How does influenza spread in children. What are the symptoms of flu in kids. Can flu cause complications in children. How to care for a child with influenza. When to seek medical help for a child with flu.

Understanding Influenza in Children: Causes and Transmission

Influenza, commonly known as the flu, is a respiratory infection caused by the influenza virus. It typically occurs between November and April, with outbreaks happening annually. The virus’s ability to mutate frequently means that immunity is short-lived, allowing people to contract the flu multiple times.

But how exactly does influenza spread among children? There are three primary modes of transmission:

1. Direct contact: This involves physical contact with an infected person, such as kissing, touching, or holding hands.
2. Indirect contact: Children can contract the virus by touching contaminated surfaces or objects, like toys, doorknobs, or used tissues.
3. Airborne transmission: When an infected person coughs or sneezes, droplets containing the virus can reach another person’s nose or mouth.

Children are particularly susceptible to catching influenza from family members, playmates, or caregivers due to their close interactions and developing immune systems.

Recognizing Flu Symptoms in Children: What to Look For

Distinguishing between a common cold and influenza can be challenging for parents. However, the flu typically manifests more rapidly and causes more severe symptoms. While children with colds often maintain their energy levels and daily routines, those with influenza are usually bedridden.

The typical symptoms of influenza in children include:

• Sudden onset of fever
• Chills and shaking
• Headache
• Muscle aches
• Extreme fatigue
• Dry cough
• Sore throat
• Loss of appetite

It’s important to note that flu symptoms can vary depending on the child’s age. For instance:

• Newborns and infants may experience an unexplained high fever without other apparent signs of illness.
• Young children often have temperatures exceeding 39.5°C and may experience febrile seizures.
• Gastrointestinal symptoms like upset stomach, vomiting, and diarrhea are more common in younger children.
• Some children may experience muscle inflammation leading to severe leg or back pain.

Potential Complications of Influenza in Children

While most healthy children recover from the flu without serious problems, it’s crucial for parents to be aware of potential complications. These can include:

• Croup: An infection of the throat and vocal cords causing hoarseness and a barking cough.
• Pneumonia: A lung infection that can be particularly dangerous in young children.
• Bronchiolitis: An infection of the small airways leading to the lungs, causing wheezing and difficulty breathing.
• Secondary bacterial infections: The flu can weaken the immune system, leading to ear infections (otitis), sinus infections (sinusitis), or additional cases of pneumonia.

Children under 2 years of age and those with chronic conditions such as heart, lung, or neurological problems are at higher risk for severe influenza and its complications.

Can influenza affect other organs in children?

In rare cases, influenza can impact organs beyond the respiratory system. The virus may affect the brain, potentially leading to encephalitis (inflammation of the brain), or the heart, causing myocarditis (inflammation of the heart muscle). While these complications are uncommon, they underscore the importance of monitoring a child’s condition closely during a flu infection.

Caring for a Child with Influenza: Home Treatment Strategies

When your child has the flu, providing proper care at home is essential for their comfort and recovery. Here are some strategies to help manage their symptoms:

1. Ensure plenty of rest and fluids: Encourage your child to sleep and offer small, nutritious meals along with plenty of fluids to prevent dehydration.
2. Manage fever: Dress your child in lightweight clothing and keep the room temperature around 20°C. For fevers above 38.5°C, consider using acetaminophen or ibuprofen (for children over 6 months) as directed.
3. Relieve sore throat: For children 3 years and older, gargling with warm water or sucking on sugarless hard candy can provide relief. Avoid lozenges containing numbing medications for young children.
4. Use caution with medications: Don’t give aspirin to children or teenagers with flu-like symptoms due to the risk of Reye syndrome. Also, avoid over-the-counter cough and cold medicines for children under 6 unless prescribed by a doctor.

Are antiviral medications necessary for children with the flu?

Antiviral medications may be prescribed in certain cases, particularly for children with chronic conditions or those at high risk for complications. These drugs are most effective when started within 48 hours of symptom onset. If your child has a chronic condition and you suspect they have the flu, contact your doctor promptly to discuss whether antiviral treatment is appropriate.

Duration of Flu in Children: What to Expect

One of the most common questions parents ask is, “How long does the flu last in children?” The duration of influenza can vary, but generally:

• Fever and muscle aches typically last 2 to 4 days.
• Cough and fatigue may persist for 1 to 2 weeks or longer.
• Overall recovery time can range from a few days to two weeks, depending on the child’s age and overall health.

It’s important to note that while the acute phase of the illness may be relatively short, some symptoms, particularly fatigue, can linger for several weeks. This extended recovery period is often referred to as the “post-flu syndrome.”

