Flu (Influenza)
Flu (also called influenza) is a virus that spreads more in autumn and winter. It passes easily from person to person through coughs and sneezes.
Children with flu may have a fever, cough, runny nose, headache, sore muscles, tiredness, and a sore throat.
Children aged 2 to 13 years should get the flu vaccine every winter. This helps protect them from getting sick and stops them from passing the flu to others. After elderly people (over 75 years old), children under 5 are most likely to need hospital care for flu.
When should you worry?
If your child has any of the following:
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Breathing very fast, too breathless to talk, eat or drink
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Working hard to breathe, drawing in of the muscles below the ribs, or noisy breathing (grunting)
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Breathing that stops or pauses
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Is pale, blue, mottled or feels unusually cold to touch
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Difficult to wake up, very sleepy or confused
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Has a fit (seizure)
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Has a rash that does not disappear with pressure (the ‘Glass Test’)
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or phone 999
If your child has any of the following:
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Breathing a bit faster than normal or working a bit harder to breathe
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Dry skin, lips or tongue
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Not had a wee in last 8 hours
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Irritable (Unable to settle them with toys, TV, food or hugs even after their fever has come down)
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Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)
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Temperature less than 36°C
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Complaining of severe pain that is not improving with painkillers
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Getting worse and you are worried
You need to contact a doctor or nurse today.
Please ring your GP surgery or call NHS 111 - dial 111
If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features
If none of the above features are present:
If your child has any other symptoms associated with their fever, you may want to look at the information on sore throat, cough, earache, diarrhoea and vomiting or tummy ache or click here.
Additional advice is also available to young families for coping with crying of well babies – click here.
Self care
Continue providing your child’s care at home. If you are still concerned about your child, speak to your health visitor, local pharmacist or call NHS 111– dial 111
Children and young people who are unwell and have a high temperature should stay at home. They can go back to school, college or childcare when they no longer have a high temperature, and they are well enough to attend.
This content has been developed by healthcare professionals from across the UK in collaboration with the RCPCH.
What should you do?
Keep checking your child for red and amber signs and seek help if they are there.
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Fever is a normal response that helps your child’s body to fight an infection.
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If your child seems unsettled or uncomfortable, you may wish to give your child paracetamol or ibuprofen.
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It can take 30 minutes for your child’s temperature to start to fall and for your child to start to feel better after taking paracetamol or ibuprofen.
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If you have given your child one of these medicines and they are still uncomfortable 2 hours later you could try the other medicine.
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There are different types of paracetamol for children of different ages including 2 different strengths of syrup - infant and Six plus. Always read the dose instructions carefully. You must wait at least 4 hours between doses. Do not give more than 4 doses in 24 hours.
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Ibuprofen is available in syrup and tablet form. Ibuprofen is not suitable for some children. If you are unsure whether your child can take ibuprofen, check with your pharmacist or doctor. Always read the dose instructions carefully. Don't give ibuprofen if your child has not had a wee in the last 12 hours. You must wait at least 6 hours between doses. Do not give more than 3 doses in 24 hours.
It can be normal for the temperature to go back up when the medicine wears off.
Avoid tepid sponging your child. It doesn’t actually reduce your child’s temperature and may cause your child to shiver.
Encourage them to drink plenty of fluids.
If a rash appears, do the glass test.
How long will your child’s symptoms last?
Symptoms often start quite suddenly and generally last 3-5 days. However symptoms such as cough can last up to two weeks.
Rarely, children can get a bacterial infection after flu. If your child is seeming to get better but then gets worse again and you are worried please go back through the assessment table above or speak to a health care professional.
When can by child go back to school / nursery?
Children and young people with mild symptoms such as a runny nose, sore throat, or slight cough, who are otherwise well, can continue to attend their education setting. However, if your child has a high temperature or is unwell, they should stay at home and avoid contact with other people, where they can. They can go back to school or childcare and resume normal activities when they no longer have a high temperature and they are well enough to attend.
For wear and tear, minor trips and everything in between.
Self-care
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Sound advice
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Sound advice
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- Help your child to understand - watch this video with them about going to the pharmacy.
For information on common childhood illnesses go to What is wrong with my child?
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Contacting the School Nurse
Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- offering immunisations
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.
Sound advice
You have a choice of service:
- Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
- Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre
For information on common childhood illnesses go to What is wrong with my child?
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.