Action Steps for Parents of Children at Higher Risk for Flu Complications

February 17, 2010 1:00 PM ET

Children younger than 5, but especially children younger than 2 years old with chronic health problems such as asthma, neurological or neurodevelopmental conditions [including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy (seizure disorders), stroke, intellectual disability (mental retardation), moderate to severe developmental delay, muscular dystrophy, or spinal cord injury], chronic  lung disease   (such as chronic obstructive pulmonary disease  [COPD] and cystic fibrosis), heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease), blood disorders (such as sickle cell disease) endocrine disorders (such as diabetes mellitus), kidney disorders, liver disorders , metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders), weakened immune system due to disease or medication (such as people with HIV or AIDS, or cancer, or those on chronic steroids) and people younger than 19 years of age who are receiving long-term aspirin therapy are all at high risk for complications from flu. If you are not sure if any of your children are at higher risk for flu complications, please check with a health care provider. See CDC's information on high risk for flu complications.

Keep children at high risk for flu complications from getting sick with the flu

• Get your child vaccinated for seasonal flu and 2009 H1N1 flu.
• Have your child cough and sneeze into a tissue or into his or her elbow or shoulder if a tissue is not available.
• Make sure your child’s hands are washed for 20 seconds with soap and water or an alcohol-based hand rub often and especially after coughing or sneezing.
• Keep your child away from people who are sick.
• Clean surfaces and objects that your child frequently touches with cleaning agents that are usually used.
• When there is flu in your community, consider your child’s risk of exposure if they attend public gatherings. In communities with a lot of flu, people who are at risk of complications from flu should consider staying away from public gatherings.
• If flu is severe in your community, talk to your health care provider and child’s school to develop a plan on how to handle your child’s special needs.

Recognize if your children are sick

Some children may not be able to tell you about their symptoms, which can result in a delay in responding to their sickness. It is important to watch carefully for the signs and symptoms of flu or unusual behavior that may be a sign your child is sick. Symptoms of flu include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and tiredness. A fever is a temperature taken with a thermometer that is equal to or greater than 100 degrees Fahrenheit (37.8 degrees Celsius). If you are not able to measure a temperature, your child might have a fever if he or she feels warm, has a flushed appearance, or is sweating or shivering.
Watch for emergency warning signs that need urgent medical attention. These warning signs include:

• Fast breathing or trouble breathing
• Bluish or gray skin color
• Not drinking enough fluids
• Not urinating or no tears when crying
• Severe or persistent vomiting
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Flu-like symptoms improve but then return with fever and worse cough

Tips for taking care of high risk children with the flu

• Contact your health care provider immediately if your child is sick. This is important because the antiviral medicines used to treat flu work best when started within the first 2 days of getting sick. It’s very important that antiviral drugs be used early to treat flu in people who are very sick (for example people who are in the hospital) and people who are sick with flu and have a greater chance of getting serious flu complications. Other people may also be treated with antiviral drugs by their doctor this season. Your health care provider will tell you what special care is needed for your child. 
• Keep your sick child at home until at least 24 hours after there is no longer a fever or signs of a fever (without the use of the use of a fever-reducing medicine). Keep your child home unless they need to go to the health care provider.
• Make sure your child gets plenty of rest and drinks clear fluids (such as water, broth, sports drinks, electrolyte beverages for infants, Pedialyte®) to keep from being dehydrated.
• If your child has a fever, use fever-reducing medicines that your health care provider recommends based on your child’s age. Aspirin (acetylsalicylic acid) should not be given to children or teenagers who have flu; this can cause a rare but serious sickness called Reye’s syndrome.
• Keep your sick child in a separate room (a sick room) in the house as much as possible to limit contact with household members who are not sick. Consider designating a single person as the main caregiver for the sick child.