Does the flu last longer in younger children?

Generally, younger children and those with weakened immune systems may experience a longer duration of flu symptoms. Infants and toddlers might have symptoms persisting for up to two weeks, while older children and teenagers may recover more quickly. However, each child’s experience with the flu can be unique, and recovery times can vary significantly.

Preventing Influenza in Children: Vaccination and Hygiene Practices

Prevention is key when it comes to influenza, especially for children. Here are some effective strategies to reduce the risk of infection:

1. Annual flu vaccination: This is the most effective way to prevent influenza. The CDC recommends annual flu shots for everyone 6 months and older, with rare exceptions.
2. Proper hand hygiene: Teach children to wash their hands frequently with soap and water, especially before eating and after using the bathroom.
3. Respiratory etiquette: Encourage children to cover their mouth and nose with a tissue when coughing or sneezing, and to dispose of used tissues immediately.
4. Avoid close contact: Keep children away from people who are sick, and keep them home if they are ill to prevent spreading the virus.
5. Clean and disinfect: Regularly clean and disinfect frequently touched surfaces at home, especially when someone is ill.

How effective is the flu vaccine for children?

The effectiveness of the flu vaccine can vary from year to year, as it depends on how well the vaccine matches the circulating strains of the virus. However, studies have shown that flu vaccination can reduce the risk of flu illness by between 40% and 60% among the overall population during seasons when most circulating flu viruses are well-matched to the vaccine. In children, the vaccine can be even more effective, reducing the risk of flu-associated hospitalization by 74%.

When to Seek Medical Attention for a Child with Flu

While most cases of influenza in children can be managed at home, there are situations where medical attention is necessary. Parents should be vigilant and seek immediate medical care if their child exhibits any of the following symptoms:

• Difficulty breathing or rapid breathing
• Bluish skin color
• Not drinking enough fluids
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Flu-like symptoms improve but then return with fever and worse cough
• Fever with a rash

For infants, additional warning signs include:

• Being unable to eat
• Having no tears when crying
• Significantly fewer wet diapers than usual

Should I take my child to the emergency room for flu symptoms?

In most cases, influenza can be managed at home or through a visit to your primary care physician. However, if your child shows signs of severe illness or is at high risk for complications, emergency care may be necessary. This is particularly true for children under 5 years old, especially those under 2, and children with chronic medical conditions. When in doubt, it’s always best to consult with a healthcare provider to determine the most appropriate course of action.

Remember, while influenza can be a serious illness, most children recover fully with proper care and attention. By understanding the symptoms, providing appropriate home care, and knowing when to seek medical help, parents can effectively manage their child’s flu and support a swift recovery.

Influenza in children | Caring for kids

Influenza (or “flu”) is a respiratory infection caused by influenza virus. Influenza outbreaks happen every year, usually between November and April. Because influenza viruses change – often from year to year – people don’t stay immune for very long. That’s why people can catch the flu more than once. The term “seasonal flu” is used for the influenza viruses that spread every year.

How does influenza spread?

Influenza viruses are found in the nose and throat. Children can catch influenza from siblings, parents, other family members, playmates or caregivers.

Germs usually spread in one of 3 ways:

• Direct contact —such as kissing, touching or holding hands—with an infected person. If you have a virus, you will have germs in your nose, mouth, eyes or on your skin. By touching other people, you can pass on the virus. 
• Indirect contact means touching something—a toy, doorknob or a used tissue—that has been touched by an infected person and now has germs on it. Some germs, like the ones that cause colds and diarrhea, can stay on surfaces for many hours. 
• Through the air when a person coughs or sneezes. Droplets from the cough or sneeze may reach another person’s nose or mouth.

How do I know if my child has influenza?

The flu strikes more quickly than a cold, and makes people feel worse. Children with colds usually have energy to play and keep up their daily routines. Children with influenza are usually in bed.

Typical influenza symptoms include:

• sudden fever,
• chills and shakes,
• headache,
• muscle aches,
• extreme fatigue,
• dry cough,
• sore throat, and
• loss of appetite.

Children with the flu may have many of the same symptoms as adults, but there can be differences:

• Newborns and babies may have a high fever that can’t be explained, and no other signs of sickness.
• Young children usually have temperatures over 39. 5°C and may have febrile seizures (convulsions). 
• Upset stomach and pain, vomiting, and diarrhea are common in younger children. Earaches and red eyes are also common. 
• In some cases, muscle inflammation can lead to severe leg or back pain. 

Can the flu cause any other complications?

Most healthy people recover from the flu without any serious problems. Fever and muscle aches usually last only 2 to 4 days, but cough and tiredness can continue for 1 to 2 weeks or more.

