Influenza (the flu)

Conditions

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Influenza – also commonly called “the flu” – is a contagious respiratory illness caused by viruses that infect the nose, throat and lungs. It can cause mild to severe illness, but is more dangerous for children than the common cold. According to the Centers for Disease Control and Prevention (CDC), every year about 20,000 children under the age of 5 years are hospitalized because of influenza complications.ⁱ It can also be fatal: during the 2013-2014 flu season, 107 flu-related pediatric deaths were reported in the United States.ⁱⁱ

To protect them from the flu, all children 6 months of age and older should get the flu vaccine every year. Parents, family members and caregivers also should get vaccinated every year.

Patients can be seen by Texas Children's experts in Infectious Disease.

Causes & Risk Factors

Flu viruses spread mainly by droplets made when people with flu infection cough, sneeze or talk. These droplets can land in the mouth or nose of people who are nearby. Less often, a child might also get flu by touching a surface or object that has flu virus on it and then touching her own mouth, eyes or her nose.”ⁱⁱⁱ

Children younger than 5 years of age, and especially children under 2 years of age, are at particular risk of developing complications from the flu. These complications include pneumonia, blood infection caused by certain bacteria that the flu viral lets in, and even brain infection. Also, children with particular medical conditions, like those listed below, are more likely to suffer complications from the flu:

asthma
diabetes
heart disease
immune problems
disabilities like epilepsy, cerebral palsy or muscular dystrophy

Symptoms & Types

Children who have the flu usually experience some or all of these signs and symptoms:

Fever (higher than 101.4 F) and chills
Cough
Sore throat
Runny or stuffy nose
Muscle or body aches
Headache
Feeling very tired
Vomiting and diarrhea, typically in young children

Diagnosis & Tests

While there are tests your doctor can perform to see if your child has the flu, the reliability of the test vary considerably depending upon the prevalence of influenza in the community.^iv During flu season (in Texas this usually begins in December), the diagnosis can often be made from a medical history and physical examination. Many pediatricians will simply examine your child to determine if she has the flu.

Treatment & Care

Many children with the flu do not need to be seen by a physician. Most otherwise healthy children with the flu do not require specific anti-viral medications, but can be treated with fluids and medicines for fever such as acetaminophen of ibuprofen. Children with the flu should never be given aspirin because they could develop a rare complication called Reyes Syndrome.

If the doctor determines that your child should be treated, there are 2 anti-viral medicines that can be prescribed:

Oseltamivir (Tamiflu® - liquid or tablet) is approved for treatment of influenza in children 2 weeks of age and older.
Zanamivir (Relenza® - inhaler) is approved for the treatment of influenza in persons aged 7 years and older.

Living & Managing

Most children who get influenza will recover as quickly as a few days or as long as 2 weeks. But some will develop complications (such as pneumonia) as a result of the flu, some of which can be life-threatening. If your child with the flu develops difficulty breathing, has altered mental status (like acting too irritable or too sleepy) or has any other unexpected severe symptoms, you should have her see a doctor right away.

Prevention

The best way to protect yourself and your family from the flu is to get yourself and everyone in your family vaccinated, especially if your child is in a high risk group. Everyone 6 months and older should get the annual flu vaccination. The CDC has a helpful page outlining who should and should not get vaccinated with 1 of the 2 types of vaccines and who should take precautions.

Older children and adults only require a single shot each year. However, children under age 9 years need 2 shots 1 month apart the first time they receive flu vaccine or if they didn’t have a flu vaccine last year.

The flu shot contains inactivated (killed) virus. It cannot give you the flu; it works by teaching the body (first time vaccinated person) learn or remember to mount an immune response to the flu.
The FluMist (nasal spray) vaccine contains attenuated (weakened) virus. It works by giving you a very mild infection. It is a nose spray – not a shot. The spray vaccine is recommended for healthy children 2 of age and older if there is no underlying medical condition (such as asthma). When available, the spray gives somewhat better protection against influenza in children 2 through 8 years of age.

Remember, getting vaccinated is the most important way to protect your child from the flu.