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An issue discussed in the MSUD eGroup was immunization for influenza (flu) each fall for children with MSUD. Kay Larsen shares information that has helped her as the mother of Maritsa, 24, who has classic MSUD. Maritsa is adopted and has neurological damage due to her early history. Maritsa has thrived under Kay's vigilant care.

I always make sure that my daughter gets an influenza shot before winter - usually in October or November. It takes three to four weeks to build up antibodies after the shot is given. The shot should be given well before flu season actually starts.

I appreciated an article in a newsletter from the metabolism department at Children's Hospital of Philadelphia, Pennsylvania.

It was written by Alice Mazur, RN, MS, CRNP, who was working in the department of metabolism at that time (1996). The article reads:

"Flu season is also coming. We urge you to have your child receive this year's flu shot. Each year predictions about which flu virus will be most prevalent are made by experts at the Center for Disease Control. They provide that information to the pharmaceutical companies, who then produce and distribute them. We believe that your child should be protected from the flu, so that severe metabolic decompensation does not occur. Each year, some children become ill from the flu and require hospitalization. We would like to prevent your child from becoming ill and the flu vaccine is a good way of preventing illness. Contact your local pediatrician, family doctor or local health department about scheduling the flu vaccine. Most health insurance carriers cover the cost of the shot. Some children do not respond well to the flu vaccine. If your child has gotten slightly ill after the flu vaccine has been given in the past, there are some steps you should take.

Decrease the protein in the diet on the day of the flu vaccine. One-half of the total protein is usually sufficient.

Give actetaminophin for fever and/or discomfort. This may be given before the shot and then given every four hours after the vaccination during that day.

Give your child extra fluids and calories on the day of the vaccination. It is usually best to use the special metabolic product (formula). If your child is not receiving a metabolic product, use high calorie, low protein drinks and foods.

Call the metabolism division if you have any questions or concerns."

I have used this advice for my daughter every year and she has not had any problems at all when receiving the shot. In addition, her regular doctor started out by dividing the vaccine into two doses instead of one - with a week or two between doses, just in case she should have a bad reaction. This requires two injections and two trips to the doctor, but is well worth it if you are nervous about giving the vaccine as I was initially.

The bad reactions that Alice talked about are usually (but not always) mild ones, consisting of soreness and redness at the injection site and mild fever.

Fortunately, either because of the vaccine or by God's grace or both, my daughter has never had the flu. And she has never had any bad reaction to the vaccine, probably because I follow these recommendations carefully.

Hope this information is helpful in some way. I would definitely urge you to show these recommendations to your child's doctor before you try them.

Melvin Carruth

This letter is a tribute to my brother Melvin Carruth! We believe he is one of the oldest living African Americans with Maple Syrup Urine Disease.

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