In young children, flu can cause croup (an infection of the throat and vocal cords causing hoarseness, barking cough, noisy breathing), pneumonia (lung infection) and bronchiolitis (infection of the tiny airways that lead to the lungs causing wheezing and difficulty breathing).

Influenza can weaken the immune system, leading to bacterial infections of the ear (otitis), lung (pneumonia) or sinuses (sinusitis).

Influenza is more severe in children under 2 years of age and in children with certain chronic conditions such as heart, lung or neurological problems.

In rare cases, influenza can affect the brain or heart.

What can I do if my child has influenza?

• Keep your child as comfortable as possible. Offer plenty of fluids and small, nutritious meals. 
• If they have a fever, dress them in lightweight clothing and keep the room temperature around 20°C. 
• To ease pain, aches or a fever with a temperature greater than 38.5°C, use acetaminophen. Ibuprofen may be used for children over 6 months old. Unless your doctor says otherwise, give the dose recommended on the package every 4-6 hours until the child’s temperature comes down. Don’t give acetylsalicylic acid (ASA [eg, Aspirin])—or any medicine containing it—to children and teenagers with colds because it can lead to brain and liver damage (Reye syndrome).
• Don’t give over-the-counter (OTC) cough and cold medicines to children younger than 6 years old unless your doctor prescribes them.
• Gargling with warm water will ease a sore throat.  For children 3 years of age or older who can safely suck on hard candy without choking can use sugarless hard candy or lozenges containing honey, herbs or pectin. Throat lozenges containing medications that numb the throat (dyclonine, benzocaine, hexylresorcinol, menthol and phenol) should not be used by young children because they can make it hard for them to swallow.

Antiviral medications

If your child has lung or heart disease, an illness that affects the immune system or some other chronic condition that requires regular medical attention and you think your child may have influenza, call your doctor right away. Your doctor may prescribe an antiviral drug. These drugs may also be prescribed for healthy people with severe influenza. They should be taken within 48 hours of the first symptoms to be most effective.

When should I call my doctor?

Call your doctor or take your baby to an emergency department if your baby is under 3 months of age and:

• is having trouble breathing,
• is not eating or is vomiting, or 
• has a fever (rectal temperature of 38. 5°C or higher).

Call your doctor or take your child to an emergency department if your child is:

• breathing rapidly or seems to be working hard to breathe,
• having chest pain, or is coughing up bloody sputum (phlegm or saliva), 
• coughing so bad that they are choking or vomiting,
• drinking very little fluid and have not urinated (peed) at least every 6 hours when awake, 
• vomiting for more than 4 hours, or has severe diarrhea, 
• much sleepier than usual, doesn’t want to feed or play, or is very fussy and cannot be comforted,
• not feeling better after 5 days and still has a fever, or was feeling better and suddenly develops a new fever, or showing signs of the flu and has a serious chronic illness. 

Take your child immediately to a hospital emergency department or call 911 if your child:

• has severe trouble breathing or blue lips,
• is limp or unable to move, 
• is hard to wake up or does not respond, 
• has a stiff neck, 
• seems confused, or 
• has a seizure (convulsion).  

How can I prevent the spread of influenza? 

• Influenza can be prevented through immunization. Children over 6 months old should get a flu shot each year. 
• If there are children younger than 5 years old or someone with a serious chronic condition in your home, everyone living in the house should get a flu shot. This is especially important if there are children under 6 months old in the home, since babies this age can’t get the flu shot themselves and could become infected if a family member gets the flu.  
• Handwashing is the most important way to reduce the spread of viruses.
• Keep babies under 3 months old away from people who are sick, if possible.
• Teach your children to cover their nose and mouth with tissues when they sneeze or cough, or to cough into their upper sleeve or elbow. 
• Avoid sharing toys that young children place in their mouths until the toys have been cleaned. 
• Avoid sharing cups, utensils or towels until they have been washed.
• If your child attends daycare, tell the caregiver about any symptoms and ask if your child should stay home that day.
• Make sure your child receives all of the recommended vaccines. They will help prevent some of the complications, such as bacterial infections of the ears or lungs.

More information from the CPS

Reviewed by the following CPS committees

• Infectious Diseases and Immunization Committee

Last updated: August 2021

The Flu: What Parents Need to Know


​​By: Flor M. Muñoz, MD, MSc, FAAP & Kristina A. Bryant, MD, FAAP


Flu—short for influenza—is an illness caused by a respiratory virus. The flu can spread rapidly through communities, as the virus is passed person to person.

When someone with the flu coughs or sneezes, the influenza virus gets into the air. Then, people nearby, including children, can inhale it through the nose or mouth.

