父母该如何判断孩子的流感病情是否恶化？
流感的标准处方是待在家里休息，喝大量液体，服用扑热息痛等非处方药物，控制疼痛和发热。
But this flu season has been a particularly scary one for parents. At least 53 children across the country have died from flu-related illness, and parents need to know how to tell if a child takes a turn for the worse — and if it is time to rush to the hospital.
但对父母来说，这个流感季尤其可怕。美国至少有53名儿童死于流感相关疾病，父母需要知道如何判断孩子的病情是否开始恶化，是否应该立即送往医院。
It is not an easy question to answer, experts say.
专家表示，这不是一个容易回答的问题。
“Every once in a while, even among healthy children, this influenza strain and others can make a person very, very sick, really fast,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University School of Medicine. “It’s deceptive.”
“偶尔，即使是在健康儿童当中，这种流感毒株和其他毒株也能在很短的时间内造成严重病情，”范德比尔特大学(Vanderbilt University)医学院传染病专家威廉·沙夫纳(William Schaffner)博士说，“它很有欺骗性。”
Most parents know they need to closely monitor children under 5 for any signs their illness is getting more severe. It is important to pay even closer attention to babies and toddlers under 2, making sure they are getting enough liquids because they can easily become dehydrated.
大多数父母都知道，他们需要密切关注5岁以下的儿童，看他们是否出现任何病情恶化迹象。对于2岁以下的婴儿和学步期儿童来说，需要更密切的关注，确保他们摄入足够多的液体，因为他们很容易脱水。
And while the vast majority of otherwise healthy children will ride out a bout of influenza and recover rather quickly, a small number will develop potentially life-threatening complications that require immediate medical attention, Schaffner said.
沙夫纳表示，虽然绝大多数健康的儿童能安然度过一场流感，快速康复，但一小部分儿童会出现可能危及生命的并发症，需要立即就医。
Children with chronic health conditions like asthma, diabetes, cystic fibrosis, cerebral palsy, heart conditions or seizures are also at increased risk for developing influenza-related complications, and the illness can exacerbate their underlying medical problems.
患有哮喘、糖尿病、囊性纤维化、脑瘫、心脏病或癫痫等慢性疾病的儿童出现流感并发症的风险也在增加，而流感会加重他们的潜在健康问题。
But half of the children hospitalized with influenza this flu season did not have any of the underlying chronic conditions that make children susceptible to complications from influenza, according to the Centers for Disease Control and Prevention, and that is not unusual.
但据美国疾病控制和预防中心(Centers for Disease Control and Prevention)称，在这个流感季因流感住院的儿童中，有半数没有任何使他们容易出现流感并发症的潜在慢性疾病，这并不罕见。
Signs to watch for in children are persistent high fevers that do not subside and fevers that abate only to flare up again after the child seems to be over the worst of the illness, experts say.
专家们表示，需要关注的迹象包括，毫不减退的持续高热，或者，短暂退热后，在孩子似乎已度过最严重阶段后，再次发热。
When that happens, time is of the essence; a persistent or recurrent fever may mean the child has developed a complication such as pneumonia or a dangerous inflammatory response, and parents must seek prompt medical attention.
这种情况发生时，最重要的是及时就医。持续或反复发热可能意味着，儿童出现了肺炎或危险的炎症反应等并发症，父母必须立即送医。
Parents should also be on the lookout for sepsis, a life-threatening complication caused by the body’s overwhelming attack against an infection. The condition is characterized by fever or chills, extreme pain or discomfort, clammy or sweaty skin, confusion or disorientation, shortness of breath and a high heart rate.
父母还应该注意败血症，它是一种致命的并发症，由身体对感染的过度攻击导致。症状包括发热或发冷，极度痛苦或不适，皮肤湿粘或出汗，意识混乱或迷失方向，呼吸短促，心跳加速。
“The trick with the flu is that it happens very quickly,” said Dr. Flor M. Munoz, associate professor of pediatrics and infectious diseases at Baylor College of Medicine in Houston. “You have to be really paying attention. Things can progress within 48 hours or so.”
“流感的棘手之处在于，它发展得很快，”休斯敦贝勒医学院(Baylor College of Medicine)儿科和传染病学副教授弗洛尔·M·蒙诺兹(Flor M. Munoz)说，“你必须非常注意。情况可能在48小时内恶化。”
Symptoms that call for immediate medical care are if a child’s breathing becomes labored, and he or she is taking fast, shallow breaths or feels chest pain or pressure; if the child’s lips turn blue or purple; if he or she is less responsive than usual; if the child’s skin becomes clammy; or if the child refuses to eat or drink or has diarrhea and is vomiting, raising the risk of dehydration.
需要立即就医的症状有：小孩呼吸出现困难或浅而急促，或呼吸时感到胸口疼痛或堵塞;小孩的嘴唇变蓝或变紫;反应不如往常;皮肤变得湿粘;或是拒绝进食、喝水，出现腹泻、呕吐，脱水风险增加。
In general, if a child is particularly irritable, is sleeping too much, seems confused, dizzy or not mentally alert, and not acting like his or her usual self, parents should seek medical help. Severe vomiting and seizures are also danger signs.
一般来说，如果小孩格外烦躁，睡眠过多，感到混乱、眩晕或迟钝，与平时行为不同，父母都应该寻求医疗帮助。严重的呕吐和癫痫发作也是危险的征兆。
For children under 2, parents must be vigilant about making sure their child is getting enough fluids, and watch for urine that becomes dark in color, a sign of dehydration that calls for immediate medical care. Other symptoms to watch for in infants are trouble breathing, inability to eat, significantly fewer wet diapers than normal and crying without producing tears.
对于2岁以下的儿童，父母必须保持警惕，确保自己的孩子饮水够量，要注意颜色较深的尿液是脱水迹象，需要立即进行医疗护理。其他需要注意的症状有：呼吸困难、无法进食、尿湿尿布数量与往常相比显著减少，以及在哭泣的时候不流眼泪。
Ibuprofen or acetaminophen can be used in older children, but acetaminophen is the preferred drug for fever in infants. It should be used only in appropriate doses, as instructed on the package (aspirin should never be used in children).
布洛芬和扑热息痛适用于年龄较大的儿童，但扑热息痛是婴儿发热的首选药物，应按照包装指示，依合适剂量服用(儿童绝不应使用阿司匹林)。
“For a baby under 1, there’s a lower threshold to see the doctor,” Munoz said. “I would be willing to wait a little longer on a 12-year-old who can tell me how he feels, but for a baby that age, it’s hard for a parent to know what’s going on. You have to watch them very carefully and be attuned to changes.”
“对于1岁以下的婴儿，看医生的门槛应该更低，”蒙诺兹说。“对于一个能告诉我他自己什么感受的12岁孩子，我会愿意再等久一些，但是对这个年纪的婴儿，父母很难知道发生了什么。你要非常仔细的留意他们，也要了解并应对变化。”
While it may not sound scientific, most experts say parents should trust their instincts. They know their children better than anyone else, and if they think something is wrong, they should call a doctor and ask for advice, or take the child to an urgent care center or emergency room.
虽然听起来不太科学，但大多数专家表示，父母应该相信自己的直觉。他们比其他人更了解自己的孩子，如果他们觉得有什么不对劲，就应该寻求医生的建议，或把孩子带去紧急护理中心或急诊室。
“When mom is really worried, that should not be trivialized — the pediatrician should look at that child closely,” Schaffner said.
“妈妈真正担心的时候，就不应该被轻视——儿科医生应给孩子仔细检查，”沙夫纳说。
