I was at the gym today and an otherwise great instructor who seems to know a lot about health was sharing incorrect information about the flu with the class of about 40 people. She said that she had received several texts from other instructors asking her to cover their classes because they were vomiting. Then she went on to say that many at first thought it was food poisoning, but it’s spreading like illness, so it’s the flu, not food poisoning. She made a big deal that the flu is here. Is vomiting from the flu?
The flu causes predominantly fever, cough, sore throat, and body aches for many days. It can cause vomiting and diarrhea, but those aren’t usually the predominant symptoms. And the flu doesn’t cause just a few hours of extreme vomiting like we’re seeing these days.
Why do I care if people call this stomach bug “flu”?
The biggest reason I care is that it leads people to make other incorrect assumptions and to get the wrong treatments.
I hear all the time that people had the flu the year they got a flu shot, so they don’t want to get it anymore.
When probed about their illness, it’s usually not consistent with the flu. It was either a cold and cough or a stomach virus.
If they think a common cold or vomiting is from the flu, they’re mistaken.
They need to know that this isn’t the flu.
Common colds and vomiting are not prevented with the flu shot.
The flu shot has nothing to do with protecting against most cases of vomiting and diarrhea or most upper respiratory tract infections.
Of course there are people who got the flu shot (or FluMist when it was available) who did come down with the flu. They had a positive flu test and symptoms were consistent with the flu. But if they get influenza after the vaccine they tend to have milder symptoms. They tend to not end up in the hospital or dead if they’ve had the vaccine. Yes, even healthy young people can end up very sick from influenza. They can even die. (The FluMist didn’t protect well and was removed from the market due to this.)
We forget about all the times people did get the vaccine and they didn’t catch the flu even with likely exposure. Lack of disease is easy to fail to acknowledge.
We know the flu vaccine is imperfect. But if the majority of people get vaccinated, we can slow the rate of spread and protect us all against influenza most effectively.
School vacation often leads to travel, which brings up a lot of questions about motion sickness, also known as car sickness, sea sickness, and air sickness. If your child suffers from motion sickness, there are many options – though some take awhile to show benefit, so plan ahead!
Whether it’s the threat of a long car trip, concern about flying, or anticipated problems on a cruise, there are many kids who suffer from motion sickness. Kids 2 – 12 years are the most likely to suffer from motion sickness. It’s less common in teens and adults and very rare in infants and toddlers. It is more common in women and people with migraines.
What causes motion sickness?
Motion sickness is thought to be triggered when the inner ear senses motion but the eyes don’t. These mixed signals coming into the brain can cause nausea, dizziness, vomiting, paleness and cold sweats.
Motion sickness often happens on ships and boats, but it also can affect kids when they travel in planes, buses and cars. Motion sickness is often worst if there is a bumpy or curvy ride.
It can also be triggered by strong smells, which is why avoiding gas stations (if possible) can help prevent it.
Sometimes trying to read a book or watching a movie during travel can trigger motion sickness.
In both children and adults, playing computer games can sometimes lead to motion sickness.
Some general tips to avoid motion sickness:
Look out the window during travel. Don’t watch other moving objects (such as cars) — watch the horizon. Teens and adults can benefit from sitting in the front seat. Younger children (12 and under) are safer in the back seat.
Avoid strong smells, such as those at the gas station, if possible.
Eat small amounts of high protein, non-greasy foods during travel. Spicy and fatty foods can exacerbate symptoms. Crackers can help.
Sleep. Or at least close eyes.
Take deep, controlled breaths.
Use a headrest to prevent head movement.
In a plane: sit over the wing and recline when possible.
On a ship: stay on deck where you can see the horizon as much as possible. Avoid the bow and stern.
Take breaks for fresh air and a short walk if possible.
Some people believe that opening the car window for fresh air helps, but close windows if the air quality is poor or irritates the rider.
No smoking or e-cigarette use in the car. Ever. Even when no one is in the car with the driver. The compounds left behind can be dangerous to children.
Avoid reading books or playing video games when traveling. Movies are tolerated more often than reading, but if they are not tolerated, stop them.
Be aware that some medicines increase the risk of motion sickness. Avoid these if possible. A full list is included in the link, but those more commonly used in children and teens are ibuprofen, some antibiotics, some antidepressants, and hormones (birth control pills).
Medicines for motion sickness:
All medicines have side effects, but many of the ones that seem to help motion sickness can have significant side effects, so risks and benefits must be considered.
Note that none of these medicines is approved under 2 years of age, but motion sickness is uncommon in infants and toddlers.If you decide upon a medicine, be sure to keep it out of reach of children to avoid overdose. Remember that during travel childproofing is more difficult!
Warning: know this number!
In case of suspected overdose, call your local poison control center at 1-800-222-1222. Put this number in all of your phones for easy access in times of emergency.
If a person is not breathing or unconscious, first call 911 and initiate CPR.
See your doctor to discuss if this prescription is appropriate for your child for motion sickness.
Prochlorperazine is an antipsychotic that helps treat severe nausea and vomiting. It comes as tablets and suppositories.
Prochlorperazine should not be used in children under 2 years old or who weigh less than 20 pounds.
Prochlorperazine requires a prescription, and a full discussion of risks and benefits should be done with your doctor before taking this medicine.
See the attached link for full list of potential side effects as well as other drug interactions.
Metoclopramide has been used for treatment of motion sickness, but carries significant risks. Please see the attached link for details.
A scopolamine patch can be considered for teens and adults but should not be used in kids under 12 years.
Some experts discourage any use in all children due to significant side effects, which include sedation, blurred vision, disorientation and mouth dryness.
See attached link for complete list of side effects. If it is used, the patch is placed behind the ear 4 hours before travel and left in place for up to 72 hours.
Ginger has been shown to help prevent motion sickness, but the specific dose is not clear. Kids can drink ginger tea or ginger ale or suck on a ginger lollipop or lozenge – only if old enough to not choke.
To make ginger tea: dissolve 1/8 – 1/4 teaspoon of powdered ginger in a cup of hot water or boil two slices of fresh ginger root (each about 1/8 of an inch thick)in one cup of water for about 10 minutes. Sweeten to taste, and offer small sips throughout the day.
Accupressure wristbands are sold in pharmacies and online, and though research is not conclusive, I have seen decent benefit from these.
They fall into the “it won’t hurt to try” category in my opinion.
I don’t know if it is the power of suggestion (placebo effect) or a real benefit, but I have seen several families rely upon these successfully.
If your child suffers from motion sickness often, there are some studies that support vestibular training. It will not work for your vacation next week, but can be considered for children who suffer to help long term.
Have your child work with a physical therapist trained in vestibular training.