Related topics: •  Colds and Kids •  Cough (Children) •  Fever (Children) •  H1N1 Virus (Swine Flu) FAQ

The flu (influenza) is an all-too-familiar illness for most parents, especially during flu season (November to April). This highly contagious respiratory tract infection can send a child to bed for three to five days with a high fever, headache, congestion, chills, coughing, diarrhea, and vomiting, as well as muscle aches and fatigue. It's caused primarily by two flu viruses, influenza A and influenza B, which spread quickly in schools and other places where people gather in large groups. Occasionally the flu virus mutates, causing enormous outbreaks. The flu may have more serious consequences for children with chronic health problems like asthma and diabetes.

The early symptoms aren't always easy to detect. The first sign may be a change in her behavior, such as acting unusually grumpy or tired. If your child has a high fever (101 to 103 degrees F), a dry cough, chills, fatigue, sore muscles, and a headache, she probably has the flu. The group of symptoms, of course, differs slightly from child to child. Children typically recover from the symptoms in about three to four days (although they may continue to feel achy for up to two weeks), and the body's immune system will build natural defenses against the virus.

Children usually become infected through contact with someone who has the flu or by touching infected items such as plastic toys and utensils. People can pass on the flu virus by touching, kissing, and coughing, and the hardy virus can live for up to two hours on the surface of objects like toys or bedposts. Because it's so easily transmitted in densely populated areas such as schools, the flu has the highest incidence among children ages 5 to 14. During flu season, anywhere from 5 to 20 percent of the entire US population may be infected with a flu virus of one type or another.

Bed rest, plenty of water and juice, and nutritious foods are the best remedies when your child has the flu. Frozen fruit bars are a good way to give her extra liquid, and hot soup or broth may ease the sense of congestion. For muscle aches, give your child a pain reliever such as acetaminophen. (Never give aspirin to children or teenagers, particularly if they may have a viral infection; this can cause Reye's syndrome, a rare but potentially life-threatening condition.) Because the flu is so contagious, practice good hygiene around your child during her illness: Use disposable paper cups, throw away used tissues promptly, and wash your hands after caring for her.

Experts recommend inoculating all children against the flu, since the illness is responsible for so much lost time from work and school. Because a bout of the flu can send even healthy children to the hospital, the Centers for Disease Control recommends the flu shot for children aged 6 months up to their 19^th birthday.

Children with chronic heart or lung illnesses, such as asthma, should receive the flu vaccine sometime between October and mid-November, according to the CDC. The CDC also strongly recommends flu vaccinations for children who are regularly hospitalized because of a suppressed immune system, for children who have chronic metabolic diseases (including diabetes mellitus and certain kidney diseases), and for children on chronic aspirin therapy.

Likewise, caretakers and family members of children at high risk, especially those taking care of children younger than 6-months-old, should be vaccinated.

If your child has never been vaccinated for influenza, she'll need two shots, one month apart, to build immunity. Because the flu vaccine is developed from eggs, children who are allergic to eggs or chicken should not be vaccinated.

Because the flu virus is so easily spread -- through human touch, on objects, and in the air -- it's tough to guard your child against it. Here are some tips that can help:

Teach her to cough or sneeze into a tissue, then throw it out immediately afterwards. If she doesn't have a tissue handy, tell her to cough or sneeze into her elbow or sleeve.

Teach her to wash her hands with soap and water for at least 20 seconds, especially after she coughs, sneezes, or touches her eyes. Alcohol-based hand sanitizers are great for killing germs. When someone in your house is sick, antibacterial wipes are good to use on surfaces in high-traffic areas, such as kitchens and bathrooms.

•Tell her not to touch her eyes, nose, or mouth. (You can spread germs from the mucus in your eyes and mouth this way.)

•Killing germs is one thing; staying healthy is another. Make sure your child gets enough sleep, stays hydrated, and eats lots of fruits and vegetables -- it will help keep her body's immune system working at its peak.

•Finally, if your child feels sick or has a fever, keep her home until the fever is gone for 24 hours (without having to take medicine to reduce it), and limit her contact with others

Yes. The flu can turn into ear, sinus, or dangerous lung infections such as pneumonia. But most normally healthy children make a full recovery from the flu in three to five days.

If your child is HIV-positive or has a chronic illness (such as cancer, sickle cell anemia, diabetes, or lung, heart, or kidney disease), call your pediatrician at the first sign of flu. Call, too, if your child is on chronic aspirin therapy and shows symptoms of flu.

In these circumstances, call for an immediate appointment:

•If your child has an earache, ear drainage, or severe pain in her face or forehead; this could signal sinusitis or an ear infection.

•If she has persistent chest pain and fever, or if she's wheezing and coughing up discolored mucus; these might be signs of pneumonia or bronchitis.

Pediatricians also stress that each child's case depends on the combination of symptoms. A child with a fairly high fever who is resting quietly, for example, probably has "normal" flu symptoms. On the other hand, a child who is running a slight fever but straining to breathe while lying in bed or watching television should be seen by her doctor. If your child becomes sick again soon after quickly bouncing back from the flu, or if she has a high fever for more than three to four days, call your pediatrician for advice.

Further Resources

Robert H. Pantell M.D., James F. Fries M.D., Donald M. Vickery M.D., Taking Care of Your Child: A Parent's Illustrated Guide to Complete Medical Care. 8^th Edition, Basic Civitas Books, 2009.

References

Last updated September 1, 2009
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