Influenza (flu) is a contagious respiratory illness caused by influenza viruses. In children, the flu typically causes sudden onset of fever (often 101–104°F), body aches, headache, fatigue, cough, and sore throat. Most children recover at home within 7–10 days. Call your pediatrician right away if your child is under 2 years, has a high-risk condition, or develops difficulty breathing — antiviral treatment with Tamiflu is most effective when started within 48 hours of symptoms.
Hey, everyone! Dr. Binns here, back with more info on these nasty winter bugs. Following up on last month’s common cold post, I’m back to talk about the dreaded flu.
What is influenza?
Influenza, otherwise known as “the flu”, is a common viral illness that is most prevalent during the colder months of the year. Children with the flu usually develop an abrupt-onset fever, body aches and fatigue, often accompanied by other respiratory and gastrointestinal symptoms such as cough, congestion, sore throat, nausea, and vomiting.
The flu tends to last longer than a typical cold – your child may be feeling pretty crummy for about a week – and may still have some lingering symptoms for about 1 more week afterwards. Flu symptoms can become severe enough to require hospitalization in a small percentage of children – this is more common in children who fall into high-risk categories. This includes (but is not limited to):
- Children younger than 5 years old, especially those younger than 2 years old
- Children with asthma or other chronic lung disorders
- Children with heart disease
- Children that are immunocompromised
- Children with sickle cell disease
- Children with metabolic disorders
- Children with neurologic disorders, such as seizures or neuromuscular diseases such as cerebral palsy
How is this virus spread?
The flu is mainly transmitted from person to person via respiratory droplets spread through coughing, sneezing, or talking. You can also pick the virus up from touching a contaminated surface and touching your mouth, nose, or eyes.
How can you differentiate between a common cold and the flu?
This can be difficult because there are some overlapping symptoms that can be attributed to both common colds and the flu. I have created a handy table for you that summarizes some of the key differences between the common cold and the flu.
Comparison of Common Cold and Influenza Symptoms
| Common Cold | Influenza | |
| Onset of symptoms | Gradual, over 1-3 days | Sudden |
| Fever | Sometimes, may be low-grade up to ~102F | Common, often high fevers up to 102-105F |
| Body aches | Sometimes, usually very mild if present | Very common |
| Fatigue | Mild | Usually severe |
| Upset stomach/nausea/vomiting | Rare | Common |
| Headache | Sometimes | Common |
| Cough | Common | Common |
| Sore throat | Sometimes | Sometimes |
Similar to COVID, the only way to know for sure if it is the flu is to be tested. If you are concerned your child may have the flu, please call our office to schedule an appointment with your pediatrician for evaluation and flu testing.
How do you treat the flu?
Make sure you are keeping your child well-nourished, especially with fluids, to help them fight off this virus. Warm fluids such as tea or soup help to soothe sore throats and relieve congestion. You can also use a cool mist humidifier to help your child breathe a little easier at night. For children older than 12 months, you can give 1 teaspoon of honey either straight or mixed into a beverage to help with cough and sore throat (honey should be avoided in children under 12 months old due to the risk of botulism).
Unfortunately, the flu is known for causing high fevers. When children have fevers, they can feel pretty wiped out and may even breathe harder and faster than usual. You can help them feel better by giving Motrin (after 6 months of age) or Tylenol for comfort. Please see our table at https://springvalleypediatrics.net/medication/ for weight-based dosing recommendations.
There are also antiviral medications, such as Tamiflu, that may slightly reduce the severity and length of symptoms if started within the first 48 hours of illness, though may have side effects such as upset stomach, nausea, and vomiting. Your pediatrician may also decide to start Tamiflu later in the course of illness for children in certain high-risk categories.
When to seek emergency care
- If your child has a fever higher than 105F
- If your child is unable to tolerate fluids
- If your child is having a lot of trouble breathing or catching their breath
How to prevent getting and spreading the flu
As always, frequent handwashing helps. In addition, covering your mouth with the crook of your elbow if you need to cough or sneeze will help prevent the spread of respiratory droplets that could infect others. This is a great skill for parents to teach and reinforce with their children at home. Please keep your child home from school if they are sick to help limit the spread of their illness to their classmates. If your child is feeling sick and must go out, please encourage them to wear a mask if possible. They may return to school once they are fever-free for 24 hours with improved symptoms.
The very best way to prevent getting the flu is to get your annual flu vaccination. These vaccines are available as a shot and as a nasal spray – the spray is available for children over the age of 2 without certain chronic health conditions. While children who have received their yearly influenza vaccine can still get the infection, they will often have milder symptoms than those who are not vaccinated and are less likely to require hospitalization. If you or your child have not yet received their influenza vaccine this year, please call us at (202) 966-5000 to schedule an appointment to receive their vaccine.
Remember that we are open 7 days a week and 365 days a year, including holidays and weekends. Wishing you all a safe and happy holiday season!
Frequently Asked Questions About The Flu in Children
How do I know if my child has the flu versus a bad cold?
The flu typically comes on suddenly — your child may be fine one hour and feel terrible the next. Key flu symptoms include a high fever (101–104°F), significant body aches, headache, and extreme fatigue. A cold usually starts gradually with a runny nose and mild sore throat. If your child has sudden high fever with body aches and fatigue, especially during flu season, it is likely influenza.
Should my child get the flu vaccine every year?
Yes. The AAP recommends annual flu vaccination for all children 6 months and older. Because influenza viruses change each year, last year’s vaccine does not provide full protection against this year’s strains. At Spring Valley Pediatrics, we offer flu vaccines beginning in September each year.
When should I call the pediatrician if my child has the flu?
Call Spring Valley Pediatrics if your child is under 2 years old with flu symptoms, has a chronic condition (asthma, diabetes, heart disease), develops difficulty breathing, has a fever above 104°F, is not improving after 7 days, or develops symptoms that were improving and then worsen.
What is Tamiflu and should my child take it?
Tamiflu (oseltamivir) is an antiviral medication that can reduce the severity and duration of flu if started within 48 hours of symptoms. The AAP recommends it for children at high risk for complications. Call Spring Valley Pediatrics as soon as you suspect flu — timing matters.
How do I care for my child at home with the flu?
Rest and fluids are the foundation of flu care at home. Acetaminophen or ibuprofen (for children over 6 months) can manage fever and pain. Do not give aspirin to children — it is associated with Reye syndrome. Keep your child home until they have been fever-free for 24 hours without fever-reducing medication.
When can my child return to school after the flu?
Your child should stay home until they have been fever-free for at least 24 hours without the use of acetaminophen or ibuprofen. This is typically 5–7 days after symptoms begin.