The virus also can be spread when people touch a contaminated hard surface, such as a door handle, and then put their hands or fingers in their nose or mouth, or rub their eyes.

This article is also available in other languages. See links to download at bottom.​​​

When is flu season?

The flu season usually starts in the fall and can last until the end of spring. Ideally, children should get an annual flu shot as soon as it is available, ideally no later than the end of October.
(See “Which Flu Vaccine Should Children Get?”)

When there is an outbreak or epidemic, usually during the winter months, the illness tends to be most frequent in preschool or school-aged children. Flu viruses are known to spread quickly among
college students and teens, too.

In the first few days of illness, the virus is easily transmitted to other children, parents and caregivers.


It is important for anyone age 6 months old and older to get the flu vaccine each year. Everyone age 6 months and older should also get COVID-19 vaccines. The COVID vaccine and flu vaccine can safely be given
at the same time or at any time one after the other.


Flu symptoms include:

• A sudden
  fever (usually above 100.4°F or 38°C)

• Chills

• Headache, body aches, and being a lot more tired than usual

• Sore throat

• Dry, hacking cough

• Stuffy, runny nose

• Some children may throw up (vomit) and have loose stools (diarrhea).

After the first few days of these symptoms, a sore throat, stuffy nose, and continuing cough become most evident. The flu can last a week or even longer. A child with a
common cold usually has only a low-grade fever, a runny nose, and only a small amount of coughing. Children with the flu—or adults, for that matter—usually feel much sicker, achier and more miserable than those with just a cold.


Kids with chronic health conditions at greater risk


Any child can develop severe, life-threatening influenza. Children who are at especially high risk for developing complications from the flu are those with an underlying chronic medical condition, such as lung, heart, or kidney disease, an immune system condition, cancer, diabetes, some blood diseases or conditions of the muscular or central nervous system.

These children may have more severe disease or complications. It is important for them to be vaccinated and, when possible, avoid other children with the flu or flu-like symptoms. Their pediatrician may suggest other precautions that should be taken.

If your child has any of these chronic health conditions and flu-like symptoms along with any difficulty breathing, seek medical attention right away. There can be serious complications, even death, from the flu, but thanks to the flu vaccine these are less common.

Flu treatment

Children may benefit from extra rest and drinking lots of fluids when they get the flu.

If your child is uncomfortable because of a fever,
acetaminophen or
ibuprofen in doses recommended by your pediatrician for his age and weight will help him feel better. Ibuprofen is approved for use in children age 6 months and older; however, it should never be given to children who are
dehydrated or who are vomiting continuously.

It is extremely important never to give aspirin to a child who has the flu or is suspected of having the flu. Aspirin during bouts of influenza is associated with an increased risk of developing
Reye syndrome.


Antiviral medicine for the flu: available by prescription

Your pediatrician can help decide whether or not to treat the flu with an
antiviral medicine. Antiviral medicine works best if started within the first one to two days of showing signs of the flu. However, in some children with increased risk for influenza complications, treatment could be started later.


Call your pediatrician within 24 hours of the first flu symptom to ask about antiviral medications if your child:

• Has an underlying health problem like asthma or other chronic lung disease, a heart condition, diabetes, sickle cell disease, a weakened immune system, a neuromuscular condition such as cerebral palsy, or other medical conditions.

• Is younger than 5 years old, especially if less than 2 years old.

• Has symptoms that are not improving.

• Is in contact with others who are at risk for complications of the flu.

How long does the flu last?


Healthy people, especially children, get over the flu in about a week, without any lingering problems. Talk with your child’s doctor if you suspect a complication like ear pain, pressure in your child’s face and head, or a cough and fever that will not go away.

When flu becomes an emergency

If your child has the flu and develops any of these symptoms, contact your pediatrician or seek immediate medical care.

• Trouble breathing or unusually rapid breathing

• Bluish lips or face

• Ribs looking like they
  pull in with each breath

• Chest pain

• Muscle pain so severe that your child refuses to walk

• Dehydration (no peeing for 8 hours, dry mouth, and no tears when crying)

• While awake, your child is not alert or interacting with you

• Seizures

• Fever above 104°F

• In children less than 12 weeks, any fever

• Fever or cough that seem to improve but then return or worsen

• Worsening chronic medical conditions, such as asthma

How to prevent the flu

Everyone needs the flu vaccine each year to update their protection and reduce te risk of serious complications. It is the best way to prevent getting the flu. Safe and effective vaccines are made each year.

