Definition
- Influenza (Flu) is a viral infection
- The nose, throat, and upper parts of the lungs are involved
- You think your child has influenza because other family members
- You think your child has influenza because close friends have it
- You think your child has influenza and it’s all around in the community
Symptoms
- Main symptoms are a runny nose, sore throat, bad cough and fever.
- More muscle pain, headache, fever, and chills than with usual colds.
- If there is NO fever, the child probably doesn’t have flu. More likely he has a cold.
Cause
- Influenza viruses that change yearly
Diagnosis: How to Know Your Child Has Influenza
- Influenza occurs every year in the fall and winter months. During this time, if flu symptoms occur, your child probably has the flu.
- Your child doesn’t need any special tests.
- Call your doctor if your child is HIGH-RISK for complications of the flu. See the list below. These are the children who may need prescription anti-viral drugs.
- For LOW-RISK children, usually you don’t need to see your child’s doctor. If your child develops a possible complication of the flu, then call your doctor. See the “When to Call Your Doctor” section.
HIGH-RISK Children for Complications From Influenza
- Children are considered HIGH-RISK for complications if they have any of the following:
- Lung disease (such as asthma)
- Heart disease (such as a congenital heart disease)
- Cancer or weak immune system conditions
- Neuromuscular disease (such as muscular dystrophy)
- Diabetes, sickle cell disease, kidney disease OR liver disease
- Diseases needing long-term aspirin therapy
- Pregnancy
- Healthy children under 2 years old are also considered HIGH-RISK (CDC 2009)
- Note: All other children are referred to as LOW-RISK
Prescription Antiviral Drugs for Influenza
- Antiviral drugs (such as Tamiflu) are sometimes used to treat influenza. They must be started within 48 hours when the flu symptoms start.
- The AAP recommends they be used for any patient with severe symptoms. They also recommend the drugs for most HIGH-RISK children. See that list.
- The AAP doesn’t recommend antiviral drugs for LOW-RISK children with mild flu symptoms.
- Their benefits are limited. They usually reduce the time your child is sick by 1 to 1.5 days. They reduce the symptoms, but do not make them go away.
- Side effects: Vomiting in 10% of children.
Return to School
- Your child can return to school after the fever is gone for 24 hours. Your child should feel well enough to join in normal activities.
- Spread is rapid. The time it takes to get the flu after contact is about 2 days. The range is 1 to 4 days. The virus is easily passed to others.
When to Call Us for Influenza – Seasonal
Call 911 Now If: Click to View
Call 911 Now (your child may need an ambulance) If:
- Severe trouble breathing (struggling for each breath, can barely speak or cry)
- Lips or face are bluish when not coughing
- You think your child has a life-threatening emergency
Call Us Now (night or day) If:
- Your child looks or acts very sick
- Trouble breathing (Exception: present only when coughing)
- Breathing is much faster than normal
- Lips or face have turned bluish during coughing
- Wheezing (tight, purring sound with breathing out)
- Stridor (harsh sound with breathing in)
- Ribs are pulling in with each breath (called retractions)
- Chest pain and can’t take a deep breath
- Dehydration suspected. (No urine in over 8 hours, dark urine, very dry mouth and no tears)
- Weak immune system. (Such as sickle cell disease, HIV, cancer, organ transplant, taking oral steroids)
- SEVERE HIGH-RISK child such as lung disease, heart disease, bedridden
- Age under 12 weeks old with fever. (Caution: Do NOT give your baby any fever medicine before being seen.)
- Fever over 104° F (40° C)
- You think your child needs to be seen urgently
Call Us Within 24 Hours If: Click to View
Call Us Within 24 Hours (between 9 am and 4 pm) If:
- You think your child needs to be seen, but not urgently
- HIGH-RISK child for complications of flu. Includes children with other chronic diseases. (See that list). Also, includes healthy children less than 2 years old.
