The Flu : A Guide for your childrens parents

What is the flu?
The flu (influenza) is an infection of the nose, throat, and lungs that is caused by influenza virus. The flu can spread from person to person. Most people with flu are sick for about a week, but then feel better. However, some people (especially young children, pregnant women, older people, and people with chronic health problems) can get very sick and some can die.

What are the symptoms of the flu?
Most people with the flu feel tired and have fever (usually high), headache, dry cough, sore throat, runny or stuffy nose, and sore muscles. Some people, especially children, may also have stomach problems and diarrhea. Cough can last two or more weeks.

How does the flu spread?
People that have the flu usually cough, sneeze, and have a runny nose. This makes droplets with virus in them. Other people can get the flu by breathing in these droplets, getting them in their nose or mouth, or touching contaminated surfaces.

How long can a sick person spread the flu to others?
Healthy adults may be able to spread the flu from 1 day before getting sick to up to 5 days after getting sick. This can be longer in children and in people who don’t fight disease as well (people with weakened immune systems).

How can I protect my child from the flu?
A flu vaccine is the best way to protect against the flu. CDC recommends that all children from the ages of 6 months up to their 19th birthday get a flu vaccine every fall or winter (children getting a vaccine for the first time need two doses).
Flu shots can be given to children 6 months and older.
A nasal-spray vaccine can be given to healthy children 2 years and older (children under 5 years old who have had wheezing in the past year or any child with chronic health problems should get the flu shot).
You can protect your child by getting a flu vaccine for yourself too. Also encourage your child’s close contacts to get a flu vaccine. This is very important if your child is younger than 5 or has a chronic health problem like asthma (breathing disease) or diabetes (high blood sugar levels).


Is there medicine to treat the flu?
There are antiviral drugs for children 1 year and older that can make your child feel better and get better sooner. But these drugs need to be approved by a doctor. They should be started during the first 2 days that your child is sick for them to work best. Your doctor can discuss with you if these drugs are right for your child.


What Can YOU Do?


How else can I protect my child against flu?

Take time to get a flu vaccine and get your child vaccinated too.
Take everyday steps to prevent the spread of germs. This includes:

• Clean your hands often and cover your coughs and sneezes


• Tell your child to:




• Stay away from people who are sick


• Clean hands often


• Keep hands away from face


• Cover coughs and sneezes to protect others (it’s best to use a tissue).

What should I use for hand cleaning?
Washing hands with soap and water (for as long as it takes to sing the Happy Birthday song twice) will help protect your child from many different germs. When soap and water are not available, wipes or gels with alcohol in them can be used (the gels should be rubbed into your hands until they are dry).

What can I do if my child gets sick?
Consult your doctor and make sure your child gets plenty of rest and drinks a lot of fluids. If your child is older than 2 years, you can buy medicine (over-the-counter) without a prescription that might make your child feel better. Be careful with these medicines and follow the instructions on the package. But never give aspirin or medicine that has aspirin in it to children or teenagers who may have the flu.

What if my child seems very sick?
Call or take your child to a doctor right away if your child:



• has a high fever or fever that lasts a long time


• has trouble breathing or breathes fast


• has skin that looks blue


• is not drinking enough


• seems confused, will not wake up, does not want to be held, or has seizures (uncontrolled shaking)


• gets better but then worse again


• has other conditions (like heart or lung disease, diabetes) that get worse



Can my child go to school if he or she is sick?
No. Your child should stay home to rest and to avoid giving the flu to other children.


Should my child go to school if other children are sick?
It is not unusual for some children in school to get sick during the winter months. If many children get sick, it is up to you to decide whether to send your child to school. You might want to check with your doctor, especially if your child has other health problems.

When can my child go back to school after having the flu?
Keep your child home from school until his or her temperature has been normal for 24 hours. Remind your child to cover their mouth when coughing or sneezing, to protect others (you may want to send some tissue and wipes or gels with alcohol in them to school with your child).

Influenza usually starts suddenly and may include the following symptoms:




• Fever (usually high)


• Headache


• Tiredness


• Cough


• Sore throat


• Runny or stuffy nose


• Body aches


• Diarrhea and vomiting




Having these symptoms does not always mean that you have the flu. Many different illnesses, including the common cold, can have similar symptoms.

Diagnosing the Flu

It is very difficult to distinguish the flu from other infections on the basis of symptoms alone. A doctor's exam may be needed to tell whether you have developed the flu or a complication of the flu. There are tests that can determine if you have the flu as long you are tested within the first 2 or 3 days of illness.

If you develop flu-like symptoms and are concerned about your illness, especially if are at high risk for complications of the flu, you should consult your healthcare provider. Those at high risk for complications include people 65 years or older, people with chronic medical conditions (such as asthma, diabetes, or heart disease), pregnant women, and young children.


