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Flu or Flu-like illness in chronically ill or disabled children

Recovery from flu or flu-like illness

Recovering from flu or flu-like illness can take longer for a child with a long term medical condition or disability. Many of the parents we spoke to said that their child took longer to recover after having flu or flu-like illness, and in some cases the symptoms or treatment of their long term medical condition or disability also changed and took time to adjust back to normal. 

A couple of weeks to recover from flu or flu-like illness was common. Parents noticed that even if their child took less than two weeks to recover their brothers and sisters would be better more quickly.
 

Logan has complex needs and it took him two weeks to fully recover from flu-like illness and be back to his old self.

Logan has complex needs and it took him two weeks to fully recover from flu-like illness and be back to his old self.

Age at interview: 25
Sex: Female
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So how long does it take for, sort of when he, after he has had the flu for him to, for the symptoms to settle down, for him to become sort of

Back to normal?

Back to normal again.

I’d say normally a week to two weeks the whole thing lasts and then we get back to our normal routine. I think they normally last about a week in terms of sickness and things like that. After that it’s a case of him gradually eating a little bit more, him wanting to drink a little bit more, him wanting to do things and being his happy self again. Stop being as grizzly as he was, that kind of thing. But I’d say two weeks for him to fully recover, get back to his old self and be laughing and running around like a crazy fool.
 

Her two year old daughter’s blood sugars are high when she has flu-like illness and she can be ill for two weeks.

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Her two year old daughter’s blood sugars are high when she has flu-like illness and she can be ill for two weeks.

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The sort of issues to do with that, with the diabetes are obviously that you’re battling the normal virus but on top of that you’re, you desperately know that she can’t battle it if her blood sugars are high, and so that if her blood sugars are high that’s making her feel ill on top of the illness being ill, because she’s doubly ill. And yes she always takes a long time to get over it.

Right. How long would you say?

I would say a couple of weeks.

Whereas we’d be, it might be something that we’ve both had and it would give, it would be a, we’d have it for three days or whatever,

Yes

And obviously then sort of her have it for a week, I mean I know a lot, that it can be two weeks but I’d say that she can actually be pretty rough for two weeks.
 

Amy has chronic lung disease. She didn’t have complications from the flu-like illness but it takes her longer to recover from illness than her siblings

Amy has chronic lung disease. She didn’t have complications from the flu-like illness but it takes her longer to recover from illness than her siblings

Age at interview: 45
Sex: Female
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But any complication from the flu?

No, just probably took her longer to get over things than sort of one of the healthy children. You’d notice more. She’d sleep a lot longer. Whereas if the others ever got it, they’d be up and running around within a couple of days, whereas Amy, it might take a week or something like that. 

And how long it took from the moment that she was taken into hospital and she went through all that and then you brought him, you brought her home, with kind of many, load of puffs every four hours to go back to, let’s say, normal. 

Probably about a week. So, obviously they gradually, even though she should be on high amount of puffs with stretches, or it would be six hourly until eventually she was down to hardly using it. But I suppose from start to finish, on average it was about a week. 
El and Arthur were very tired and weak for a while. Building up their immune system again took some children longer after flu or flu-like illness. Lyndey noticed that her children had more frequent illness episodes after flu or flu-like illness because they were run down and their immune system was low. Alfie has leukaemia and after he had flu or flu-like illness he had a cough that lasted for a month afterwards.
 

El has asthma and she was very tired and weak for a long time after having flu-like illness.

El has asthma and she was very tired and weak for a long time after having flu-like illness.

Age at interview: 44
Sex: Female
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So on a typical kind of flu episode how long does it take for her to get sort of better, up and running again,

In comparison with other children that don’t have it she does take a lot longer and she seems to be, she seems to be a little lot, much worse affected as well, you know. She seems to take longer to recover and be worse and then have periods of time when she might be ok and appear to bounce back and they’ll sort of, like a typical flu up and down, a bit up and down where she’ll be quite flat for a lot of the time. Yeah.

So roughly one week, two weeks?

I’d say at least two weeks really because I think unwell for a week, a full week but then afterwards really under the weather still. You know, very, very low on energy, still coughing a lot, struggling with appetite, you know, that sort of thing. Just taking a long time to bounce back really. 
Some children had no longer term effects from having flu or flu-like illness.

Clare said it took Eliza, age 11, no longer than anyone else to recover from flu-like illness. Adam’s son has skeletal dysplasia. He took longer to recover when he was aged three or four than he does now, he is seven, and he usually recovers from flu or flu-like illness in a week.
 

Judith who is 12 years old ‘bounced’ back within two weeks and had no longer term effects from flu-like illness.

Judith who is 12 years old ‘bounced’ back within two weeks and had no longer term effects from flu-like illness.

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Six, six days where she was definitely feverish.

And just -

And, and then the other symptoms of increasing and decreasing severity at either side of that-

Okay.

-taking it up to about two weeks.

She - yeah, as I say, she's generally speaking very healthy, very strong. So we, we haven't seen really ear infections or long term infections following on from the flu. It is the illness, and then she's a bit convalescent with - quite grumpy and not herself for a while. Once she rests, she tends to bounce back within two weeks afterwards, with rest and care.
During flu or flu-like illness, children often had the treatment of their chronic health condition adjusted. This also took time to return back to normal for some children. Mirella’s three year old son had his asthma medication increased and it was a five day period to return to normal levels. Lyndey was advised by the asthma nurse to keep her child’s inhalers at a high dose for a couple of weeks after having flu-like illness. Jack had to be weaned off the oxygen that he was taking at night. Louise son’s insulin needs changed dramatically during flu or flu-like illness and she said it was hard to get back to normal.
 

