What Parents Should Know About Influenza (The Flu)

Introduction

Every winter, influenza, commonly known as the flu, spreads across communities, affecting millions of people worldwide. Pediatricians and family physicians frequently address misconceptions and myths about this illness. Understanding influenza—what it is, how it spreads, its symptoms, treatment options, and prevention methods—can help parents make informed choices to protect their children.

How Bad Will the Flu Be This Season?

To predict the severity of an upcoming flu season, experts analyze flu trends in the Southern Hemisphere. In recent years, many countries have experienced more severe flu seasons, with different dominant strains circulating in different regions. For example, H3N2 was the dominant strain in South America and Australia, while H1N1 was prevalent in Africa. Although this prediction method isn’t foolproof, it provides valuable insights.

The effectiveness of the flu vaccine also plays a role. While the vaccine may not always be a perfect match for circulating strains, studies have shown that it still provides significant protection, reducing the risk of severe illness and hospitalization in children. Even if vaccinated individuals contract the flu, they often experience a shorter, milder illness.

What Is Influenza?

Influenza is a viral infection that primarily affects the respiratory system, including the nose, throat, and lungs. It is caused by influenza viruses, categorized into four types: A, B, C, and D. However, only Influenza A and B cause seasonal flu outbreaks. The flu virus constantly evolves, which is why annual vaccinations are necessary.

Certain groups are at higher risk for severe flu complications, including young children (especially those under 5 years old), older adults, and individuals with underlying health conditions. In the 2023-2024 flu season, the U.S. reported a record high of 200 pediatric flu-related deaths, with about 80% occurring in unvaccinated children. Surprisingly, about 50% of these fatalities were among previously healthy children.

Symptoms of Influenza

Flu symptoms can appear suddenly and are often more severe than the common cold. Common flu symptoms include:

Fever (often high, 100.4°F or above)
Chills
Cough
Sore throat
Runny or stuffy nose
Muscle or body aches
Headache
Fatigue (tiredness)
Gastrointestinal symptoms (vomiting, diarrhea, nausea) – more common in children

If your child has difficulty breathing, persistent high fever, confusion, or dehydration, seek medical attention immediately.

How Influenza Spreads

Influenza is highly contagious and spreads through:

Respiratory droplets (coughing, sneezing, talking)
Contact with contaminated surfaces (toys, doorknobs, tables)
Aerosolized particles released into the air

Symptoms typically develop 1 – 4 days after exposure. While most people are most contagious in the first few days of illness, children and immunocompromised individuals may shed the virus for longer periods.

Diagnosing Influenza

Doctors often diagnose the flu based on symptoms and community flu activity. In many cases, a nasopharyngeal swab is used for a rapid influenza diagnostic test (RIDT), which provides results within 15 – 30 minutes. More accurate PCR tests may also be used but take longer.

Expected Clinical Course

Most children recover from the flu within a week, though some symptoms, like cough and fatigue, can linger for several weeks. While antiviral medications can shorten the duration of illness, supportive care is the mainstay of treatment.

Potential Flu Complications

Influenza can lead to severe complications, including:

Hospitalization due to dehydration, respiratory failure, or secondary bacterial infections
Secondary bacterial infections, such as pneumonia, ear infections, or throat abscesses
Febrile seizures (occurring in 5% of children with high fevers)
Rare but serious complications, such as sepsis, meningitis, myositis, and myocarditis

Flu Treatment Options

Treatment focuses on symptom relief and supportive care:

Rest: Encourage plenty of sleep.
Hydration: Offer fluids like water, clear broths, or electrolyte drinks.
Fever Management: Use acetaminophen (Tylenol) or ibuprofen (Advil) to reduce fever and discomfort (avoid aspirin in children due to the risk of Reye’s syndrome).
Humidity & Steam Therapy: Helps relieve congestion and soothe sore throats.

What Is Tamiflu?

Tamiflu (Oseltamivir) is an antiviral medication that inhibits viral replication. It can:

Reduce symptom duration by 1 – 2 days
Decrease the severity of illness
Lower the risk of complications
Be used preventively for high-risk individuals after exposure

However, Tamiflu must be taken within 48 hours of symptom onset for maximum effectiveness. Side effects can include nausea, vomiting, headaches, and, in rare cases, neuropsychiatric symptoms (e.g., nightmares, seizures). Some healthcare providers hesitate to prescribe it routinely, but it remains an option for high-risk children.

Other antiviral medications, such as Zanamivir (Relenza) and Baloxavir (Xofluza), are also available.

When Can Children Return to School?

Per CDC guidelines, children can return to school when:

They have been fever-free for 24 hours (without fever-reducing medication)
Their symptoms have improved, and they are well enough to participate in daily activities

Flu Prevention Strategies

The best way to prevent the flu is through vaccination and hygiene practices.

1. Get the Flu Vaccine

Recommended for everyone 6 months and older
Reduces the risk of severe flu illness, hospitalization, and complications
Updated annually to protect against circulating flu strains

2. Practice Good Hygiene

Wash hands frequently with soap and water.
Cover coughs and sneezes with a tissue or elbow.
Avoid touching the face (especially the eyes, nose, and mouth).

3. Keep Your Home Germ-Free

Disinfect frequently touched surfaces (doorknobs, light switches, phones, toys).
Wash bedding and clothes regularly, especially when someone is sick.

4. Encourage a Healthy Lifestyle

Ensure your child gets enough sleep, eats a balanced diet, and exercises regularly to boost immunity.

When to Call the Pediatrician

Always trust your instincts as a parent. Call your pediatrician if:

Your child is under 3 months and appears sick.
Symptoms persist beyond a few days or worsen.
Your child has severe pain, irritability, or lethargy.
Signs of dehydration appear (no urination, dry mouth, no tears).
Your child has difficulty breathing or a persistent high fever.

Conclusion

Influenza is a common yet potentially serious illness that parents should not take lightly. Knowing its symptoms, treatment options, and prevention methods can help protect your family. The flu vaccine remains the best defense, and good hygiene habits further reduce the risk of infection.

By staying informed and proactive, you can navigate flu season safely. Remember, protecting your child from the flu also helps safeguard infants, grandparents, and those with weaker immune systems. Stay safe, stay healthy, and have a flu-free season!