The Centers for Disease Control and Prevention recommends flu vaccination for all children younger than 19. Children--especially those younger than 5 and those with health problems--are more likely to develop complications from the flu than healthy adults. In addition, CDC epidemiologists say younger children and children with risk factors not only develop complications more often than other children, they are also more likely to die from them.
Pneumonia
Pneumonia represents the most common complication of influenza in children. Pneumonia typically presents with cough, fever, shaking chills, chest pain and shortness of breath that begin abruptly, usually after the child seems to be improving. Influenza-related pneumonia may be primary, meaning caused by the influenza virus itself, or secondary, meaning caused by bacteria that invade and capitalize on tissue damage caused by the influenza virus.
Bronchitis
Bronchitis related to influenza develops by the same mechanism as pneumonia related to influenza, except that, in the case of bronchitis, it's the tubes that connect to the lungs, rather than the lungs themselves, that are affected. Like pneumonia, bronchitis also presents with cough, fever, chest pain and shortness of breath. In addition, with bronchitis, parents and caregivers can often hear the child wheeze--a musical, whistling sound that accompanies each breath as air tries to squeeze past the swollen bronchi.
Otitis Media
Otitis media is an infection of the middle ear that develops when fluid accumulates behind the ear drum. Otitis media related to influenza develops when bacteria gain access to the ear from the respiratory tract via the Eustachian tube, then multiply because swelling or mucus obstructs normal drainage. Signs and symptoms include fussiness, tugging at the ears, ear pain, difficulty sleeping, fever, fluid draining from the ear, unusual clumsiness or trouble with balance and decreased hearing.
Sinusitis
Like the middle ear, the sinuses offer space for bacteria to grow and multiply when normal drainage is interrupted by influenza infection. Signs and symptoms of sinusitis include headache or pain under the eyes, fever, fussiness, lethargy, cough, congestion and sore throat or nausea due to postnasal drip.
Encephalitis
Inflammation of the brain, known as encephalitis, is an uncommon but serious complication of influenza in children. Signs and symptoms include headache, fever, irritability, altered level of consciousness, hallucinations, muscle weakness, loss of sensation or paralysis, tremors and sometimes seizures. Without treatment, severe cases can progress to brain death. According to a 2010 report in Pediatric Critical Care Medicine, encephalitis occurred more often with the 2009 H1N1 flu than older flu strains, a which is particularly relevant since 2009 H1N1 was expected to cause additional cases during the 2010-2011 flu season.
References
- CDC: Seasonal Influenza (Flu): People at High Risk of Developing Flu-Related Complications
- "Pediatric Nursing;" Pediatric Influenza; A.M. Bramley et al.; December 2009
- "Pediatric Critical Care Medicine;" Neurological Sequelae of 2009 Influenza A (H1N1) in Children; S.A. Baltagi et al.; March 2010