Know the Risks from the Flu

In some people, the flu can cause serious complications, including bacterial pneumonia, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma or diabetes. Children and adults may develop sinus problems and ear infections.

People May Have Different Reactions to the Flu

The flu can cause mild to severe illness and at times can lead to death. Although most healthy people recover from the flu without complications, some people, such as older people, young children, and people with certain health conditions (such as asthma, diabetes, or heart disease), are at high risk for serious complications from the flu.

Know How the Flu Spreads

The flu usually spreads from person to person in respiratory droplets when people who are infected cough or sneeze. People occasionally may become infected by touching something with influenza virus on it and then touching their mouth, nose or eyes.

Healthy adults may be able to infect others 1 day before getting symptoms and up to 5 days after getting sick. Therefore, it is possible to give someone the flu before you know you are sick as well as while you are sick.


Best Protection against the Flu: Vaccination

The single best way to protect yourself and others against influenza is to get a flu vaccination each year. Two kinds of flu vaccine are available in the United States:


• The "flu shot" — an inactivated vaccine (containing killed virus) that is given with a needle, usually in the arm. The flu shot is approved for use in people older than 6 months, including healthy people and people with chronic medical conditions (such as asthma, diabetes, or heart disease).


• The nasal-spray flu vaccine — a vaccine made with live, weakened flu viruses that do not cause the flu (sometimes called LAIV for “live attenuated influenza vaccine” or FluMist®). LAIV (FluMist®) is approved for use in healthy* people 2-49 years of age who are not pregnant.

Yearly flu vaccination should begin in September or as soon as vaccine is available and continue throughout the influenza season, into December, January, and beyond. This is because the timing and duration of influenza seasons vary. While influenza outbreaks can happen as early as October, most of the time influenza activity peaks in January or later.
Related Information

Antiviral drugs are available to treat and prevent the flu. For more about treating the flu with antiviral drugs, see Influenza Antiviral Drugs.

Antiviral Drugs for Seasonal Flu

What are flu antiviral drugs?


Flu antiviral drugs are drugs that decrease the ability of flu viruses to reproduce. While getting a flu vaccine each year is the best way to protect you from the flu, antiviral drugs can be used as a second line of defense to treat the flu or to prevent flu infection.

What are the treatment benefits of flu antiviral drugs?

For treatment, antiviral drugs should be started within 2 days after becoming sick. When used this way, these drugs can reduce the severity of flu symptoms and shorten the time you are sick by 1 or 2 days. They also may make you less contagious to other people.


How effective are antiviral drugs at preventing the flu?

When used to prevent the flu, antiviral drugs are about 70% to 90% effective. It’s important to remember that flu antiviral drugs are not a substitute for getting a flu vaccine.

What flu antiviral drugs does CDC recommend for use in the United States for the 2008-09 season?

CDC and the Advisory Committee on Immunization Practices (ACIP) recommend that oseltamivir (brand name Tamiflu®) or zanamavir (brand name Relenza®) should be used for the treatment and prevention of flu in the United States this season. Although amantadine and rimantadine (two other influenza antiviral drugs) also are FDA-approved for treatment or prevention of influenza, these two drugs are NOT recommended for use in the United States during the 2008-09 flu season because recent flu viruses are resistant to these drugs. When viruses are resistant to drugs, the drugs don’t work or don’t work as well.


Who should take antiviral drugs for flu?

CDC has provided guidelines for health care professionals on the use of antiviral drugs (see Information for Health Care Professionals: Using Antiviral Agents for Seasonal Influenza). In general, antiviral drugs can be offered to anyone who wants to avoid and/or treat the flu, people who are at high risk of serious flu-related complications may benefit most from these drugs. Also, close contacts of people with the flu who are at high risk of serious flu-related complications may benefit from antiviral drugs to protect them from getting sick.

How can I get an antiviral drug for flu?

Antiviral drugs must be prescribed by a health care professional.

How long should antiviral drugs be taken?

The length of time antiviral drugs should be taken depends on how they are being used. To prevent flu, antiviral drugs should be taken for as long as flu viruses are circulating in a given setting. To treat flu, oseltamivir and zanamivir are taken for 5 days. See Treatment & Prevention: Influenza Antiviral Drugs for more information.

What side effects can occur with flu antiviral drugs?

Side effects differ for each drug. If an antiviral drug has been prescribed for you, ask your doctor to explain how to use the drug and any possible side effects. Health care professionals prescribing flu antiviral drugs should alert patients about adverse events that can occur. For more information about side effects, see Antiviral Drugs: Summary of Side Effects.