The flu vaccine is especially important for:

• Children, including infants born preterm, who are 6 months to 5 years of age

• Children of any age with chronic medical conditions that increase the risk of complications from the flu

• All contacts and care providers of children with high risk conditions and children under 5 years old

• People who are
  pregnant, are considering pregnancy, have recently delivered, or are breastfeeding during the flu season. This is to protect the parent and the baby, which is important since newborns and infants under 6 months old are not able to receive their own vaccination.
• All health care workers

Flu vaccine

Both the inactivated (killed) vaccine, also called the “flu shot,” given by injection in the muscle, and the live-attenuated
nasal spray vaccine, can be used for influenza vaccination this season. There is no preference for a product or formulation. Any of these vaccines should be given as available in your area.

The vaccine boosts your body’s immune system to protect you from the virus. This takes about two weeks after getting vaccinated. Getting vaccinated before the flu starts spreading around will keep your family healthy so they can continue to enjoy the activities that help them thrive.

Flu vaccine side effects

The flu vaccine has few side effects. The most common side effects from the flu shot are fever and redness, soreness or swelling at the injection site. The most common side effects from the nasal spray vaccine are runny nose, congestion and sore throat.

Children with egg allergies can receive the flu vaccine. Children with a previous allergic reaction after a dose of flu vaccine should be seen by an allergist. The allergist can help parents decide if their child should receive an annual flu vaccination.

More information

• 
  Ask the Pediatrician:
  Do college students and teens need a flu shot?
• 
  Which flu vaccine should children get?
• Ask the Pediatrician:
  Can my child get a COVID-19 vaccine and flu vaccine at the same visit?
• 
  Flu: A Guide for Parents of Children or Adolescents With Chronic Health Conditions​

Other languages available​​​

• ​Arabic
• 
  Korean
• 
  Simplified Chinese
• 
  Somali
• 
  Swahili
• 
  Vietnamese​​

About Dr. Muñoz Flor Muñoz, MD, MSc, FAAP, is associate professor of Pediatrics and Infectious Diseases at Texas Children’s Hospital and Baylor College of Medicine. She is a member of the American Academy of Pediatrics Section on Infectious Diseases.

About Dr. Bryant Kristina A. Bryant, MD, FAAP, a pediatric infectious diseases specialist at the University of Louisville and Norton Children’s Hospital, is the lead for Red Book Online. She also is the immediate-past president of the Pediatric Infectious Diseases Society.


The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Influenza in children. What is flu in children?

IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

Influenza in children is an acute infection caused by influenza viruses types A, B, C; characterized by damage to the respiratory tract, intoxication and a high probability of developing secondary bacterial complications. Influenza in children occurs with high fever (up to 39-40°C), chills, general weakness, catarrhal symptoms (sore throat, runny nose, dry cough, hyperemia of the pharynx). Diagnosis of influenza in children is based on clinical and epidemiological data, laboratory detection of the virus (RIF, PCR, ELISA, RSK, RTGA). Symptomatic treatment of influenza in children is carried out with antipyretic, desensitizing, expectorant drugs; etiotropic therapy – antiviral drugs.

• Causes
• Influenza symptoms in children
• Diagnostics
• Treatment of influenza in children
• Prognosis and prevention
• Prices for treatment

General

Influenza in children belongs to the group of acute respiratory viral infections (ARVI), which also includes parainfluenza, adenovirus infection, respiratory syncytial infection, rhinovirus infection. Every year, influenza causes seasonal epidemics that affect up to 30% of the population, half of which are children and adolescents. Children from 3 to 14 years of age are most susceptible to influenza. Susceptibility to influenza in a child is 4-5 times higher than in an adult. Influenza in children often occurs with complications (associated with bronchitis, pneumonia, sinusitis, etc.), causes exacerbations of chronic diseases, so the prevention of influenza epidemics is a serious problem in pediatrics.

Influenza in children

Causes

Influenza is a highly contagious infection that spreads easily from person to person. Epidemics of seasonal influenza in children are caused by RNA-containing viruses of three types – A, B and C. The main surface antigens of the influenza virus are hemagglutinin (H) and neuraminidase (N), on the basis of which antigenic subtypes of viruses are isolated.

The type A virus, which can cause epidemics and pandemics, has the highest variability in its antigenic structure. Its hemagglutinins are represented by 15 subtypes (H1–H15), and neuraminidase by 10 subtypes (N1–N10). The h2N1 and h4N2 strains typically circulate during seasonal influenza. Type A virus strains are common in humans, birds, and pets.

Antigenic variability of type B virus is less pronounced; usually the pathogen causes local outbreaks or epidemics within the same country. Mass outbreaks of influenza type B often precede or coincide with outbreaks of influenza type A. Influenza B virus circulates only in the human population, affecting children more often.

