Flu in Children

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 (or upper respiratory tract infection).

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 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
• 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
• Fever with a rash - influenza can cause a petechial rash

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'.

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

Generally, there are no specific treatments for viruses - they just run their natural course. General measures include keeping fluids up to prevent dehydration and using Acetaminophen (Paracetamol) for fever and misery.

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 Organisation.

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

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.
• 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

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 Organisation 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

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.

• 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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CDC

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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

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Last reviewed 20 August 2009

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