Can flu antiviral drugs help with other illnesses such as the common cold?

No. Flu antiviral drugs only work against flu viruses. They will not help reduce symptoms from the common cold or any other flu-like illnesses caused by viruses other than flu viruses. Many other viruses cause winter illnesses besides the flu.

Can people who are not in a high-risk group receive antiviral drugs?

Yes. Consult with your doctor to determine if you should take antiviral drugs this season.

Can antiviral drugs be helpful for people unable to take the flu vaccine?

Yes. CDC and ACIP recommend use of antiviral drugs for people allergic to eggs (which can cause them to have an allergic reaction to the vaccine) or for people who previously have encountered complications from Guillain-Barre syndrome (GBS) associated with influenza vaccination. In addition, taking antiviral drugs may be recommended among persons that may not have a good immune response to the flu vaccine.

Should people use antiviral drugs before or after receiving the live attenuated influenza vaccine (LAIV) called FluMist®?

LAIV is one of two types of flu vaccine. It is given as a nasal spray and contains weakened, live virus. Flu antiviral drugs taken from 48 hours before through 2 weeks after getting LAIV can lower or prevent the vaccinated person from responding to the vaccine and the person may not get immune protection from the vaccine.

Antiviral drugs can be taken with the inactivated (i.e. killed) flu vaccine.

Can antiviral drugs be given even if a person is not tested for flu or if a flu test does not indicate that they have influenza?

Yes. For individual patients, influenza testing is not required for antiviral drugs to be prescribed. Testing is done based on health care provider recommendations.

Tests are available that can test for flu viruses in as little as 30 minutes or less. Flu testing can be used to rapidly confirm the flu as the cause of outbreaks. However, results from these rapid tests are not 100% accurate; the test may indicate that a person does not have influenza even though they really do have the flu. So, other information in addition to influenza test results, if done, need to be factored into decisions about using antiviral drugs. One consideration will be information about influenza circulating in the community in general.
What are Tamiflu® (oseltamivir) and Relenza® (zanamivir)?

Tamiflu® and Relenza® are chemically related antiviral drugs known as neuraminidase inhibitors that fight against both influenza A and B viruses.

Oseltamivir (brand name Tamiflu ®) is approved to both treat and prevent flu in people one year of age and older.

Zanamivir (brand name Relenza ®) is approved to treat flu in people 7 years and older and to prevent flu in people 5 years and older.

What are the possible side effects of Tamiflu® (oseltamivir)?

Tamiflu® has been in use since 1999. The most common side effects are nausea and vomiting which usually happen in the first 2 days of treatment. Taking Tamiflu® with food can reduce the chance of getting these side effects. On November 13, 2006, a new precaution about Tamiflu® was added. The precaution warns that people with the flu, mostly children, may be at an increased risk of self-injury and confusion shortly after taking Tamiflu® and should be closely monitored for signs of unusual behavior. This precaution was added after the FDA received post marketing reports (mostly from Japan) about persons (primarily among children and adolescents) who had purposefully injured themselves or been delirious while using Tamiflu® (oseltamivir) to treat influenza. The reports appear to be uncommon. For more information, visit the Food & Drug Administration's MedWatch page.

What should be done if complications while taking Tamiflu® (oseltamivir) occur?

Contact a health care professional immediately if someone taking Tamiflu® shows any signs of unusual behavior.

What are the possible side effects of Relenza® (zanamivir)?

Relenza® has been in use since 1999. The most common side effects are diarrhea, nausea, sinusitis, runny or stuffy nose, bronchitis, cough, headache, dizziness, and ear, nose and throat infections. Some persons, mostly those who already had a chronic lung disease such as asthma, have reported serious breathing problems such as wheezing or shortness of breath after taking Relenza® (zanamivir). In rare cases, people have had an allergic reaction to the drug, including rashes and edema (a build up of fluid in body-tissue) of the face and throat.


Who is at risk for complications from Relenza® (zanamivir)?

Persons with chronic lung diseases such as asthma or chronic obstructive pulmonary disease are not recommended to use Relenza® (zanamivir), as some patients have reported difficulty breathing after inhaling the drug.

What should be done if complications while taking Relenza® (zanamivir) occur?

If you have side effects while taking Relenza® (zanamivir) talk to your health care provider immediately.


Can influenza antiviral drugs be used in pregnant women?

Oseltamivir and zanamivir are both "Pregnancy Category C" medications, indicating that no studies have been conducted to assess the safety of these drugs for pregnant women. Because of the unknown effects of these drugs on pregnant women and their unborn children, these two drugs should be used during pregnancy only if the potential benefit justifies the potential risk to the unborn child. Physicians considering using one of these drugs in a pregnant woman should consult that drug package insert.