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Your normally overactive four-year-old doesn't seem quite himself over the past two hours. He has had a runny nose and a bit of a cough. He then begins to complain of a headache and sore throat. Next, his body aches all over and he insists on laying down. You take his temperature, which reads 103.5! His cough gets worse and he starts vomiting. The most common bug out there that can cause such a plethora of symptoms – is the FLU. The flu is a virus (called influenza). It is therefore not treatable with antibiotics.

The flu will usually cause three or more (or all) of the following symptoms:

1. High fever, chills
2. Sore throat
3. Headache
4. Nausea
5. Vomiting
6. Diarrhea
7. Abdominal pain
8. Body and muscle aches
9. Stuffy nose
10. Clear or green runny nose
11. Cough – dry or productive
12. Irritated, red eyes

If you think your child has the flu, the first step is to relax. Don't worry. Here are some guidelines to help you and your child get through this illness:

• Treat the symptoms - decide which symptoms are bothering your child the most, and focus on treating those. For example, ibuprofen for head and body aches and fever, a cough medicine if needed, a nasal decongestant if needed. It is safe to mix these three types of medicines. Alternatively, you can give a multi-symptom cold and flu medicine that treats a variety of symptoms. Not sure exactly what to give? Click here for a link to our medicine cabinet for dosing and information.
• Drink lots of fluids
• Multi-symptom cold medicine – give children one year of age and older a cold medicine that relieves several of the main symptoms that he is having such as headaches, stuffy nose, cough, and fever. This mix of three or four medicines in one is generally a bit too much for kids under one, however. Infants younger than one can use one or two medicines for the worst of the symptoms.
• Ibuprofen – often better for the aches and pains of the flu than acetaminophen. Click on it for dosing.
• Warm bath or hot water bottles – these can relieve muscle and body aches.
• Prescription anti-viral medications – periodically a new drug comes out that can treat the flu. They are like an "antibiotic for the flu virus". These medications can do two things – shorten the duration of the illness and lessen the symptoms. It must be started right at the beginning of the flu to be effective. They are generally only for children 12 and older.

There are generally only three situations that might necessitate a call to your doctor or a visit to the ER during the night:

• High fever – most high fevers don't require a call to your doctor after hours. Click here to help you determine if your child's fever warrants a call to the doctor.
• Dehydration – most children will get mild to moderately dehydrated during the flu. Click on here to help you decide if your child is severely dehydrated and needs a call to the doctor or ER visit.
• Severe headaches with stiff, painful back-of-the-neck and persistent vomiting. These could be symptoms of meningitis. Click on it to help you decide.

Most children with the flu don't even need to see a doctor. Here are some guidelines to help you decide if a doctor's visit is warranted:

• Fever more than four days – while this may still be just the flu, it's best to double check with your doctor.
• Moderate to severe dehydration – click here to help you decide this.
• You have a gut feeling that your child is unusually ill.
• Severe cough with chest pain AND shortness of breath. This may mean pneumonia is setting in.

Dr. Sears advices: When it's only "the flu" as with most viruses the fever fluctuates from very high to normal and your child feels much better when the fever is down. With more serious infections the fever usually stays high (above 102º) and the child seems sick or sicker during most of the illness – although this fever pattern clue is not always diagnostic.

In past years, the flu shot has only been recommended for infants and children with chronic heart, lung, and immune diseases. The Centers for Disease Control and Prevention recently changed their recommendation to state that ALL infants 6 months and older should get a flu shot. They should continue to get a yearly flu shot through age 5 years. The reason for this is many infants are hospitalized each year for complications of the flu, and some even die. Vaccinating all infants and young children would prevent these fatalities.

Beyond age 5 years, the only kids who should continue to receive a yearly flu shot are those with asthma or other chronic lung diseases, heart conditions (not including simple heart murmurs), diabetes, immune deficiencies and kids on chronic immune suppressing medications such as oral steroids (not if just taking it for a few days). Healthy children without any of these conditions generally should not get a flu shot after age 5. This is also true for adults. Most normal, healthy adults do not need a flu shot.