one night -- and you're all starting to lose it.)

7. Your preschooler came home with a cold and promptly gave it to your 17-month-old. If you'd been smart, you would have:

A. strapped a mask on your preschooler as soon as he showed the first signs of sickness.
B. been more vigilant about making sure your older child didn't kiss or play with the baby.
C. sent your preschooler to stay with your child-free (and gracious) sister for a few days.

8. The best way to reduce the duration of flu or a cold is to...

A. ramp up the vitamin C.
B. look for natural herbal remedies such as echinacea, zinc, and oscillococcinum.
C. pack up and flee to the tropics for the winter.

Kid with thermometer

Image Source/Getty Images.

1. If you said C, you're a good flu-spotter.

Flu is like a high-octane cold," says pediatrician Harley A. Rotbart, M.D., a Parents advisor and author of Germ Proof Your Kids. Viruses that cause colds and flu can all produce a sore throat, a runny nose, fever, and a cough. But whereas a cold comes on gradually, flu hits harder and faster. "It's the sudden onset of fever, chills, and bone-deep fatigue, either before or after the congestion and cough, that usually signals flu," says Dr. Rotbart. "With flu, fever is often higher than with colds, and muscle aches are more common."

Spotting flu early helps avoid serious complications, such as bronchitis or pneumonia. If your child is older than 1, an antiviral medication, such as Tamiflu or Relenza, taken within 48 hours, may cut the duration and severity of the illness.

2. If you picked A, you're immune to vaccine confusion.

Each year, the flu virus morphs into something new. That's why the American Academy of Pediatrics (AAP) recommends that all children 6 months to 19 years receive the influenza vaccine annually. Yet less than half of kids in this age group have been vaccinated during the last two flu seasons, according to the Centers for Disease Control and Prevention (CDC). Fifty-five percent of adults didn't get the shot last year, either. One reason for all of the shot-skippers: Only 30 percent are "very confident" that it's safe.

This makes little sense to physicians and public-health officials. They say there's no need to worry about the minute amount of thimerosal, a mercury-based preservative used in bulk production of multi-dose vials of the vaccine, despite false claims that it can trigger problems including autism. (Most kids get single-dose shots anyway.) The vaccine is grown in chicken eggs, but the CDC recently said the shot is even safe for those who have egg allergies -- though you should always get your doctor's okay first.

The injected vaccine contains three inactive influenza viruses that guard against the most common strains of flu scientists believe will strike each year. "Some people get the flu even though they get vaccinated, but it's not from the shot," says Susan Rehm, M.D., vice chair of the department of infectious diseases at the Cleveland Clinic, in Ohio. "A dead virus can't make you sick. But flu shots are given around the same time many other respiratory viruses circulate, so people who get sick may mistakenly blame the vaccine."

Everyone who is eligible should get vaccinated -- especially pregnant women; adults over 65; those with asthma, cancer, diabetes, or other illnesses that weaken the immune system. So should teachers, day-care workers, and anyone who regularly comes in contact with kids. The vaccine is not approved for children under 6 months (babies who get the flu are hospitalized since the risk of serious complications is high), but infants may be protected if their mom got vaccinated during pregnancy. Children 6 months to 2 years old should have the traditional shot; kids 2 and older can get either the shot or Flumist nasal spray. Healthy adults under 50 can get the traditional shot, Flumist, or Fluzone Intradermal vaccine, in which a very fine needle is inserted only a few millimeters into the skin, not into muscle. Certain groups cannot get the nasal spray, such as kids with asthma and any child under 5 years with a history of recurrent wheezing, so discuss your options with your doctor.

3. Did we trick you on this one? The correct answers are A, B, and C.

"I get more calls about fever than about anything else," says Dr. Rotbart. A healthy baby has a normal body temperature (taken rectally) between 97? and 100.4?F. Call your doctor if your infant falls above or below that range.

"Fever is a sign of infection, but don't let the number on the thermometer scare you," adds Parents advisor Jane Morton, M.D., clinical professor of pediatrics at Stanford University School of Medicine, in Palo Alto, California. "Some of the most benign viruses, like roseola, are associated with fever as high as 104?F, while some serious ones, such as meningitis, might only cause a fever of 102?F." So pay closer attention to your child than to the temperature.

If your child seems truly miserable, it's fine to give a weight-appropriate dose of acetaminophen, or ibuprofen for babies older than 6 months -- but never aspirin or baby aspirin, which has been linked to Reye's syndrome, a serious brain and liver disease. If he has a mild virus, he'll look and feel better until the med wears off. If he doesn't, call the doctor. Temperature is usually lower in the morning and higher later on. So if your child looks worse at the end of the day, it doesn't always mean he's getting worse. Make him more comfortable by giving a lukewarm bath and then dressing him in light layers.

4. None of them are right. Don't be fooled by phlegm!

"The color or thickness of mucus has no bearing on how sick a person is or whether she needs medication," says Dr. Morton. But if a cough, postnasal drip, or excessive nasal discharge lingers for more than two weeks, your child may have developed a sinus or an ear infection. A dry cough that turns wet could signal pneumonia. In those cases, antibiotics may be needed, although pneumonia is frequently viral and clears up on its own. (Antibiotics have zero effect on the common cold or flu.)

