Influenza (“The Flu”)  Basics:

• The Flu is a seasonal respiratory virus. Common symptoms include: fever, cough, runny nose/congestion, muscle aches, headache, fatigue, shortness of breath, and less commonly vomiting or diarrhea. Symptoms typically last between 3-6 days

• Most children recover without complications. However, some children are at higher risk for getting very sick including those that are less than 5 years old, immunocompromised, or have chronic medical conditions like moderate/severe asthma, a neuromuscular disorder, heart disease, sickle cell disease, diabetes, obesity. 

• Oseltamivir (Tamiflu) is an antiviral medication that decreases hospitalization rate and duration of hospitalization. It also can shorten fever duration by 12-24 hours.  Side effects are common and include abdominal pain, nausea, diarrhea, headaches, vivid dreams/nightmares, and hallucinations. It may be prescribed in high-risk children.

• Your child should get the flu shot every year.  The flu shot helps prevent children from getting the flu and can lessen symptom severity. Your child should get the flu shot even if they have already had the Flu this season as it can protect against other strains.

General Treatment

• The best treatment is prevention – it is NOT too late to get your flu shot! Flu shots will not prevent you from contracting the flu, but will make your course of illness less severe and help keep you out of the hospital

• For most children, the treatment for the Flu is supportive. Pillars of supportive care include:

  • Fever/Pain control: Use Acetaminophen and Ibuprofen for fever control.  Fevers are not dangerous, but they make your child feel bad which impacts their ability to drink and stay hydrated. Acetaminophen can be used every 4 – 6 hours (up to 4 times/day). Ibuprofen may also be used every 6 hours if your child is older than 6 months. These may be alternated or given together.

  • Hydration: Encourage small/frequent sips of formula/breast milk, Pedialyte and/or water (if older than 6 months). The best measure of hydration is urine output.  Generally we like at at least 4 voids in 24 hours

  • Nasal hygiene: Frequent nasal suctioning with a bulb suction or ‘NoseFrida’, humidifiers, steam showers all help clear the nose.  Post nasal drip is often the biggest cause of cough with these infections. 

  • Cough: Honey, for children older than 1 year, is the most helpful and only recommended cough medication. 

• Children at higher risk of getting very sick from the Flu may benefit from Tamiflu for treatment or prevention if they have a close contact with the Flu.  Make an appointment if your child had any of the high risk features mentioned above.

When to seek care:

• If your child is less than 5 years old or has one of the high risk conditions noted above

• If fever last more than 5 days

• If cough is worsening or your child is breathing harder/faster

• If ear pain develops

• If your child is not urinating at least 4 times per day

• If your child has severe or worsening muscle aches/pains or dark urine

• If you are concerned

When to go to the Emergency Room:

• If your child is in respiratory distress

• If your child is lethargic or difficult to arouse

• If your child is showing signs of severe dehydration: lethargy, little/no urine output, dry lips, sunken fontanelle (soft spot)

• If you are worried

When to return to school/activities:

• Your child may return to school when fever free for more than 24 hours without fever reducing medication and has improving symptoms.

Additional Resources: 

• CDC.gov – Key Facts about the Flu
• HealthyChildren.org – Flu Homepage
• HealthyChildren.org – The Flu: What Parents Need to Know