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Flu: A Guide for Parents of Children or Adolescents with Chronic Health Conditions

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Influenza (flu) is an infection of the nose, throat and lungs caused by the influenza viruses. It can cause mild to severe illness, pneumonia, and other complications.

Children younger than age 5, but especially children younger than 2 years old, and children and adolescents with chronic health conditions are at greater risk for serious flu complications. These flu complications can result in hospital stays and even death. The best way to prevent the flu is by getting a flu vaccine each year.

How do I know if my child is at greater risk for flu-related complications?

Your child is at higher risk if they have any of the following conditions:

  • Asthma

  • Neurological and neurodevelopmental conditions including disorders of the brain; spinal cord; peripheral nerve and muscle. Examples include cerebral palsy, epilepsy (seizure disorders), stroke, intellectual disability, moderate to severe developmental delay, muscular dystrophy or spinal cord injury

  • Chronic lung disease (such as cystic fibrosis, or chronic lung disease of prematurity)

  • Heart disease (such as congenital heart disease and congestive heart failure)

  • Blood disorders (such as sickle cell disease)

  • Endocrine disorders (such as diabetes mellitus)

  • Kidney disorders

  • Liver disorders

  • Obesity (childhood obesity is defined as a body-mass index at or above the 95th percentile, for age and sex)

  • Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)

  • Weakened immune system due to disease or medication (such as children or adolescents with HIV or AIDS, cancer, bone marrow or solid organ transplantation or those on chronic steroids or other immune suppressive treatment)

  • Receiving long-term aspirin therapy for chronic disorders

  • Pregnancy

What are symptoms of the flu?

Symptoms of the flu can include:

  • Fever*

  • Cough

  • Sore throat

  • Runny or stuffy nose

  • Body aches

  • Headache

  • Chills

  • Fatigue

  • Sometimes vomiting and diarrhea

*It is important to note that some people sick with flu may not have a fever.

What is a flu complication?

Most people who get the flu will recover in a few days to less than 2 weeks, but some people will develop complications because of the flu, some of which can be life-threatening and result in death.

Pneumonia, bronchitis, and sinus and ear infections are examples of complications from the flu. The flu can also make chronic health conditions worse. For example, people with asthma may experience asthma attacks while they have the flu.

How can I protect my child against the flu?

  • Flu vaccines: The most important thing is for your child to get a flu vaccine every year. Children younger than 6 months are at high risk of serious flu illness, but are too young to be vaccinated. People who care for them should be vaccinated instead in order to protect them. When a pregnant woman is vaccinated, the antibody produced in response to the vaccine also offers protection to the developing baby.

  • Distance: Your child should avoid close contact with people who are sick.

  • Hand washing: Wash hands often with soap and running water (as long as it takes to sing the "Happy Birthday" song twice). If soap and water are not available, use an alcohol-based hand sanitizer. Help your child wash their hands if needed.

  • Germ control: Encourage your child to avoid touching their eyes, nose, mouth, and to use a tissue or elbow to cough or sneeze into.

  • Cleaning: Keep surfaces in the house and toys clean by wiping them down with a household disinfectant according to the directions on the product label.

  • Health: If your child has a chronic health condition, make sure that it is under the best control.

  • Plan: Have a plan in case your child becomes sick with the flu.

What can I do if my child gets sick?

  • Doctor: Call or take your child to the doctor if your child develops flu-like symptoms. The doctor may want to begin antiviral drugs as quickly as possible. Antiviral drugs are prescription medicines that fight against the flu in your body.

  • Home care: Excluding doctor visits, keep your child at home until they no longer have a fever for at least 24 hours and are feeling more like themselves.

  • Covering coughs: Ensure that your child covers coughs and sneezes.

  • Rest and fluids: Make sure your child gets plenty of rest and drinks fluids to keep them from becoming dehydrated.

  • Medicines: Ask your doctor about fever-reducing medicines based on your child's age. Children younger than 4 years of age should not be given over-the-counter cough/cold medicines without approval from a health care provider. Aspirin should not be given to children or teenagers who have the flu; this can cause a rare but serious illness called Reye's syndrome. Remember that the fever helps your child fight the infection, so it is not always necessary to give fever-reducing medicines.

  • Sick room: Keep your sick child in a separate room (sick room) in the house. Limit as much contact as possible with other members of the household who are not sick. Make one person in the house the main caregiver for the sick child.

  • Protect pregnant women: Pregnant women should get a flu shot. If possible, pregnant women should not be the main caregivers of a child with the flu until they recover.

When can my child go back to school after being sick?

Usually, your child should stay home for at least 24 hours after the fever is gone. A fever is defined as 100.4° F/38.3° C or greater. The fever should be gone without the use of a fever-reducing medicine.

Is the flu vaccine safe for my child with chronic health problems?

Yes. The flu vaccine that is given as a shot is approved for use in children 6 months and older, including both healthy children and those with chronic health problems. Because children with chronic health conditions are at a higher risk of getting flu related complications, it is especially important that they get a flu shot.

What types of vaccine should my child receive and how many doses?

Children with or without chronic health conditions should get the flu shot (inactivated flu vaccine) only. Children 6 months to 8 years old may need 2 doses of the vaccine. Children 9 years of age and older need only one dose. Talk with your doctor to discuss how many doses are recommended for your child.

How can I plan ahead with my child's school or child care?

Find out your child's school or child care providers plan for flu season. Let them know your child is at high-risk for flu related problems.

The American Academy of Pediatrics and the Centers for Disease Control and Prevention recommend that all children 6 months and older, especially those with chronic health conditions, get a seasonal flu vaccine.

More information

Last Updated
Adapted from the Centers for Disease Control and Prevention
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.
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