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Children under two years and especially under 12 months of age are especially vulnerable to ‘flu and its complications since they have not had prior exposure to the virus, and therefore have no immunity to it.

How is ‘flu recognised in children?
‘Flu occurs almost exclusively in a short season in winter so at other times of the year it is an unlikely cause of illness. Symptoms start very abruptly. In a very young child, a fever (with irritability or listlessness) may be the only sign of infection with ‘flu. In older children there are usually signs linking the fever to the respiratory tract, such as very sore throat, dry cough or watery nose. Other signs include body aches, headache, sore eyes, earache and vomiting. In children, several other viruses can cause illness indistinguishable from ‘flu. Luckily, the time frame for ‘flu is short and improvement should occur after 48 – 72 hours, along with the virus’s departure.

When should I take my child for medical attention?
Any drop or rise in temperature in a baby under three months, any temperature above 38 degrees Celsius in a child aged three to six, and a temperature above 39 degrees Celsius an older child would require medical advice. A fever persisting more than 48 hours despite treatment with an antipyretic (fever-lowering drug such as paracetamol) also needs medical investigation.

Severe ear pain may indicate middle ear infection (otitis media), which is the commonest complication of ‘flu in young children. Any breathing difficulty requires urgent medical attention. Pneumonia is the most dangerous complication of ‘flu.

What can I do at home?
A child with a high temperature may be at risk for a febrile convulsion (fever fit). The fever should be brought down with paracetamol syrup and sponging the child with tepid water may be helpful. Aspirin is never used in children with a fever because if the fever is caused by a virus there is a risk that the child will develop Reye's syndrome (a rare but fatal condition which affects the brain and liver).

Although there are many cold and ‘flu remedies available over the counter in chemists and supermarkets, these are generally not advisable in young children and should be discussed with a pharmacist or doctor. There are specific anti-influenza drugs now available (zanamivir and oseltamivir) and these might be prescribed by your doctor if the diagnosis is definite and circumstances warrant this treatment.

Can the ‘flu vaccine be used in children?
Children older than six months can have the yearly ‘flu vaccine and this is recommended for all children by American health authorities. The ‘flu vaccine is especially important for children who have a heart condition (such as a congenital heart defect) or lung condition (such as asthma) or any long-term illness. Children who have a severe egg or poultry allergy will usually not be eligible for the vaccine. A new ‘flu vaccine that is given as nasal drops rather than by injection should become available within the next few years. – Dr Jane Yeats, virologist, updated February 2008

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