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Influenza

As with any illness, tell the child’s family if you are concerned about their health. Contact 911 or your local emergency system if you think a child may be having a medical emergency.

Influenza, often called the flu, is a contagious disease that infects the nose, throat, and sometimes lungs.

What are the symptoms of influenza?

Influenza is more serious than the common cold, and most people with the flu feel very ill. They often have:

  • Fever
  • Body aches
  • Chills
  • Cough
  • Tiredness
  • Sometimes nausea, vomiting, and diarrhea

How does influenza spread?

Most experts believe that flu viruses are spread mainly by tiny droplets made when people with flu cough, sneeze, or talk. These droplets can land in the mouths or noses of people who are nearby. Less often, a person might get flu by touching a surface or object that has flu virus on it and then touching their own mouth, nose, or possibly their eyes. Influenza spreads quickly because:

  • People can spread influenza viruses before they know they are ill and after they feel better.
  • The time between exposure and getting the infection is short, usually two or three days.
  • Influenza viruses live for up to 48 hours in the environment, infecting others who touch objects that have the virus on them.

Influenza is often seasonal, happening in the fall and winter. Rarely, a new influenza virus causes a pandemic.

Who is at risk?

Anyone can get the flu. Children, especially those younger than 2 and those with chronic health conditions, are particularly at risk for complications of influenza that often need hospitalization. But any young child, including those with no prior health conditions, can have complications. These complications include:

  • Pneumonia
  • Difficulty breathing
  • Severe muscle inflammation, including the heart muscle
  • Seizures
  • Encephalitis (brain infection)
  • Changes in mental status like confusion, disorientation, or loss of alertness
  • Widespread organ dysfunction
  • Death

How can providers limit the spread of influenza?

Usually, a child with a fever, cough, or runny nose doesn’t have the flu. Instead, they may have another common virus, even during flu season. It’s not practical for health care workers to test all children who might have influenza. Deciding whether to exclude a child from care is based on the child’s symptoms and behavior and your program’s exclusion policy.

If a child has a fever and needs more care than staff can give, like needing to be held all the time, or if the child can’t take part in activities, then excluding the child is the right thing to do. During flu season, a child who has been excluded because of suspected influenza should stay excluded until 24 hours after they are fever-free without taking fever-reducing medicine. Children are more likely to spread influenza viruses when they have a fever.

Exclusion is helpful, but exclusion alone does not work well to prevent the spread of influenza because the virus is present before someone has symptoms. This is why vaccination is so important.

Seasonal Vaccination

The best way to prevent influenza is seasonal vaccination. Children older than 6 months can be immunized against influenza. All children older than 6 months and their caregivers should get the flu vaccine every year, preferably before the end of October. 
Children who get the flu vaccine are significantly less likely to need hospitalization from flu complications than those don’t get vaccinated. The flu vaccine also dramatically reduces a child’s risk of death from influenza.

Staff should get a flu vaccine to avoid missing work and infecting others in the community, and to protect children in their centers who can’t get a flu vaccine, including infants who are younger than 6 months. Caregivers and family members of young infants should be immunized against influenza to protect young infants.

Refer to Caring for Our Children (CFOC) Standard 7.3.3: Influenza.

Hand-washing technique

Washing your hands is easy, and it is one of the most effective ways to prevent the spread of germs. The Centers for Disease Control and Prevention (CDC) recommends these five steps:

  1. Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
  2. Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.
  3. Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
  4. Rinse your hands well under clean, running water.
  5. Dry your hands using a fresh paper towel or an air dryer.

Infection Control

In a setting with young children, infection control is not easy because of close contact, developmentally appropriate behaviors like mouthing toys and eating with hands, and young children’s inability to contain and control their nasal and oral secretions. Here’s how staff can help:

  • Wash hands regularly for 20 seconds using good hand-washing technique. Washing with liquid soap and water is best.
  • Help children with hand-washing. Wash infants’ hands at the sink using soap and water. Help other children with washing, making sure they do it correctly.
  • Prevent contact with nasal secretions and saliva as much as possible. For sneezing and coughing, teach children and staff to cover their noses and mouths with a disposable facial tissue if possible, or with an upper sleeve or elbow if no facial tissue is available in time. Teach everyone to remove any mucus on skin or other surfaces and to wash their hands after using facial tissues. Change or cover clothing with mucus on it.
  • Throw away facial tissues after each use.
  • Wash hands after touching any items that have mucus or saliva.
  • Be sure to follow routine cleaning, sanitizing, and disinfecting steps.

As always, use your program’s health experts, including your Health and Mental Health Services Advisory Committee or child care health consultant, to stay up to date and to develop policies and procedures to prevent the spread of illness.

How can programs partner with families?

To encourage seasonal flu vaccination, consider these steps:

  • Educate families about the seriousness of influenza and the easy ways to get a vaccination. Ideally, a child’s health care provider should have flu vaccines, but other places have flu vaccines if needed. Use the flu vaccine finder, and enter a ZIP code to find the nearest place to get a flu vaccine.
  • Host a flu clinic at your program for staff, children, and families. Many immunization providers can help set up a flu clinic on site.
  • Track influenza immunization rates. Sending reminders and checking in with families can increase immunizations rates, which decreases the spread of influenza in your center.

Share information with families:

For Your Family Newsletter

Tailor the messages below to include in your family newsletter:

  • The flu can be dangerous for children. Each year, thousands of children younger than 5 are hospitalized because of influenza. The flu vaccine is safe and helps protect children from the flu and its complications.
  • Everyone should get a flu vaccine. Anyone older than 6 months should get a flu vaccine to avoid the flu and to avoid spreading the flu to babies who are not old enough to be vaccinated.
  • Get a flu vaccine during pregnancy because flu vaccines can’t be given to infants younger than 6 months. If you’re pregnant, you can protect your unborn child by getting a flu shot. You pass on protection that lasts for several months after your baby is born.
  • The flu vaccine is safe. It can prevent infection, reduce hospitalizations, and reduce the risk of death from flu. People who got the vaccine are much less likely to get seriously ill or need to go to the hospital if they get the flu.
  • No-cost or low-cost flu vaccines are available at your local health department. Get your flu vaccine before the end of October. Consider adding specific contact information for the nearest health department’s vaccine clinics in your newsletter.

« Go to Infectious Disease Fact Sheets

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