- Nonstop coughing spells
- Age under 3 months old with any cough
- Earache or ear discharge
- Sinus pain (not just congestion)
- Fever lasts more than 3 days
- Fever returns after gone for more than 24 hours
Call Us During Weekday Office Hours If:
- You have other questions or concerns
- Age over 6 months and needs a flu shot
- Coughing causes vomiting 3 or more times
- Coughing has kept home from school for 3 or more days
- Nasal discharge lasts more than 2 weeks
- Cough lasts more than 3 weeks
- Flu symptoms lasts more than 3 weeks
Parent Care at Home If: Click to View
Parent Care at Home If:
- Influenza with no complications and your child is LOW-RISK
Care Advice for Seasonal Influenza
What You Should Know:
- Flu symptoms include cough, sore throat, runny nose, and fever. During influenza season, if your child has these symptoms, he probably has the flu.
- Special tests are not needed. Usually, you don’t need to call or see your child’s doctor.
- If your child develops a complication of the flu, then call your child’s doctor. Examples are an earache or trouble breathing. These problems are included in the “When to Call Your Doctor” section.
- For healthy people, the symptoms of influenza are like those of a common cold.
- With flu, however, the onset is more abrupt. The symptoms are more severe. Feeling very sick for the first 3 days is common.
- The treatment of influenza depends on your child’s main symptoms. It is no different from treatment used for other viral colds and coughs.
- Bed rest is not needed.
- Here is some care advice that should help.
Runny Nose with Lots of Discharge: Blow or Suction the Nose
- The nasal mucus and discharge is washing germs out of the nose and sinuses.
- Blowing the nose is all that’s needed.
- For younger children, gently suction the nose with a suction bulb.
- ut petroleum jelly on the skin under the nose. Wash the skin first with warm water. This will help to protect the nostrils from any redness.
Nasal Washes To Open a Blocked Nose:
- Use saline nose drops or spray to loosen up the dried mucus. If you don’t have saline, you can use warm tap water.
- Put 3 drops in each nostril. (If age under 1 year old, use 1 drop. Also, do 1 side at a time.)
- Blow (or suction) each nostril out while closing off the other nostril. Then, do the other side.
- Repeat nose drops and blowing (or suctioning) until the discharge is clear.
- How often: Do nasal washes when your child can’t breathe through the nose. Limit: No more than 4 times per day.
- Saline nose drops or spray can be bought in any drugstore. No prescription is needed.
- Saline nose drops can also be made at home. Use 1/2 teaspoon (2 ml) of table salt. Stir the salt into 1 cup (8 ounces or 240 ml) of warm water.
- Reason for nose drops: Suction or blowing alone can’t remove dried or sticky mucus. Also, babies can’t nurse or drink from a bottle unless the nose is open.
- Other option: use a warm shower to loosen mucus. Breathe in the moist air, then blow each nostril.
- For young children, can also use a wet cotton swab to remove sticky mucus.
Medicines for Colds:
- Age Limit. Before 4 years, never use any cough or cold medicines. Reason: Unsafe and not approved by the FDA. Also, do not use products that contain more than one medicine.
- Cold Medicines. They are not advised. Reason: They can’t remove dried mucus from the nose. Nasal washes are the answer.
- Decongestants. Decongestants by mouth (such as Sudafed) are not advised. They may help nasal congestion in older children. Decongestant nasal spray is preferred after age 12.
- Allergy Medicines. They are not helpful, unless your child also has nasal allergies. They can also help an allergic cough.
- No Antibiotics. Antibiotics are not helpful for colds. Antibiotics may be used if your child gets an ear or sinus infection.
Homemade Cough Medicine:
- Goal: Decrease the irritation or tickle in the throat that causes a dry cough.
- AGE 3 months to 1 year: Give warm clear fluids to treat the cough. Examples are apple juice and lemonade. Amount: Use a dose of 1-3 teaspoons (5-15 ml). Give 4 times per day when coughing. Caution: Do not use honey until 1 year old.
