How can I tell if my preschooler has the flu?
It may not be easy. That's because the symptoms of the flu in children are remarkably similar to those of colds and other viral illnesses.
That said, if the flu is going around and your child has the following symptoms, there's a good chance that it's the flu: the sudden onset of fever, typically 101 degrees Fahrenheit (38.3 degrees Celsius) or higher, headache, muscle aches, fatigue, and chills, followed by respiratory symptoms such as a runny nose and a dry cough. (If congestion or coughing shows up much before the fever, it's more likely your child has a cold.)
Your child may also be irritable and have a poor appetite, a sore throat, and swollen glands. The flu can also bring on abdominal pain, diarrhea and vomiting.
How did my child get the flu?
The flu viruses (influenza A and influenza B) are potent pathogens in close quarters, spreading easily through the air. If your child is near a person with the flu who is coughing or sneezing, he'll breathe in those infected droplets through his mouth or nose and get infected. A person with the flu is contagious for about 24 hours before symptoms begin and for about a week after.
Because the flu proliferates when people are in close contact, it travels easily through schools, daycare centers, playgroups, and families. Usually the unsuspecting victim will get sick one to three days after exposure. Perhaps your child was infected at preschool, or maybe someone in your family had the virus and you wrote it off as a cold. (It's possible that a sibling or parent had it, for example, and only developed mild symptoms, because the severity of the flu differs from person to person.)
My child is miserable. What can I do to make him feel better?
The best treatment for the flu is bed rest, plenty of fluids, and as much nutritious food as your child can handle. Try offering frozen fruit bars to encourage him to get extra liquids — along with soup or broth, which may ease his congestion as well.
For muscle aches and fever, give your child a pain reliever such as children's acetaminophen or ibuprofen. (Never give a child aspirin unless your doctor has recommended it, especially if he has a viral infection. It can trigger Reye's syndrome, a rare but life-threatening condition.)
If your child is at high risk for complications because of an underlying medical condition, his doctor may be able to prescribe an antiviral medication that can help ease the symptoms and shorten the duration of the flu by a day or two. The trick is in making the diagnosis as soon as possible, though, because the medication must be given in the first 48 hours. Once that 48-hour window closes, the antiviral medications are no longer effective.
Resist the urge to pressure your doctor for antibiotics, which kill only bacteria. A virus, not bacteria, causes the flu, so antibiotics won't work. In some cases, however, if your child develops a secondary bacterial infection, such as pneumonia, an ear infection, or bronchitis, as a result of having the flu, antibiotics may be in order.
Your child should start feeling better in three to five days. You'll notice his fever break first and then his appetite should return. But this is just an average — some children (and adults) have a cough and associated body aches that hang on for two weeks or more.
What can I do to prevent my preschooler from getting the flu again?
You can help keep your child healthy by making sure that he eats well, gets enough rest and exercise, and practices good hygiene — especially by helping him wash his hands before eating and after going to the bathroom. Of course, you'll want to wash your hands with soap and hot water too, to prevent spreading germs at home. Still, the flu is easy to pick up no matter how healthy and conscientious your child may be.
The good news is, if your child has the flu now, he's less likely to get it again this year because he's developed immunity to the particular strain that's going around. But next year is another story. As you may know, the strain of virus that causes influenza changes every year, so researchers develop a new flu vaccine each year to help prevent outbreaks.
The Centers for Disease Control and Prevention (CDC) recommends that all healthy children between the ages of 6 months and 59 months (4 years, 11 months) get a flu shot. The CDC also recommends a yearly shot for household contacts and caregivers of children under age 5.
Getting the vaccine is particularly important if your child is in a high-risk group — if he has diabetes, a suppressed immune system, severe anemia, or a chronic heart, lung (including asthma), or kidney disease. Children on long-term aspirin therapy for diseases such as juvenile rheumatoid arthritis are also good candidates for the flu vaccine because the aspirin they take puts them at risk for Reye's syndrome if they come down with a virus.
But even if your child is perfectly healthy, you may consider getting him vaccinated. Studies suggest that vaccinating children for the flu cuts down on influenza-related hospitalizations in those children and among adults who were in contact with them.
Protection begins about two weeks after the vaccination. If your child has never been vaccinated for influenza, keep in mind that he'll need two shots, one month apart, to build immunity. If you decide to have your child vaccinated, it would be best to do it in the fall or early winter. Flu season can start as early as October and last into May, though the peak months are generally January and February.
Unfortunately, the flu vaccine isn't foolproof. Its effectiveness depends on the health of your child (it's more effective in healthy children) and how well the vaccine is matched to the virus that's currently circulating; some years, those who develop the vaccine get a closer match than in other years.
Effectiveness in healthy children ranges from 44 percent to 91 percent, but these rates vary from one year to the next. If your child does get the flu after getting vaccinated, there's a good chance he'll get a milder case. (Of course, the shot will not protect your child from other viruses that may seem like the flu.)
Shortages of the flu vaccine occur during some flu seasons. In these instances children and adults considered high risk are given first priority. Your child's doctor can keep you up-to-date on the availability of the vaccine before each flu season.
Is there any reason not to get my child vaccinated against the flu?
If your child has had a negative reaction to a flu vaccine before, tell your doctor. She may advise against his getting another shot. If your child is allergic to eggs, he shouldn't get the shot, which is made with egg protein. And if your child is currently ill with a fever, his doctor may suggest postponing the vaccination until he's feeling better.
Some people are concerned about giving children flu shots because some of the shots contain the preservative thimerosal, which contains mercury. While the CDC reports that there is no evidence that thimerosal is harmful, and that the benefits of the flu shot outweigh any potential risks, thimerosal has been eliminated from all childhood vaccinations as a precautionary measure on the recommendation of the American Academy of Pediatrics and the Public Health Service. However, some flu vaccines still contain the preservative. If you're concerned about thimerosal, ask your child's doctor whether she can obtain a thimerosal-free vaccine for your child.
Side effects of the flu shot may last a day or two and could include soreness at the injection site, a low-grade fever, and aches. Severe allergic reactions are rare but possible.
When should I call my child's doctor?
Call your child's doctor:
• If your child has a fever over 103 degrees F (39.4 degrees C) or any fever that lasts longer than three days
• If your child develops a cough that persists for more than a week
• At the first sign of the flu if your child is HIV-positive or has a chronic illness (such as cancer, sickle-cell anemia, diabetes, or heart, lung, or kidney disease)
• At the first sign of the flu if your child has rheumatoid arthritis or Kawasaki disease, both of which are treated with long-term aspirin therapy. (In such cases, the benefits of aspirin outweigh the tiny risk of Reye's syndrome.)
• If your child has an earache
• If your child is wheezing or seems to be working harder than usual to breathe
• If he becomes sick again soon after bouncing back from the flu, or if he has a high fever for more than three or four days. (He may have a secondary infection that needs to be treated.)
• If your child shows any signs of dehydration
