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Children and the Flu

Prevention

The vaccine is recommended for healthy and at risk children who are between 6 and 23 months of age. In addition, the vaccine is recommended for children 2 years and older who are at increased risk for serious complications because of an underlying chronic medical condition. This includes children who:

• Have chronic heart or lung conditions, including asthma and cystic fibrosis
• Have cancer
• Have had a bone marrow or organ transplant
• Have a weakened immune systems due to HIV/AIDS, cancer treatment or steroid therapy
• Have metabolic diseases including diabetes, kidney disease, anemia or other blood disorders
• Are between 6 months and 18 years of age and receive long-term aspirin therapy

In addition, women who will be pregnant during the flu season, especially those with a high-risk pregnancy as well as women who will be in the third trimester between December and February, should be vaccinated.

If you think that you or your child is at increased risk for developing flu complications, talk with your doctor.

There are currently two types of influenza vaccine. The more common of the two has been used in the United States for many years and is safe for children over 6 months of age. Another version, which was released for the first time this year, is approved for children five years and older. Talk with your child's doctor to find out which vaccine is right for your child. Since influenza viruses change often, the vaccine is updated every year. The vaccine begins to protect individuals from the flu about two weeks after injection and may last up to a year. Some people who get vaccinated still may come down with the flu, but they will usually get a milder case than those who did not get the shot.

In the absence of vaccine, however, there are other ways to protect against flu. A few prescription antiviral medications are approved and commercially available for use in preventing flu in children at special risk of complications who are 1 year or older.

Ways to Reduce Your Child's Risk of Contracting the Flu

Besides having your child vaccinated before flu season begins, there are a few other things that you and your family can do to reduce the transmission of the flu virus in your household.

• Wash Hands -- If your child is old enough, teach him or her to frequently wash their hands using soap and water. Hand washing is one of the most basic and proven methods for preventing the spread of disease. It is important for you to wash your hands frequently as well, especially after coughing, sneezing or using commonly shared items in your house or workplace.

• Get Vaccinated -- Ideally, parents, other family members and caregivers of high-risk children should be vaccinated to decrease the likelihood of contracting the flu themselves and then exposing the child. However, with the shortage of vaccine this year, this may not be possible.

• Cover Mouths and Noses -- Use a tissue to cover your mouth and nose when you cough or sneeze and teach your children to do the same.

• Avoid Those Who Are Sick -- If your child attends child care or school, make sure children and staff stay home when they are sick. And, when your child has the flu, take precautions to limit their interaction with others.

Signs and Symptoms

The following are common signs and symptoms of the flu in children:

• Fever, often around 102 degrees Fahrenheit
• Headache
• Extreme tiredness
• Dry cough
• Sore throat
• Runny or stuffy nose
• Muscle aches

In addition, the flu sometimes is accompanied by gastrointestinal symptoms, such as nausea, vomiting and diarrhea, which are much more common among children than adults.

It is important to recognize that infants and young children are unable to tell you how they are feeling. For example, rather than telling you his or her throat hurts, your child may be especially irritable or resistant to drinking fluids. It is always a good idea to contact your child's doctor if he or she is particularly irritable, uninterested in feeding or exhibiting other signs of discomfort.

Transmission

The flu is contagious. A person can spread the flu starting one day before he or she feels sick and up to seven days after getting sick. Children can be contagious for longer than seven days, often for around two weeks.

Flu viruses are spread when a person who has the flu coughs, sneezes or speaks and spreads virus-laden droplets into the air that other people inhale. The virus also can be spread when a person touches a surface with flu viruses on it, such as a door handle, and then touches his or her eyes, nose or mouth.

Diagnosis

Your child may have the flu if he or she has a sudden onset of fever, body aches and respiratory symptoms, especially if it is between November and April, which is the usual flu season in the United States. However, people can get the flu at any time of the year.

There is a diagnostic test available to check for the flu, called direct fluorescent antibody (DFA). This test involves getting secretions from the back of the nasopharynx, or the space at the back of the nose and above the soft part of the palate. DFA is most often used when a definitive diagnosis would impact the medical care of the child or family.

Caring for a Child with the Flu

If your child comes down with the flu, make sure that he or she takes it easy. It is important for children with the flu to:

• Get plenty of rest
• Drink a lot of liquids

Never give aspirin to children or teenagers who have flu-like symptoms, particularly fever, without first speaking to a doctor. Giving aspirin to children and teenagers with the flu can cause a rare but serious illness called Reye syndrome. It is OK to give children medicines that do not contain aspirin, such as Tylenol and Motrin, as directed by their doctor to relieve symptoms.

When to Seek Medical Help

Parents, do not hesitate to contact your child's doctor if you have concerns about the flu, questions about your child's symptoms or if you think your child should receive the flu vaccine. The doctor will be able to answer your questions and go over information specific for your child's age as well as any pre-existing conditions he or she may have.

Take your child to the pediatrician or to the emergency department if he or she displays any of the following symptoms:

• Rapid or labored breathing
• Bluish skin color
• Not drinking enough to maintain hydration
• Not waking up or interacting
• Irritability to the point that he or she doesn't want to be held

Also consult a doctor if your child's flu symptoms improve but then return and include a fever and worse cough.

Reviewed by health care specialists at UCSF Children's Hospital.
Last updated May 8, 2007

This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.