- AGE 1 year and older: Use HONEY ½ to 1 teaspoon (2-5 ml) as needed. It works as a homemade cough medicine. It can thin the secretions and loosen the cough. If you don’t have any honey, you can use corn syrup.
- AGE 6 years and older: Use COUGH DROPS to coat the sore throat. If you don’t have any, you can use hard candy.
Sore Throat Pain Relief:
- Age over 1 year. Can sip warm fluids such as chicken broth or apple juice.
- Age over 6 years. Can also suck on hard candy or lollipops. Butterscotch seems to help.
- Age over 8 years. Can also gargle. Use warm water with a little table salt added. A liquid antacid can be added instead of salt. Use Mylanta or the store brand. No prescription is needed.
- Medicated throat sprays or lozenges are generally not helpful.
Fluids:
- Try to get your child to drink lots of fluids.
- Goal: Keep your child well hydrated.
- It also will thin out the mucus discharge from the nose.
- It also loosens up any phlegm in the lungs. Then it’s easier to cough up.
Fever:
- For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. See Dose Table. Note: lower fevers are important for fighting infections.
- AVOID ASPIRIN because of the strong link with Reye syndrome.
- For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.
- For babies, dress lightly. Don’t wrap in too many blankets. Reason: can make the fever higher.
Pain Medicine:
- For muscle aches or headaches, give acetaminophen (Tylenol) OR ibuprofen. Use as needed. See Dose Table.
Prescription Antiviral Drugs for Influenza:
- Antiviral drugs (such as Tamiflu) are sometimes used to treat influenza. They must be started within 48 hours of when flu symptoms start.
- The AAP recommends they be used for any patient with severe symptoms. they also recommend the drugs for most HIGH-RISK CHILDREN. See that list.
- The AAP doesn’t recommend antiviral drugs for LOW-RISK children with normal flu symptoms.
- Their benefits are limited. They reduce the time your child is sick by 1 to 1 1/2 days. They reduce the symptoms, but do not make them go away.
- Side effects: Vomiting in 10% of children.
Return to School:
- Spread is rapid, and the virus is easily passed to others.
- The time it takes to get the flu after contact is about 2 days.
- Your child can return to school after the fever is gone for 24 hours. Your child should feel well enough to join in normal activities.
What to Expect:
- Influenza causes a cough that lasts 2 to 3 weeks.
- Sometimes your child will cough up lots of phlegm (mucus). The mucus can be gray, yellow or green. This is normal.
- Coughing up mucus is very important. It helps protect the lungs from pneumonia.
- We want to help a productive cough, not turn it off.
- The fever lasts 2 to 3 days.
- The runny nose lasts 7 to 14 days.
Prevention: How to Protect Yourself From Getting Sick:
- Wash hands often with soap and water.
- Alcohol-based hand cleaners also work well.
- Avoid touching the eyes, nose or mouth. Germs on the hands can spread this way.
- Try to avoid close contact with sick people.
- Avoid ERs and urgent care clinics if you don’t need to go. These are places where you are more likely to be exposed to flu.
Prevention: How to Protect Others – Stay Home When Sick:
- Cover the nose and mouth with a tissue when coughing or sneezing.
- Wash hands often with soap and water. After coughing or sneezing are important times.
- Limit contact with others to keep from infecting them.
- Stay home from school for at least 24 hours after the fever is gone. (CDC 2009).
Flu Shot and Prevention:
- Getting a flu shot is the best way to protect your family from flu.
- Yearly influenza vaccines are strongly advised for all children over 6 months of age. (AAP)
- Adults should also get the shot.
- The shot most often prevents the disease.
- Even if your child gets the flu, the shot helps to reduce the symptoms.
Call Your Doctor If:
- Breathing becomes hard or rapid
- Retractions (pulling in between the ribs) occur
- Dehydration occurs
- Earache or sinus pain occurs
- Fever lasts more than 3 days
- Nasal discharge lasts more than 14 days
- Cough lasts more than 3 weeks
- Your child becomes worse