There are several flu symptoms in children that parents can recognize, which also help differentiate influenza from the common cold.
What is influenza?
Influenza is an acute respiratory infection caused by influenza viruses.
Seasonal influenza outbreaks occur annually, typically from November to April. The virus undergoes frequent genetic changes each year, and immunity following infection or vaccination does not provide long lasting protection. As a result, individuals may contract influenza more than once.
Influenza spreads rapidly from person to person, particularly in crowded settings or environments where people live, study, or work in close proximity. Children are among the most susceptible groups and are considered a major source of transmission within the community.
Compared with the common cold, influenza has a more abrupt onset and causes more pronounced systemic symptoms. While children with a cold often maintain their usual activity levels, those with influenza typically appear significantly ill and may require bed rest.
How does influenza spread in children?
Influenza viruses are present in respiratory secretions from the nose and throat. Children frequently touch their eyes, nose, and mouth, place objects in their mouths, and have close physical contact during play, all of which facilitate rapid viral transmission. In addition, routine interactions between children and caregivers, such as holding hands, feeding, carrying, or changing diapers, further increase the risk of spread.
Influenza is primarily transmitted through respiratory droplets. These droplets are expelled when an infected person coughs or sneezes and can travel through the air to the mouth or nose of individuals nearby, typically within a distance of approximately one meter.
The virus may also spread via direct contact. An infected person can contaminate their hands after touching their nose or mouth, wiping nasal secretions, coughing, or sneezing, and then transmit the virus through physical contact.
Indirect transmission via contaminated surfaces is also common. Influenza viruses can survive for several hours on objects such as toys, doorknobs, computer keyboards, and other hard surfaces. When another person touches these surfaces and subsequently touches their eyes, nose, or mouth, infection may occur.
Caregivers with contaminated hands may inadvertently transmit the virus between children through routine contact.
Flu symptoms in children and potential complications
Symptoms
Influenza in children presents with a wide range of symptoms. The illness typically begins abruptly with high fever, chills, and shivering, accompanied by headache, myalgia, marked fatigue, dry cough, and sore throat. Loss of appetite is common. Children with influenza often appear significantly ill and may prefer to remain in bed due to profound weakness.
Differences in symptoms compared with adults
Although children with influenza may share many clinical features with adults, several distinctions should be noted:
- Infants and young babies may present with unexplained high fever without other obvious respiratory symptoms.
- Young children often develop temperatures above 39.5°C and may be at risk of febrile seizures.
Potential complications
- Influenza is a significant cause of croup (infection of the larynx and vocal cords), pneumonia, and bronchiolitis (infection of the small airways) in young children.
- Gastrointestinal symptoms such as vomiting, diarrhea, and abdominal pain are more common in children than in adults. Ear pain and conjunctival redness may also occur more frequently.
- In some cases, viral myositis may develop, leading to severe leg or back pain.
- Most otherwise healthy children recover from influenza without serious complications. Fever and myalgia typically resolve within 2 - 4 days, although cough and fatigue may persist for 1 - 2 weeks or longer.
- In rare instances, influenza can affect the central nervous system, causing prolonged seizures, confusion, or decreased responsiveness. Cardiac involvement is also possible but uncommon. In addition, influenza may weaken the immune system, increasing susceptibility to secondary bacterial infections such as otitis media, pneumonia, or sinusitis.
- Severe influenza is more likely in children under 2 years of age and in those with underlying chronic medical conditions.
What is the common cold?
The common cold is a highly prevalent respiratory illness, most commonly caused by rhinovirus infection. Most individuals experience multiple episodes of the common cold beginning in childhood and continuing throughout life.
Cold viruses typically enter the body through the nose and sinuses. In response, the nasal mucosa produces clear mucus to help trap and eliminate the invading virus.
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Common cold symptoms develop gradually and typically peak within 2–3 days. The most common manifestations include:
- Nasal congestion or rhinorrhea
- Sneezing
- Sore throat
- Dry cough
- Postnasal drip
- Watery eyes
There is no specific cure for the common cold; however, it is generally self limiting. Symptoms can be managed with adequate rest, sufficient fluid intake, and over the counter (OTC) medications when necessary.
Complications are uncommon, and medical consultation is usually not required. However, individuals with weakened immune systems, asthma, or other chronic respiratory conditions may experience more severe illness and should be monitored closely.
Distinguishing influenza from the common cold in children
The common cold and influenza are seasonal respiratory infections caused by different viruses. The key distinction is that influenza typically presents with more severe symptoms and carries a higher risk of serious complications and hospitalization.
In most cases, symptoms of both conditions are mild and can be managed at home. However, it is essential to monitor for warning signs, particularly in children at higher risk of complications.
Although influenza and the common cold share similar clinical features, important differences exist in terms of onset, severity, and potential outcomes.
