Influenza, commonly known as the flu, is a respiratory illness caused by a virus. It has the ability to quickly spread among kids and within communities through person-to-person transmission. When an infected person coughs or sneezes, the influenza virus is released into the air, allowing anyone nearby to inhale the virus through their nose or mouth. Additionally, the virus can be transmitted when people come into contact with contaminated surfaces, such as doorknobs, and subsequently touch their nose, mouth, or eyes with their hands or fingers. Even for experienced parents, it can be difficult to distinguish flu symptoms in kids from other common childhood illnesses, like a cold, COVID-19, or respiratory syncytial virus (RSV). Here’s what parents need to know about the flu, how to treat it, and how to prevent it.

Common Symptoms of Flu in Kids

According to the American Academy of Pediatrics (AAP), influenza often triggers a mixture of sudden fever (typically above 100.4°F), dry cough, sore throat, runny nose, chills, muscle aches, headaches, and an overall sense of malaise. This might cause your little one to feel extra tired and grumpy. It can also cause vomiting and diarrhea in some children. Another hallmark of the illness: symptoms of the flu in kids tend to come on abruptly. A child may seem completely fine and then suddenly begin showing all of the aforementioned symptoms within a matter of hours.

How Long Do Flu Symptoms Last in Kids?

Healthy people, particularly kids, recover from the flu in about a week, without any lingering problems. After the first few days of being sick, a stuffy nose, lingering cough, and sore throat tend to be the most prevalent symptoms. By contrast, a child who has a common cold may only have a low-grade fever, runny nose, and a little bit of coughing. A kid who has the flu will also feel a lot sicker and more uncomfortable than a child who simply has a cold. Give your pediatrician a call if you believe your child may have any additional complications, such as ear pain, pressure in your child's face and head, or a cough and fever that will not resolve on their own.

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COVID vs Flu Symptoms in Kids

COVID-19 and the flu share several similarities as contagious respiratory viruses. Typically, children with the flu show a sudden onset of symptoms, including fever, cough, and a runny nose, lasting for several days. On the other hand, kids with COVID-19 may either remain asymptomatic or experience a brief period of fever along with congestion, cough, and loss of taste and smell.

When Is Flu Season?

The flu season typically spans from fall to the end of spring, with outbreaks and epidemics more common during winter, particularly among preschool and school-aged children. College students and teenagers are also prone to the rapid spread of flu viruses. The AAP recommends all individuals aged 6 months and older receive an annual flu vaccine, ideally before the end of October. In the initial days of illness, the flu virus can easily transmit to other children, parents, and caregivers. The AAP also advises everyone aged 6 months and older to receive both the flu vaccine and COVID-19 vaccines. These vaccines can be safely administered simultaneously or at different times.

How is Flu Treated?

When kids have the flu, they need to get lots of extra rest and stay hydrated by drinking plenty of fluids. If your little one is experiencing discomfort due to a fever, your pediatrician may recommend giving them acetaminophen or ibuprofen in appropriate doses based on their age and weight. Ibuprofen is safe for kids 6 months and older, but it shouldn’t be administered to dehydrated children or those who are continuously vomiting. Another key point: never give aspirin to a child suspected of having the flu or diagnosed with it. The use of aspirin during influenza can increase the risk of developing Reye syndrome, a rare but serious condition that causes swelling in the liver and brain.

Contact your pediatrician as soon as possible if your child shows any signs of the flu. They may be able to prescribe an antiviral medication if appropriate. Antiviral medication is most effective when started within the first one to two days of flu symptoms, but it can still be beneficial in some instances even if initiated later. It’s also especially important to call your doctor within the first 24 hours of symptoms if your little one:

• Has an underlying health condition such as asthma, chronic lung disease, heart condition, diabetes, sickle cell disease, weakened immune system, neuromuscular disorders (e.g., cerebral palsy), or other medical conditions.
• Is younger than 5 years old, particularly if they are under 2 years old.
• Shows symptoms that are not improving.
• Has close contact with individuals at high risk of flu complications.

What Do I Need to Know About the Flu Vaccine for Kids?

Both the inactivated (killed) vaccine, commonly known as the "flu shot," administered via injection in the muscle, and the live-attenuated nasal spray vaccine are good choices for influenza vaccination. (It should be noted, however, that the nasal spray is only available to children older than 2 years, according to the Centers for Disease Control). There is no preference for a specific product or formulation, and either is acceptable based on availability in your area.

The vaccine works by enhancing your child’s immune system to defend against the flu virus. It takes approximately two weeks after vaccination for a child’s immune response to develop fully. By getting vaccinated before the flu begins to spread, you can ensure the well-being of your entire family, so that they can avoid getting sick and continue to engage in activities they enjoy.

What Are the Side Effects of the Flu Vaccine?

The flu vaccine is generally well-tolerated with minimal side effects. The most commonly reported side effects of the flu shot include fever and redness, soreness, or swelling at the injection site. For the nasal spray vaccine, common side effects may include a runny nose, congestion, and sore throat. It’s important to note that kids with egg allergies can still receive the flu vaccine. However, if a child has experienced an allergic reaction after a previous dose of the flu vaccine, you should consult an allergist who can provide additional guidance regarding the safety of an annual flu vaccination.

When Does Flu Become an Emergency?

If your child has the flu and experiences any of the following symptoms, it is important to contact your pediatrician or seek immediate medical care:

• Trouble breathing or unusually rapid breathing
• Bluish lips or face
• Ribs appearing to pull in with each breath
• Chest pain
• Severe muscle pain leading to refusal to walk
• Signs of dehydration (no urination for 8 hours, dry mouth, absence of tears when crying)
• Lack of alertness or interaction while awake
• Seizures
• Fever above 104°F
• Any fever in children under 12 weeks old
• Fever or cough that initially improves but then returns or worsens
• Worsening of pre-existing chronic medical conditions, such as asthma

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