Influenza C virus has a stable antigenic structure; infects humans and pigs; causes only sporadic cases. Therefore, all influenza vaccines (Influvac, Vaxigripp, Grippol, Inflexal B, Agrippol, etc.) contain surface antigens of viruses A and B that are relevant in this epidemiological season.

Influenza viruses among children are spread mainly by airborne droplets when talking, sneezing, coughing. Also, children can become infected with the flu through hygiene products, toys and other objects contaminated with the virus. The spread of influenza among children is facilitated by the variability of weather conditions (fluctuations in humidity and air temperature), a decrease in immune reactivity, hypovitaminosis, lack of sunlight, being in children’s groups.

Influenza viruses enter the body through the nose or oropharynx, are fixed in the cylindrical epithelium of the respiratory tract. With the help of hemagglutinin, influenza viruses attach to the cell, and thanks to neuraminidase, which destroys cell membranes, they penetrate inside the cell, where the production of viral proteins and viral RNA replication begins. New viruses then exit the host cells, infecting other healthy cells and continuing the process of reproduction. In the clinical aspect, these processes are expressed in catarrhal inflammation. Through the damaged epithelial barrier, viruses enter the bloodstream and spread throughout the body, causing specific influenza intoxication.

Flu symptoms in children

The period of latent virus carrying lasts from several hours to 2-4 days. The onset of influenza in children is acute, with a predominance of intoxication syndrome over catarrhal phenomena. In an infant, the only manifestation of influenza may be high fever; in children under 5 years of age – high fever up to 39-40 ° C, rhinitis and cough; in older children – fever, sweating, chills, dry cough, sore throat and sore throat.

The general toxic effect on the body is accompanied by a deterioration in appetite, lethargy, adynamia, headache, myalgia and arthralgia, and vomiting. Capillarotoxicosis causes an increase in the permeability of the vascular walls, the development of a hemorrhagic syndrome – nosebleeds, hemorrhages on the skin and mucous membranes, injections of scleral vessels. With influenza in children, toxic damage to the central nervous system may occur: encephalopathy, neurotoxicosis, convulsions, hallucinations, delirium. From the side of the cardiovascular system, tachycardia and muffled heart tones are detected; from the urinary organs – microalbuminuria, microhematuria, decreased diuresis.

According to the severity of catarrhal phenomena and symptoms of intoxication, mild, moderate, severe and hypertoxic forms of influenza in children are distinguished. With a typical mild and moderate course of influenza in children, improvement occurs after 3-4 days, but catarrh persists for 1.5-2 weeks. In the period of convalescence, asthenia may persist for a long time (fatigue, weakness, sweating). The hypertoxic form of influenza in children occurs with a high percentage of mortality due to the occurrence of fatal pulmonary edema, fulminant pneumonia, DIC, acute respiratory, cardiovascular and renal failure.

Complications of influenza in children are divided into respiratory and non-respiratory. The most common complications of the first group occur in children under 5 years of age and include viral and secondary bacterial pneumonia caused by pneumococcus, pathogenic staphylococcus, hemolytic streptococcus; false croup, bronchiolitis, otitis media, sinusitis. Complications of the non-respiratory type are represented by myocarditis, myositis, encephalitis, Reye’s syndrome, etc.

The most at risk of severe complications of influenza are children under 2 years of age, as well as children suffering from concomitant diseases (bronchial asthma, congenital heart defects, immunodeficiency, diabetes mellitus, kidney disease).

Diagnostics

When diagnosing influenza in children, the pediatrician takes into account epidemiological data and the clinical picture of the disease (fever, intoxication, catarrhal phenomena, physical changes).

Laboratory confirmation of influenza in children can be carried out using express methods (PCR and RIF), by which viral antigens are determined in swabs-prints from the mucous membrane of the nasal cavity and oropharynx. In some cases, serological and virological methods are used (ELISA, RSK – complement fixation reaction, RTGA – hemagglutination inhibition reaction, etc.).

To rule out influenza complications, children may need to consult narrow specialists (children’s otolaryngologist, pediatric pulmonologist), a general urine and blood test, chest x-ray, bacteriological examination of sputum, and blood cultures for sterility.

Differential diagnosis of influenza in children should be carried out with other acute respiratory viral infections, enterovirus infection, hemorrhagic fevers, prodromal periods of hepatitis A and measles, mononucleosis.

Treatment of influenza in children

Children with mild to moderate influenza are treated at home. Young children, as well as in severe or complicated infections, are hospitalized in an infectious diseases hospital. During the period of fever, it is necessary to observe bed rest, drink plenty of warm fluids.

