Children's Hospital Colorado

Flu (Seasonal Influenza) in Kids

Urgent or Emergency Care?

If you believe your child needs immediate attention and you have concerns for a life-threatening emergency, call 911. Not sure what counts as urgent and what's an emergency when your child is sick or injured? When it can't wait, know where to take your kids.

Help Me Decide

Children's Hospital Colorado wants to help you protect your children and family from the flu. Educate yourself and encourage friends and family to understand the latest information on the flu this year. 

What is the flu?

Influenza, commonly known as the flu, is a highly contagious viral infection of the respiratory tract. The flu is often confused with the common cold, but flu symptoms tend to develop quickly and are usually more severe than the typical sneezing and congestion of a cold.

Flu symptoms can include:

  • High fever
  • Cough
  • Sore throat
  • Body aches
  • Chills
  • Fatigue
  • Headache
  • Runny nose
  • Vomiting (most common in young children)

Learn more about the flu from the Centers for Disease Control and Prevention (CDC).

The 2019-2020 flu season

Seasonal influenza refers to many different strains of an influenza virus. Flu A and Flu B are the strains that infect humans. The flu vaccine covers those strains that are predicted to be the main strains circulating for that season. Now all flu shots will contain either three or four strains. 

Here's what you need to know:

  • Children between the ages of 6 months and 9 years will need two doses of this year's influenza vaccine 4 weeks apart if they have never received a flu shot before, if they have only received one dose of vaccine before, or if it isn't known whether they received flu vaccine previously.   
  • All children 9 years of age and older only need one dose. 

Talk with your primary care physician's office about your child receiving this seasonal vaccination.

For more information, please call the Children's Colorado Flu Hotline: 720-777-4358.

Getting your flu vaccine

Every adult and child older than 6 months of age should get a flu vaccine. Be sure to consult with your child's doctor about the flu vaccine. Also learn who is a top priority for the vaccine this season, how the vaccine works, side effects and other considerations.

Contact your doctor about getting vaccinated, or find a flu clinic near you.

Quick facts about the 2019-2020 vaccine

  • Significant quantities of influenza vaccine are now available in the United States.
  • The vaccine is now available in the community. Getting your influenza vaccination in September is not too early, and protection will last for the whole season.
  • The flu vaccine is available in two forms: the flu shot and the nasal spray vaccine.
  • The flu shot is approved for children 6 months of age and older, including healthy people and people with chronic medical conditions.
  • For the 2019-2020 season, children can either receive the nasal spray vaccine or the flu shot. At Children's Colorado, only the flu shot is available.

 How can I prevent the flu?

  • Get vaccinated. The CDC recommends all adults and children older than 6 months receive a flu shot.
  • Hand washing is one of the most important things you can do to protect yourself and others. 
  • Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick, too.
  • Stay home when you are sick to prevent others from catching your illness. If possible, stay home from work, school, or public places until at least 24 hours after a fever has ceased without the use of fever-reducing medications. (A fever is defined as 100ºF or 37.8ºC.)
  • Cover your mouth and nose with a tissue when coughing or sneezing. If you don't have a tissue, then cough or sneeze into your sleeve. It may prevent those around you from getting sick.
  • If you don't have a tissue, cough or sneeze into your upper sleeve or elbow, not your hands.
  • Clean your hands after coughing or sneezing, washing with soap and water, or with alcohol-based hand cleaner.
  • Avoid touching your face often because germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose or mouth.

Is it a cold or the flu?

Questions to ask concerning.... Flu Cold
Was your child's onset of illness sudden gradual
Does your child have a high fever lower fever
Is your child's fatigue level severe mild
Is your child's cough severe moderate
Is your child's head achy headache-free
Is your child's appetite decreased decreased
Are your child's muscles achy fine
Does your child have chills no chills
  • If most of your answers fall into the first category, then your child likely has the flu.
  • If most of your answers fall into the second category, then your child likely has a cold.
  • Unless they're severe, flu symptoms are treated the same as cold symptoms.

What do I do if my child has flu symptoms?

If you suspect your child may have influenza, call your pediatrician or primary care provider for advice. If your child has flu-like symptoms and is only mildly ill, it is best to care for him or her at home and limit contact with others. If you think your child has a viral infection, make sure they are getting plenty of fluids. Do not give your child aspirin or aspirin-containing products (Pepto-Bismol, for example). Treat their fever with Tylenol or Motrin.

If your child exhibits more severe symptoms, contact your healthcare provider or seek urgent care or emergency care. If you have questions about the flu, you can also call the Colorado Health Information hotline at 1-877-462-2911.

When do I call my doctor?

If your child is experiencing influenza symptoms, it's not always necessary to see or call your doctor. Below are some guidelines to help you decide when to call your family physician.

Call your child's doctor now (night or day) if:

  • Your child looks or acts very sick.
  • Breathing becomes difficult or fast.
  • Dehydration occurs (symptoms include no urine in 12 hours, dry mouth or no tears).
  • Your child has bluish skin color.
  • Your child is not waking up or not interacting.
  • Your child is being so irritable that they do not want to be held.
  • Flu-like symptoms improve, but then return with fever and worse cough.
  • Fever with a rash occurs.

Call your child's doctor during the day if:

  • Your think your child needs to be seen.
  • Your child is considered high risk and has flu symptoms.
  • Earache or sinus pain occurs.
  • Fever lasts more than 3 days.
  • Cough lasts more than 3 weeks.
  • Your child becomes worse.

