Paediatric specialists issue urgent guidelines following the deaths of two children from flu-related symptoms

Carla Bowes, of Sydenham, told the POST this week that her son, 8-year-old Liam, died last Wednesday after initially having flu-like symptoms.

Paediatric specialists are urging parents to seek immediate emergency treatment if their children experience difficulty breathing, high fevers, or diarrhoea and vomiting following the recent deaths of two children who presented with severe flu-like symptoms.

Dr Ashendri Pillay, a paediatric infectious diseases specialist at Inkosi Albert Luthuli Central Hospital, said respiratory viruses circulating in Durban include influenza, respiratory syncytial virus (RSV) and SARS-CoV-2. 

Pillay, head of the hospital’s Paediatric Infectious Diseases Unit, said they have noticed an overlap of symptoms - including fever, nasal congestion, cough, and sneezing - between influenza, RSV and SARS-CoV-2.

RSV is highly-contagious and commonly causes bronchiolitis and pneumonia in young children and infants. 

She said symptoms to watch for included a high fever (> 38.5°C), extreme tiredness or lethargy, severe body or muscle ache (the child may refuse to walk), and a dry persistent cough.

“Headaches, sore throat, diarrhoea, vomiting or stomach pain should also be common symptoms."

Pillay said parents need to take their children to the emergency room if they experienced breathing difficulties, such as fast breathing, wheezing, or struggling for breath, or develop cyanosis, bluish or pale lips, tongue, or skin.

“A child who has an altered mental state and appears limp or has difficulty waking up, severe dehydration, or seizures, should also be rushed to an emergency room,” Pillay added.

She urged parents to ensure that their children are up-to-date with their immunisations, and encouraged them to get annual influenza vaccinations for their children.

“Parents also need to encourage regular handwashing with soap and water, and cough etiquette, where children cover their noses and mouths when coughing or sneezing."

Dr Trishka Manilall, a general practitioner in Durban North, said they have noted that influenza A and RSV were the predominant viruses this flu season.

“These two viruses are responsible for most admissions to paediatric wards. The symptoms of flu range from mild to severe illness. It includes fever, a runny or blocked nose, cough, sore throat and general body pains and weakness. Small children may be less playful and have a poor appetite.”

Manilall said that while the viral flu does not respond to antibiotics, many parents insist on them. These antibiotics don't improve symptoms or attack viruses but could only cause gastric upset. 

“Emphasis is on managing mucus production with gentle suctioning when needed and antihistamines to reduce mucus production. A chesty cough should be assessed by a doctor and may require nebulisation with a facemask. This can also be continued at home.

"Supportive care will include paracetamol for fever and maintaining hydration with clear fluids. Mild cases of flu improve with just the above treatment.

"Sometimes antivirals may be prescribed depending on symptoms and after assessment by the doctor.  Monitoring and identifying danger signs as discussed above become important thereafter."

A report from the National Institute of Communicable Diseases (NICD) indicated that from June 1 to June 7, and from 171 samples tested, 60 (35.1%) cases of influenza, 39 (22.8%) cases of respiratory syncytial virus (RSV) and no cases of SARS-CoV-2 were detected.

From December 29 to June 7, out of 3484 samples tested, the NICD detected 629 (18.1%) cases of influenza, 493 (14.2%) cases of RSV, and 48 (1.4%) cases of SARS-CoV-2.

Carla Bowes, of Sydenham, told the POST this week that her son, 8-year-old Liam, died last Wednesday after initially having flu-like symptoms.

Reaction Unit South Africa, a private security company, posted that a four-year-old boy, from Verulam, died on Wednesday after displaying flu-like symptoms.