Flu in Children

This page concerns flu in children. This is not about the common cold but about infection with influenza that can make children very unwell.


What is Flu?

Flu in children refers to infection with the influenza virus. Children get lots of viruses but flu in children gives more severe symptoms that the usual viruses that cause the common cold - read more (or upper respiratory tract infection).

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Are there different types of flu?

Yes, there are generally 2 main types of influenza - Influenza A and Influenza B. However, there are many different strains of each of those. Every season, there are different types that will be circulating.

Flu in children is caused by similar strains to those causing flu in adults.

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What are the symptoms of flu in children?

Flu symptoms include:

  • fever, cough
  • sore throat
  • body aches
  • headache, chills, fatigue
  • diarrhea in some cases

In children, emergency warning signs that need urgent medical attention include:

  • Fast breathing or trouble breathing
  • Bluish or gray skin color
  • Not drinking enough fluids and becoming dehydrated - read more
  • Not waking up or not interacting
  • Being so irritable that the child does not want to be held
  • A very bad "cold" or your child looks very sick - read more
  • Fever with a rash - influenza can cause a petechial rash - read more

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How can you tell the difference between a cold and flu in children?

Flu or influenza infection is much more severe than the common cold. It comes on suddenly and there is often high fever.

You will notice that with flu in children they are much sicker than with the usual cold. A cold usually lasts 4 days or so before if starts to improve but influenza infection can last 10 days before there is improvement.

You can get shivering with the fever associated with influenza but this is not common with a 'cold'.

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Are some people more susceptible to the flu?

Anyone can get the flu, but some people are more likely to get more severe symptoms and complications, including:

  • young children
  • the elderly
  • people with chronic illness

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What is the treatment of flu?

  • Generally, there are no specific treatments for viruses - they just run their natural course. General measures include:
    • keeping fluids up to prevent dehydration - read more
    • Although Acetaminophen / Paracetamol can be given if your child is extremely miserable with fever, the fever is the body's way of fighting the influenza virus. So if you can, try and avoid giving Acetaminophen or Paracetamol to reduce the fever, so the virus clears from the body more quickly
  • Some strains of influenza are severe and public health guidelines suggest treating with specific anti-viral drugs, such as oseltamivir (Tamiflu) or zanamivir (Relenza) which reduce the severity of the infection - this was the case for "bird flu" (Influenza A H5N1)and "swine flu" (Influenza A H1N1). You will need to check with local health agencies to know whether an anti-viral agent is thought to be useful in your particular case.
  • Whether an anti-viral treatment has been recommended or not, there are important measures that need to be taken with everyone who has the flu to prevent spread.
  • It is important to carefully follow public health advice if there is an epidemic or pandemic (so widespread infection). You can always check what the current advice is by going to public health websites like the CDC or World Health Organization.

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How is flu in children spread?

The influenza virus is spread like other viruses by droplets, so when the infected person sneezes or coughs, the virus particles are spread.

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What are the measures to prevent spread of flu?

For flu in children and adults, the following measures should be undertaken to prevent spread of the virus:

  • Keep away from other people, other than family, so no day-care. In adults, you should stay away from work for at least 7 days but children may need to stay isolated for up to 10 days.
  • Cover your nose and mouth when you cough or sneeze. Ideally use a tissue and then throw the tissue in the trash after you use it. If you don't have a tissue, wash your hands after coughing or sneezing.
  • Teach your child to cough or sneeze into the crook of the arm (into the bent elbow). That stops the droplets and we don't use our elbows for doing things so this prevents spread
  • Wash your hands often with soap and water, especially after you cough or sneeze. Wash for at least 10-20 seconds and dry thoroughly. Alcohol-based hand cleaners are also effective. Wash your hands at least 10 times per day. If water and soap are not available, friction using ash or sand is also effective.
  • Avoid touching your eyes, nose or mouth. Germs spread this way.
  • Keep surfaces clean - the virus can last up to 8 hours on surfaces if sneezed out onto them.
  • Wash utensils and dishes thoroughly before sharing with others. Do the same for linen and towels

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Does immunization prevent flu in children?

Every year there is a flu vaccine available - it usually consists of the 3 strains that are thought to be most likely to be problematic that year (the World Health Organization decides which strains to include every year). The vaccine takes at least 2 weeks to work - it is given usually 2 months before the "flu season" which is winter.

The flu vaccine does prevent infection with the strains included but will not prevent infection from a pandemic flu, like bird flu or swine flu (as generally these are not predicted). These vaccines may need to be developed after the pandemic starts.

Check local guidelines as many people are eligible to get free flu vaccines.

The CDC recommends yearly flu vaccine in the following:

  • Children aged 6 months up to their 19th birthday
  • Pregnant women
  • People 50 years of age and older
  • People of any age with certain chronic medical conditions
  • People who live in nursing homes and other long-term care facilities
  • People who live with or care for those at high risk for complications from flu, including:
    • Health care workers
    • Household contacts of persons at high risk for complications from the flu
    • Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)

Influenza vaccine should not be given to:

  • children less than 6 months of age
  • children with a known severe allergy to eggs
  • anyone who has had a severe reaction to past flu immunization
  • anyone unwell with a fever

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What is H1N1 Flu or Swine Flu?

The H1N1 strain (also known as swine flu) is a type of Influenza A. It has come to public attention in April 2009 because of a pandemic, which means that the infection spread widely across the world. The virus had features seen in viruses known to infect pigs, which is where the name swine flu came from. However, you do not get this infection from eating pigs or pig products.

If you or your child has flu symptoms and has possibly been in contact with someone who has been in an area known to have H1N1, then you should contact your doctor - by phone initially as you don't want to come into contact with any more people than necessary. If you must be in contact with others, wear a facial mask (or put a facial mask on your child) to prevent droplet spread of the virus. Your child may be advised to take an antiviral like oseltamivir (Tamiflu) or zanamivir (Relenza) - there is ongoing research into effectiveness of these drugs in H1N1 infection. Follow all medical guidelines.

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What should I do if there is a pandemic or health alert about flu?

  • Follow medical guidelines that are issued
  • If you have flu symptoms, isolate yourself from others - if you must be in contact with others, wear a mask
  • Follow the guidelines for prevention of spread of viruses

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Search This Site


  • CDC - Center for Disease Control

To go to the top of the Flu in Children page, click here

To go to the main Infections page, click here

To go to the Pneumonia page, click here

To return to the Home page, click here

Last reviewed 12 June 2011

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Dr Maud MD

Dr Maud MD (MBChB, FRACP, FRCPCH), a specialist pediatrician, provides health information and medical advice for parents of babies and toddlers. Read more about Dr Maud.

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