Overview

It’ll soon be that time of year again. When the weather turns cold we all retreat to huddle indoors. It will be cosy, sure, as being in close proximity to others helps us share warmth. But it also means that winter is a prime time for illnesses to spread, particularly for children at school. One of those illnesses is of course, influenza. Read on to find out more about influenza in children and how to treat it.

What is influenza?

You may know influenza as it is more commonly referred to as ‘the flu’. Influenza is an acute, viral respiratory infection.¹

‘Acute’ refers to the way influenza is caught and symptoms arise suddenly.

‘Viral’ means that the infection is caused by a virus (rather than a bacteria or fungi). There are three types of influenza viruses (A, B and C) that affect humans. Influenza A and Influenza B are the most likely to cause clinical illness.

‘Respiratory’ refers to the infection being focused around the airways, and can affect the nose, mouth, throat, windpipe and lungs.

Influenza is highly infectious, meaning that it can spread rapidly. Influenza viruses are normally transmitted when an infected individual coughs or sneezes, releasing thousands of tiny droplets into the air that are then breathed in by nearby people. It is easier for the flu to spread in places with large groups of people, including children at schools.¹

What are the symptoms of influenza?

With influenza, symptoms usually appear suddenly, around two days after being exposed to the virus. Symptoms can include:²

• Runny nose
• Cough
• Fever
• Headache
• Muscle aches
• Sore throat

Children with influenza will look generally ill. They may be more tired, fussy or irritable than usual.

What’s the difference between influenza and the common cold?

The common cold is another illness that runs rampant throughout winter. Influenza symptoms are very similar to common cold symptoms. NHS lists some differences to look out for:

• Onset: Cold symptoms appear gradually. Influenza symptoms can appear quickly and suddenly within a few hours.
• Symptoms: Colds tend to affect mainly the nose and throat. The effects of influenza can affect other areas and feel more severe.
• Intensity: Colds do not usually prevent people from following their usual routines of going to school or work. Influenza can be exhausting and make people feel too unwell to keep to their normal commitments.

What’s the difference between influenza and Covid-19?

Covid and influenza also share similar symptoms and can feel severe enough to be debilitating. One key difference is that although a change in sense of taste or smell is a common symptom with COVID-19, it is rarer with influenza.  COVID-19 tests can also be bought in supermarkets and pharmacies to confirm whether the illness is  COVID-19 or not.

How serious is influenza?

For most healthy adults, catching influenza will cause little more than a sniffly nose, coughing, headaches and fever. After a few days of rest and hydration, the immune system will take care of the influenza infection and the individual will make a full recovery. In children, influenza can be much more unpleasant. Young children under the age of 6 are the most likely age group to be hospitalised from complications of influenza. Complications can arise where, while the body is fighting off the influenza infection, a second infection develops, such as:¹

• Bronchitis – inflammation of the airways
• Otitis media – ear infection
• Sinusitis – swelling of the sinuses
• Pneumonia – inflammation of the lungs

Influenza can also worsen existing respiratory disorders, including asthma.

Young children, particularly those under the age of 6, are at higher risk of developing complications with influenza. Other groups at higher risk of complications can include pregnant women, the elderly, and those with underlying health conditions including (asthma, COPD, diabetes, chronic heart disease, chronic renal disease, chronic liver disease, chronic neurological conditions, immunosuppression from disease or medications, and dysfunctions of the spleen).³

What treatments are available for a child with influenza?

Most children with influenza will get better at home, given plenty of rest and fluids to allow their body to focus on fighting off the infection. Children with influenza should stay at home until they feel better, which usually takes about a week. It is important to ensure that they have plenty of liquids to prevent dehydration.²

For symptomatic relief, there are a number of products that can be bought over the counter.