After flu-like illness, Louise explained that her son’s insulin needs changed dramatically and it was hard to get ‘back on track.’

After flu-like illness, Louise explained that her son’s insulin needs changed dramatically and it was hard to get ‘back on track.’

Age at interview: 37
Sex: Female
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Cos I compare him to his younger sibling and see, cos they often get ill together. So, I find obviously my younger son who has not got a chronic illness, he recovers very quickly. Whereas my other son is probably still unwell while the other one is sick. So, and also what I’ve found with my son, my eldest is that he can appear to have recovered, but then can quickly fall down with another virus. So his immune system takes a long time to get back on peak. 

So roughly how long do you think before he’s sort of kind of his, his normal self.

Probably two weeks.

Two weeks.

Yeah, yeah.

You think those two weeks-

Probably a week of full blown, blown flu, sorry. Three days beforehand and then the week, the week after I would see, oh, he looks better to, to you or I, but really his insulin needs have changed dramatically and I still have to be really, really vigilant about yeah.

Sorry, it is sort of kind of more than two weeks.

There’s like a trail, yeah. And I mean, there has been times he’s been like a week off with a, with a bug. I’ve sent him to school for a week, but because that week, I didn’t manage it properly, he was unwell the following week, so it lasted a whole, nearly a whole month. So, yeah, that is, it can last quite a long time. 

And you can see that because of his insulin needs.

Yeah, suffering lots of hypos. Looking drained because he has no energy from the hypos. Yeah, it’s quite hard to get back on track. 
 

When Kwame had flu-like illness, his asthma medication was increased to ten puffs of his inhaler every four hours. Over a five day period it was gradually reduced to normal levels.

When Kwame had flu-like illness, his asthma medication was increased to ten puffs of his inhaler every four hours. Over a five day period it was gradually reduced to normal levels.

Age at interview: 42
Sex: Female
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And then when you’re sort of sent home from the A&E do you, do they give you instructions of how to manage him at home and what to do?

Yeah, the last time he actually got it which I can’t remember when it was but it was last year anyway, we came home with an inhaler and I think it was five days, that was the longest time he’s ever had to do it but five days on an inhaler and we came home and he was having to have ten puffs every four hours which was a lot, ‘cos it’s normally just two puffs with inhalers.

That’s right, yeah.

But because his breathing had got so bad, and they did say to me yeah to kind of, and then I had to wean him off of it over like a five day period and I thought, “Oh that was really bad kind of episode.”

Yeah

But…

Yeah.

Yeah after that he was fine I think maybe for about two weeks he was kind of short of breath sometimes but yeah since then he’s been fine.
Flu or flu-like illness also had an impact on children’s long term health condition. Karen explained that it took a while for Alex’s asthma to return to how it was before he had flu-like illness. Kwame who has chronic lung disease was short of breath for a couple of weeks after having flu-like illness and was on more oxygen overnight for a while.
 

Jack was seriously ill with flu-like illness and spent three weeks in intensive care. Six months later his liver function tests are still abnormal and his blood pressure is lower than before the flu episode.

Jack was seriously ill with flu-like illness and spent three weeks in intensive care. Six months later his liver function tests are still abnormal and his blood pressure is lower than before the flu episode.

Age at interview: 40
Sex: Female
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So how was the recovery process?

Wasn’t too bad, he sort of, he did, I think, was nine days IV piptaz, because his CR, the, they started him on, to my knowledge, they started on the antibiotics because of the changes to his like chest x-ray in A&E, so they ordered them in then. But his CRP never went above 41, so I wasn’t really happy with him having the antibiotics because I think, I know it raised, but Jack’s had a CRP of over 200 before today so I would prefer to keep sort of good antibiotics for when he really needs them. And I felt at that time he didn’t really need a strong antibiotic which is piptaz and like, probably one of the best to give. And the Tamiflu I think was seven days, I think. And then after they finished [child noises] it was just, I think, a case of getting his lungs clear because a couple of times we thought, “Oh, we’ve got him ready for HDU”, and then they’d listen and they’re like, “No, he’s a bit quiet again on the other side”. So he was very positional as well and afterwards with his secretions if you like so he was on, you know, the big Hill-Rom bed that rotates you to try and keep, because he, he, like, they’d say, “We’re quiet on the right, so we’ll work on the right”. And then a couple of days later he’d collapse on the left. So it was trying to find that balance of getting him and then, be, weaning him down to see if PAP ASB and, and he’d collapse whole lung and have to go back up to Bipap and then I think, he had the shingles as well which I think set him back a little bit. And then after about three weeks I think he just thought, “You know what, I’ve had enough of being sick”. 

I think or he just must have felt great, because, it’s my understand, I mean, I’ve never had the flu that you feel really lethargic and everything and I don’t know if it was because he was on the Bipap so much that because that’s done all his breathing for him he’s been able to sort of recuperate a bit quicker than what he normally would. I mean, he was still at home in more, in he’s still in more oxygen overnight than what he has been previous slowly weaning that down. And his heart rate as well is considerably lower than what it was before the flu. So I don’t know if that was, if that’s like an ongoing thing or just a complication or, and his liver is still abnormal. So he’s not totally over all the effects that it caused but I think the initial thing. He see, he was a lot better. 
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