According to the Centers for Disease Control and Prevention (CDC), millions of Americans get the flu each year. While most recover without medical care, more than 200,000 have to be admitted to the hospital and about 36,000 die. Flu is most serious for children younger than 5 and those with certain kinds of medical problems, the CDC says. Flu symptoms sometimes present differently in children compared to adults.
Systemic Symptoms
Systemic symptoms of the flu reflect the response of the immune system to the infection. They include fever, chills and sweats, headache, muscle aches and fatigue. According to the American Academy of Pediatrics (AAP), flu in children is characterized by fever greater than 100 degrees F. However, notes the CDC, the absence of fever does not necessarily rule out flu. The immune systems of younger children and children with certain kinds of medical problems may be less robust than those of healthy older children, leaving them less able to mount a fever. In addition, children can't always articulate their symptoms, so caregivers must be attentive to symptoms such as irritability, lethargy, lack of appetite and increased need for sleep.
Respiratory Symptoms
Respiratory symptoms of the flu include cough, sore throat, runny nose and nasal congestion. According to the AAP, the cough associated with flu is usually dry, meaning it does not produce sputum (mucus.) Most of the respiratory symptoms of flu in children are easy to spot. The exception is sore throat. It may be difficult to get a good look at a child's throat, but you can rely on other signs, such as refusing food and drink and fussiness during feedings.
Gastrointestinal Symptoms
According to the CDC, flu in children is sometimes associated with vomiting and diarrhea. In infants, it may be difficult to differentiate vomiting from spit-up, which usually resembles breast milk or formula and occurs in relation to feedings. Vomiting may be brown or green (bilious), may occur unrelated to feedings and may happen more frequently than spitting-up. Similarly, infant stools normally are different from adult stools, which can make diarrhea difficult to diagnose. Stools that occur more frequently than normal or look different from the child's baseline may be diarrhea. Dehydration develops quickly in children compared to adults, so it's important to monitor urine output. Urine that is darker than normal and fewer trips to the bathroom (wet diapers in infants) may signal a problem.