• Saline nasal drops/spray and steam: Saline is a saltwater solution that can be used to clear stuffy and runny noses, helping the child to breathe more freely. As saline solutions are non-medicated, they are safe for children of all ages. However, they can be fiddly and the child may be unwilling to cooperate. Sitting the child in a warm bath and allowing them to breathe the steam in can be a suitable alternative as the steam has a gentler effect in clearing blocked noses.
• Menthol vapour rubs: Menthol has decongestant effects. When rubbed onto the child’s chest or dabbed onto a cloth, the menthol is inhaled by the child as a vapour, helping to unblock the nose. Menthol vapour rubs may not be suitable for use with young children.
• Cough liquids: Cough liquids (including simple linctus, marshmallow extract, or glycerol syrups) can gently soothe sore throats in coughs in children. It is important to make sure the cough liquid product is made for children. Always check the age range of any medicine products that are bought. Specific cough liquid products made especially for children are available in the UK. Some are licensed for children over 1 year of age, while others are only licensed for children over 6 years of age.
• Paracetamol: Paracetamol can be used to relieve headaches, sore throats and fever in children over 3 months. This medicine is available in liquid and sachet forms, which are easier for children to take.
• Ibuprofen: Ibuprofen is an anti-inflammatory medicine that can relieve fever and pain in children over 3 months. Consult the child’s doctor if the child is asthmatic or diabetic.
• Antiviral medication: In severe cases, or in children younger than 6 months, children with influenza may be prescribed antiviral treatment by their doctor. Antiviral medications reduce the severity and duration of symptoms by a few days and reduce the likelihood of complications. In otherwise healthy children, antiviral treatment is not always necessary as the child will get better in time with rest and fluids.

Can I use both paracetamol and ibuprofen at the same time to treat the child?

It is best to use either paracetamol or ibuprofen to begin with. Do not combine both without speaking to the child’s doctor.

Can I give aspirin to my child?

Although aspirin and ibuprofen are both anti-inflammatory medicines, aspirin should NOT be given to children under 16 years of age. In children, aspirin can cause Reye’s Syndrome.

Are antibiotics good for influenza?

Antibiotics are medicines that treat bacterial infections. Influenza is caused by viruses, not bacteria. This means that antibiotics won’t work for treating influenza.

How can I prevent a child from catching influenza?

General hygiene measures can help to prevent children from catching influenza. However, the best way to prevent a child from catching influenza is by giving them prior protection by vaccination, or the ‘flu jab’.

What is the flu vaccine?

The flu vaccine introduces parts of a weakened or inactivated form of the influenza virus into the body. The body’s immune system is then activated and readies itself to protect the individual against future infections of the influenza virus. Vaccinating children allows them to stay in school and stops them from passing influenza on to older relatives who are also vulnerable to complications.

There are different types of children’s flu vaccines available for free on the NHS. For most young children aged between 2 to 17 years, the flu vaccine is given as a nasal spray that is quick and painless. This type of vaccine contains weakened versions of the flu virus that the child’s immune system can build up a response to.  Other forms of flu vaccine can be provided as an injection if the nasal spray is not suitable for the child.⁴

When can my child receive the flu vaccine?

Since flu viruses can change every season, the flu vaccine is also updated every season, with each flu season running each year during wintertime. A flu vaccine from a previous season may not give full protection against flu from the current season. This is why it is important to stay up to date with vaccinations each year. The flu vaccine is normally given at the start of winter, to give time for the body to build up a response to the vaccine and develop its protection against flu.

For this year’s flu season 2024-2025, children aged between 2 to 17 years will be offered the flu vaccine as part of the NHS childhood flu immunisation programme. Children aged between 2 to 3 years can receive their vaccination at the child’s GP. Children aged between 4 to 11 years will be offered the flu vaccine at primary school. Children aged between 12 to 17 years will be offered the flu vaccine at secondary school. Children aged between 6 months and 2 years will be offered the flu vaccine only if they have certain health conditions that cause them to have a higher risk of complications.⁴

Summary

Influenza can be particularly unpleasant in children. Luckily, there are plenty of treatments available to help the child with their symptoms, including nasal sprays, cough liquids, paracetamol and ibuprofen. Vaccines can give children the best protection against influenza and are offered for free as part of the NHS.