Find a physician for your child

Your child's doctor should be your primary resource for answers to your flu questions. If you do not have a doctor for your child, contact our ParentSmart Healthline™ at 720-777-0123 for help finding a doctor and for answers about the flu.

Parents' most frequently asked questions about the flu

Remember that the best way to protect yourself and your family is to take basic preventive measures such as washing your hands, avoiding sick people and getting your family vaccinated.

Please consider this information before calling or visiting your doctor.

1) Does my child have the flu?

The classic symptoms of the flu are a fever with a cough and a sore throat. If your child has flu symptoms and it is widespread in the community, they probably have it. Your child doesn't need any special tests to reach this conclusion. Currently only patients who need hospitalization are tested.

If your child has a sore throat with a fever and doesn't develop a cough, they may need to be checked for Strep throat.

2) How can I make my child feel better?

The treatment of the flu depends on your child's main symptoms. To open a blocked nose, use a nasal wash with saline. For a cough, use one to two teaspoons of honey (do not use for children under 1 year old). Ibuprofen will help a sore throat. To prevent dehydration, encourage extra fluids.

3) My child hurts everywhere. Is that serious?

The flu can cause soreness everywhere: headache, back pain, chest pain and leg pain. To soothe sore muscles, give ibuprofen to reduce inflammation every 6 hours, up to 4 times a day as needed. To prevent stomach irritation, always administer pain medication with food. If pain is severe and lasts more than 90 minutes after taking ibuprofen, your child probably should see a doctor.

4) Does my child need to see a doctor?

For serious symptoms such as trouble breathing, rapid breathing or dehydration, bring your child to the doctor immediately. For non-urgent symptoms such as an earache or sinus pain, go to the doctor within 24 hours. Most healthy children with the flu don't develop any of these complications and can easily be treated at home.

5) Does my child need Tamiflu?

The CDC recommends Tamiflu for anyone who develops severe symptoms or for high-risk children with any flu symptoms. High-risk children are those with underlying chronic health problems or healthy children under 2 years old.

Tamiflu is not helpful if more than 48 hours have passed since the start of the flu symptoms, unless your child is hospitalized or has high-risk medical conditions. If your child is otherwise healthy and over age 2, they should do fine without Tamiflu.

6) How should I treat a fever of 102˚ to 104˚F?

A high fever is over 104˚F. Fevers are not harmful and do not need treatment. In fact, they turn on the body's immune system and help fight infections. So if your child is sick, having a fever is beneficial.

7) It's been three days, so why does my child still have a fever?

Fever caused by the flu viruses normally lasts two or three days. If the fever lasts more than three days (72 hours), your child may need to see a doctor. More importantly, if the fever goes away for more than 24 hours, then returns, bring your child to the doctor. He or she may have a secondary bacterial infection such as an ear infection.

8) Can I alternate Tylenol and ibuprofen?

It's rarely necessary and we don't recommend it routinely. If your child's doctor recommends it, however, we suggest you only rotate the medicines for fevers over 104˚F that do not come down 2 degrees with one medicine alone.

To safely alternate fever medication, administer Tylenol every 4 hours, and alternate with ibuprofen every 6 hours. To avoid the risk of overdose, do not alternate medicines for more than 24 hours.

  • Do not give aspirin if your child or teen has the flu. 
  • Get information about acetaminophen and ibuprofen drug dosage from your doctor or pharmacist.

9) The fever is gone; why is my child still coughing?

Fever disappears when the immune system starts producing antibodies to fight the virus. The cough normally continues for two or three weeks due to a damaged lining of the throat and windpipe. Recent research showed that honey was more effective at quieting coughs than over-the-counter cough medicines. If coughing is non-stop and interferes with normal activities, however, your child should see a doctor to rule out underlying asthma. 10% of children have asthma and it can be well controlled with asthma medicines.

10) What should I do if my child is vomiting?

Treat with small amounts of clear fluids every 5 to 10 minutes. If your child becomes dehydrated or if isolated vomiting without diarrhea lasts more than 48 hours, your child should see a doctor. If your child only vomits after taking Tamiflu, try to hide the bitter flavor in foods such as chocolate syrup. If vomiting continues, your doctor may need to stop the Tamiflu.

In general, anyone who wants to reduce their chances of getting the flu can get vaccinated. However, certain people especially should get vaccinated each year: They are either people who are at high risk of having serious flu complications or people who live with or care for those at high risk for serious complications. 

The American Academy of Pediatrics (AAP) recommends annual trivalent or quadrivalent seasonal influenza immunization for all individuals, including all children and adolescents, aged 6 months and older during this influenza season. In addition, special efforts should be made to vaccinate individuals in the following groups:

  • All children (including infants born preterm) who are 6 months of age and older who have conditions that increase the risk of complications from influenza (e.g., children with chronic medical conditions such as asthma, diabetes mellitus, immunosuppression or neurologic disorders)
  • All household contacts and out-of-home care providers of:
    • Children with high-risk conditions
    • Children aged <5 years, especially infants aged <6 months
    • All healthcare personnel (HCPs)
    • All women who are pregnant, are considering pregnancy, have just delivered or are breastfeeding during the influenza season

Flu vaccine recommendations for the 2019-2020 season

Healthcare providers have been advised that they can use either the flu shot or nasal spray vaccine for season. The AAP recommends the flu shot this season, but if not available, or if the child prefers the nasal spray, they can receive that instead. In general, any vaccine is better than no protection at all.

Get additional information about the 2019-2020 influenza vaccine.

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