5. If you picked A, you're right.

If you keep a child home every time he has a mild cold, it could be years before he leaves the house. But figuring out whether a kid is contagious isn't as simple as you might think, doctors say. "Children (and adults) are most contagious a few days before getting sick and a few days after," says Timothy R. Shope, M.D., M.P.H., a pediatrician at the Children's Hospital of Pittsburgh. "By the time a child's nose is running, the cat's already out of the bag."

So what to do? Keep your child home if he's feverish and miserable, or if caring for him would be too much for your child-care provider on top of her other charges. "But if he seems well enough to join in daily activities, send him," says Dr. Shope.

6. Did you pick B? There's the rub!

Oral OTC cough medicines don't really work in young kids and can have side effects, research has found. What's more, combination cough and cold products make it easier to unwittingly overdose a child (or yourself). And antihistamines could have the unintended effect of making a child hyperactive instead of drowsy.

Truth is, coughing is a protective mechanism that keeps secretions from draining into the lower part of the respiratory tract. There's no reason to suppress it unless it's interfering with your child's sleep, she says. (Your sleep shouldn't factor into it -- sorry!) To get a child 1 year or older through the night, try a mentholated chest rub like Vicks. The combination of menthol, camphor, and other ingredients may warm the area and boost circulation, soothing a cough. Honey is another option. Give 1/2 teaspoon to kids 2 to 5 years old to coat the throat and soothe a cough; give 1 teaspoon to 6- to 11-year-olds. (Never give honey to a child under 1 because of the risk of infant botulism.)

Doctors also recommend a single-ingredient pain reliever -- in this case, ibuprofen (give only acetaminophen to babies under 6 months). Neither directly affects a cough, but often it's the achiness associated with a viral infection that keeps kids up at night, Dr. Morton explains. Ibuprofen has an anti- inflammatory effect that eases aches and pains so a child may sleep better; acetaminophen also eases pains, though the relief only lasts for about four hours, compared to ibuprofen's six. However, it comes in suppository form for a child who can't or won't take meds orally or is vomiting.

See your doctor if the cough drags on for more than a couple of weeks. It could signal an allergy, asthma, or a secondary bacterial infection such as pneumonia or an ear infection.

7. If you answered B, you're right

If someone in the family gets a cold or flu, it's hard, but not impossible, to prevent others from catching it, Dr. Rotbart says: "You don't need to compulsively fumigate your home or insist that your child wear a mask, but it's smart to set up a gentle quarantine and ramp up your disinfecting routine."

Remind your preschooler not to kiss his younger brother or touch his hands or face. Keep his toothbrush, towels, and linens separate from those of the rest of the family. Use paper cups in the bathroom. Disinfect anything little fingers might have touched, including crib rails, faucets, and doorknobs. And station alcohol-based hand sanitizers around the house (but out of reach of young kids) and keep one in your car.

One area where it does make sense to be compulsive is hand-washing. "It's the single most important step you can take to prevent infection," says Dr. Rotbart. According to a CDC study, there's no evidence that antibacterial soaps work any better than plain soap and water.

8. If you picked A, you know your C.

"Vitamin C can somewhat lessen the number of days you feel sick, as well as how bad you feel," says Dr. Rotbart. "But there's no evidence that taking mega-doses of vitamin C will reduce the number of colds you get." Your best bet: Take the recommended daily allowance for vitamin C from foods. If anyone in your home gets sick, supplement with 200mg per day for kids over age 5 and 500mg daily for you.

While many people swear by alternative remedies, the AAP says there have not been enough rigorous studies to prove that they're safe or effective. "Just because something is natural doesn't make it safe," says Dr. Morton. In fact, a zinc nasal spray has been implicated in a permanent loss of smell and taste in adults. If you do plan to try an herbal remedy, first check with a pharmacist or a physician specializing in complementary medicine.

And if you picked C, you have the right idea: Flu rates have been shown to be lower in warmer climates. Alas, most of us don't have that option.

If she's 4 or older, find out whether your child has a clue about cold and flu with this True/False mini-quiz.

1. When you sneeze or cough, you should always cover your mouth with your hand.
False. Colds are spread by tiny droplets that get on your hand and then on whatever you touch. They may be "alive" even six hours later. It's rare that germs float through the air to infect someone. So cough into a tissue (and throw it away pronto), the crook of your elbow, or your shoulder.

2. Washing hands is important, but it's okay to skip the drying part.
Nope! Germs are more easily spread from one person to another if your hands are wet. So, even though you scrubbed with soap, be sure to dry your hands thoroughly!

3. When I tell you to wear a hat and boots if it's cold outside, you don't really have to because all parents say stuff like that.
Not so. If your body is chilled, it may not be strong enough to fight off a cold or flu bug. Wearing a hat, warm coat, and even boots can keep you healthier.

4. It's okay to take a little sip from my friend's water bottle even if she has a cold.
Not so fast... Sharing is important, but not when it comes to colds. If a friend is sick, don't drink from her water bottle or straw and don't share forks, spoons, or towels.

Originally published in the October 2012 issue of Parents magazine.