Etiotropic therapy of influenza in children should be prescribed as early as possible. In pediatric practice, the following antiviral drugs are used: rimantadine, umifenovir, seltamivir, alpha interferon, tilorone, etc. Symptomatic therapy for influenza in children includes taking antipyretic and anti-inflammatory drugs (paracetamol, ibuprofen), mucolytics (ambroxol, bromhexine, fenspiride), antitussive drugs ( butamirate citrate, prenoxdiazine, oxeladine), instillation of vasoconstrictor drops into the nose, etc.

In the complex of pharmacotherapy of influenza in children, antihistamines and vitamin complexes are used. With the development of laryngitis or tracheitis, ultrasonic inhalations (medicinal, alkaline) are effective. In case of bacterial complications, antibacterial drugs (penicillins, macrolides, cephalosporins, etc. ) are prescribed. During the period of convalescence after the flu, children are recommended to take adaptogens and immunomodulators.

Prognosis and prevention

Typical cases of seasonal flu usually end in the recovery of children. A threat to life occurs in severe, hypertoxic and complicated forms of influenza in children from risk groups.

To prevent mass outbreaks of seasonal infection and increase collective immunity, additional vaccination of children against influenza is carried out annually. If a child in the family has the flu, other children and family members need to carry out emergency prophylaxis with antiviral drugs and interferons. During the influenza epidemic, measures are taken to separate children (isolation of patients, restriction of mass events, extraordinary holidays), anti-epidemic measures are taken (wet cleaning of premises with disinfectants, ventilation, quartzing).

You can share your medical history, what helped you in the treatment of influenza in children.

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1. self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

   symptoms, treatment, signs and prevention of disease

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   Contents

   • Main symptoms
   • Causes of high morbidity in children
   • Influenza diagnostics
   • Treatment of influenza in children
   • Disease prevention: the most important aspects

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   Influenza is an acute respiratory viral disease, it is transmitted by airborne droplets (for example, when sneezing) and is caused by one of the influenza virus strains. ¹ The disease is usually classified as seasonal. Children, according to statistics, get sick 3-5 times more often than adults. ³

   Influenza, with some similarities to the common cold, is more dangerous for the body, especially for children, is fraught with more serious complications, has much more pronounced symptoms and is very contagious. Therefore, it is important to recognize the infection in time, paying attention to typical symptoms, get an appointment with a doctor and take immediate action.

   In this article, we will talk about the characteristic signs that make it possible to recognize the disease, talk about why children get sick with it more often than adults. We will also touch on the important topic of diagnosing, treating and preventing influenza in children.

   Main flu symptoms in children

   The disease caused by the influenza virus can be recognized by the following features:

   • acute onset . The incubation period lasts from 12 hours to 3 days, on average it is 1-2 days. At the same time, the disease develops quite quickly, the first symptoms of influenza in a child appear immediately, without the so-called prodromal period – the time between the incubation period and the disease itself, when the signs are not yet expressed, but the person is already able to understand that he is getting sick. ³ This, among other things, allows us to immediately assume that the child does not just have a cold;
   • high temperature . Even in the case of mild severity, the temperature can reach 38.5 °C, with moderate severity – 38.5-39.5 °C, and with severe – 40-40.5 °C. It is temperature that is one of the main indicators of the severity of the disease. ² Fever may cause convulsions; ⁴
   • weakness, muscle pain and headache, sometimes vomiting . All these are manifestations of intoxication. School-age children can tell their parents about it themselves, in a very young child one can notice apathy, isolation, drowsiness, or, conversely, irritability and excitability; ³
   • eye discomfort . Usually this is pain when moving the eyes, which the child himself can tell about, as well as photophobia and lacrimation – this is noticeable from the outside. ³ Such signs are not typical for a cold – when they appear, it is most likely that it is the flu;
   • skin changes . Children’s skin, as a rule, becomes moist and pale, ³ and in young children, marbling of the skin can be noted; ⁴
   • cough . In the early days, it is usually dry, often painful, or “barking”, and may be accompanied by a sore throat. Later, the cough becomes wet, sparse mucous sputum begins to separate; ²
   • other respiratory symptoms . They usually do not appear immediately, but 1-2 days later than the others and are less pronounced – these are far from the main symptoms of influenza in children. ³ In addition to sore throat (which may be due to coughing), nasal congestion and slight discharge from it may disturb. ³

   Having found signs of flu in a child, it is recommended to immediately seek medical help from a pediatrician. No other infectious disease has such a serious percentage of complications (up to 10%). And it is in children that the possible complications are most serious. It’s pneumonia (80–90% of all complications), sinusitis, otitis media, as well as diseases of organs not related to the respiratory system (meningitis, pyelonephritis, etc.). ³ In patients aged 6 months to 5 years, the course of the disease can be very severe with the development of encephalitis. Therefore, do not hesitate to see a pediatrician.