Causes
More than 200 different viruses can cause the common cold, including rhinoviruses and certain coronaviruses (excluding the virus responsible for COVID-19).
Influenza is caused by influenza viruses, with three main types affecting humans: influenza A, B, and C. Types A and B are the most common during seasonal outbreaks.
Symptoms
Because the common cold and influenza share similar clinical features, it can be difficult, or even impossible, to distinguish between them based on symptoms alone.
In general, influenza is more severe than the common cold. Cold symptoms tend to develop gradually, whereas influenza has a sudden onset and more intense manifestations.
Runny or congested nose is more commonly associated with the common cold. In contrast, the following symptoms are more typical of influenza and less common with a cold:
- Fever ≥ 37.8°C lasting 3–4 days
- Myalgia, particularly in the lower back
- Chills
- Marked fatigue or weakness
- Headache
Vomiting and diarrhea are not typically associated with the common cold but may occur in influenza, particularly in children.
It is possible to have influenza without classic symptoms such as fever. To confirm whether an individual has influenza or a common cold, specific diagnostic testing can be performed within the first few days after symptom onset.
Symptoms of both the common cold and influenza may overlap with other respiratory illnesses, including COVID-19 caused by the SARS-CoV-2 virus.
Complications
The common cold rarely leads to serious complications, although it may trigger asthma exacerbations in individuals with underlying asthma.
In contrast, influenza can result in severe complications such as pneumonia or secondary bacterial infections. Each year, influenza related complications account for thousands of hospitalizations and deaths worldwide.
Most individuals recover from influenza within a few days to two weeks. Cold symptoms, which are generally milder, typically peak within 2–3 days and gradually resolve over one to two weeks.
Transmission
The common cold and influenza are transmitted in similar ways. Both viruses are highly contagious and can spread through:
- Close contact with an infected individual
- Inhalation of respiratory droplets containing the virus
- Contact with contaminated surfaces followed by touching the eyes, nose, or mouth
Treatment of the common cold and influenza
Antibiotics are not effective against viral infections such as the common cold or influenza. Most individuals recover within approximately two weeks without the need for medical treatment. During this period, symptoms can be managed with supportive home care measures.
For individuals at high risk of severe influenza complications, the Centers for Disease Control and Prevention (CDC) recommend early initiation of antiviral therapy. Antiviral medications may reduce symptom severity, shorten the duration of illness by 1–2 days, and help prevent serious complications.
Supportive care for the common cold and influenza
Over the counter (OTC) medications may help relieve uncomfortable symptoms such as pain, body aches, and fever, improving overall comfort during recovery. Adequate fluid intake and sufficient rest are also recommended to support the immune response and facilitate recovery.
The following home remedies may also help relieve symptoms:
- Saline nasal drops or spray can help alleviate nasal congestion.
- Steam inhalation with eucalyptus may reduce nasal blockage.
- Gargling with salt water or using throat lozenges can soothe sore throat discomfort.
- Acetaminophen (paracetamol) and similar medications may help reduce fever and relieve body aches.
Emergency warning signs
Medical attention should be sought immediately if any emergency warning signs are observed.
In children with influenza, the following symptoms are considered dangerous:
- Rapid breathing or difficulty breathing
- Bluish or pale discoloration of the lips or face (cyanosis)
- Chest pain or chest tightness
- Signs of dehydration (dry mouth, reduced urination, absence of tears)
- Lethargy or decreased responsiveness
- Fever above 39°C or persistent high fever not responding to antipyretics
Influenza vaccination and other preventive measures
Annual influenza vaccination remains the most effective strategy for preventing influenza, as it enables the immune system to develop protective antibodies against circulating influenza viruses.
The CDC recommends annual influenza vaccination for everyone aged 6 months and older, with rare exceptions.
Additional measures to reduce the risk of respiratory viral infection and transmission include:
- Avoiding close contact with individuals who are ill
- Covering the mouth and nose when coughing or sneezing
- Practicing frequent hand hygiene or using alcohol-based hand sanitizer when soap and water are unavailable
- Avoiding touching the eyes, nose, and mouth
- Regularly disinfecting frequently touched surfaces, especially when someone is sick
- Maintaining adequate sleep, regular physical activity, and stress control
- Staying well hydrated and consuming a balanced, nutritious diet
Due to the COVID-19 pandemic, minimizing the transmission of respiratory illnesses, including influenza, has become more important than ever during flu season.
Note: The information provided in this article by Hong Ngoc General Hospital is for reference purposes only and does not replace medical diagnosis or treatment. Patients should not self-medicate. For an accurate assessment of their medical condition, individuals are advised to visit a qualified healthcare facility for direct examination, diagnosis, and appropriate treatment planning by a physician.
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