   Causes of high childhood morbidity

   So why do children get sick with this virus more often, more severely, and with more serious complications than adults? The reason is simple: the children’s immune system is not yet fully formed and remains imperfect. This is especially true for those who live in large cities with poor environmental conditions.

   At risk are children attending kindergartens and schools, sports clubs. They are constantly in a large team and in the same room, which greatly increases the likelihood of the spread of this contagious virus. ⁴

   Diagnostics

   • history taking . The pediatrician listens to the complaints of the parents and the child himself, if he is already talking. Everything is important: the signs that are right now, information about how the disease began and how it developed;

   • physical examination . During the appointment, the pediatrician will conduct a physical examination of the small patient to assess his current condition. The examination allows not only to detect hidden symptoms, but also to determine how severe the disease is, whether hospitalization is required;

   • laboratory test . It usually includes a blood test (general with a leukocyte formula, CRP (C-reactive protein), procalcitonin, biochemical, coagulation – depending on the severity of the course), urinalysis (general). They may also take material from the nasopharynx to confirm the flu and determine its type;

   • instrumental diagnostics . The doctor may prescribe an x-ray of the chest, paranasal sinuses, ECG or echocardiography, as well as other examination methods.

   The need to use certain diagnostic methods is determined by the doctor depending on the symptoms and severity of the condition. Do not worry if the pediatrician examined the child only with the help of some of the indicated methods.

   Treatment of influenza in children

   In most cases, children with a mild or moderate form are treated at home. Usually, they are hospitalized only with a severe form or the presence of complications, if the treatment of influenza in children at home is not possible. At the same time, doctors recommend everyone, regardless of severity, to observe bed rest, diet and a certain diet: you need to feed often, but in small portions, give young children to drink at least 150 ml of water per kilogram of weight during a fever, and 100 ml / kg – after the temperature drops. ² In addition to compliance with the regimen, the pediatrician may prescribe medications: which ones, depends on the symptoms and their severity.

   Medical care includes symptomatic therapy to alleviate the course of the disease. Combination medications, such as children’s Coldrex, may be prescribed.

   The main active ingredient in its composition is paracetamol, it can bring down the fever, as well as relieve headaches, aching muscles and joints, relieve discomfort in the throat. It is this component that is indicated as the main one in all clinical guidelines for the treatment of respiratory diseases included in the Rubricator of Clinical Guidelines of the Ministry of Health of the Russian Federation. ⁵

   The preparation also contains phenylephrine, which reduces swelling of the nasal mucosa and facilitates nasal breathing if the child has a runny nose. And vitamin C helps to fill the increased need for it during the period of illness.

   For the treatment of children, you can use Coldrex Junior (used at the age of 12 years, but not younger than 6 years old) or Coldrex HotRem (if the child is 12 years old or older). ⁶

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   Disease prevention: the most important aspects

   • Specific prophylaxis . First of all, it refers to vaccination. It is considered the most effective means of prevention, and modern vaccines are administered to children from the age of 6 months. ²
   • Non-specific . Nonspecific. It is aimed at limiting contact with infections and maintaining social distance. So, during the period when the epidemic threshold is exceeded, children should be less likely to be in crowded places, wash their hands more often, take vitamins.

   Even very thorough prevention is not able to 100% protect a child from influenza, and his symptoms always appear suddenly. Therefore, we recommend that you always keep Coldrex on hand. It is able to alleviate the condition of the child and helps to endure the disease more easily.

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   References

   1. Clinical guidelines “Influenza in children” (approved by the Ministry of Health of the Russian Federation, 2017). http://astgmu.ru/wp-content/uploads/2020/04/gripp-u-detej-2017.pdf
   2. Lobzin Yu. V., Babachenko I. V., Vasiliev V. V., Uskov A. N. Peculiarities of influenza in children, modern possibilities of treatment and prevention // Consilium Medicum, 2016, p. 12–13. https://cyberleninka.ru/article/n/osobennosti-grippa-u-detey-sovremennye-vozmozhnosti-lecheniya-i-profilaktiki
   3. Krasnova E. I., Loskutova S. A., Panasenko L. M. Influenza in children – causes, course and possibilities of treatment // Elektron. Journal. lvrach.ru, accessed 7.07.2022. https://www.lvrach.ru/2013/08/15435781
   4. Influenza in children – website of the Center for Hygienic Education of the Population of Rospotrebnadzor http://cgie.62.rospotrebnadzor.ru/content/1214/129233/
   5. https://minzdrav.gov.ru/ru
   6. Instructions for preparations Coldrex.

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