How to Know If Your Kid Has the Flu or Just a Cold
If you’re anything like us, you’re in the midst of a mild (OK, full-blown) flu panic. And according to the CDC, anxiety is warranted.
But of course, the best antidote to fear is information.
So we asked San Diego pediatrician Dr. Jaime Friedman, a Fellow of the American Academy of Pediatrics, all our burning questions.
If you need us, we’ll be over here sanitizing our kids’ hands.
Q) Are there any telltale signs that a child's cold may in fact be the flu?
A) The flu (influenza) comes on suddenly. It feels like you've just hit a wall. The fatigue, body aches and fever all come at once.
Colds are usually gradual. First, a sore throat and runny nose. Then the congestion gets worse, and children will develop a cough that will go from dry to wet because of post-nasal drip and will start to get worse before it gets better.
Sometimes the fever with a cold is at the beginning and sometimes a few days into it. The fever is usually lower with a cold than the flu.
Q) So flu symptoms have a faster onset than typical cold symptoms?
A) Flu is a sudden onset and colds are gradual.
But they both have a similar incubation period. That means they both cause illness within a few days of exposure.
The timing of a fever with a cold, if it occurs, will vary. Sometimes it is an [initial] symptom, and sometimes it comes a few days after the start of the runny nose and cough.
With the flu, fever is one of the initial presenting symptoms along with the muscle aches and fatigue. With the flu, you are less likely to have a runny nose and congestion like you have with a cold.
Q) How soon after your child gets a fever should you go to the pediatrician? Should you wait 24 hours or for the fever to get above a certain temperature before you take your child to the doctor?
A) This really depends on the season and what else is going on.
During flu season, if your child suddenly develops a high fever (102-104), you may want to be seen as soon as you can, in case your doctor wants to start Tamiflu. Tamiflu is most effective if started within 48 hours of the start of symptoms.
If your child has been having cold symptoms for a few days and then gets a fever 101-102, it's OK to wait a day or two to see how they do before being seen by a doctor.
However, if your child gets a fever with any chest pain, trouble breathing, headache with neck pain, or ear pain, then take them in to be checked.
Fever and sore throat without cold symptoms can be strep, but the quick test most offices use is more active after 48 hours of symptoms, so for this you can wait a day or two to be seen.
Q) Is all the flu panic in the media right now warranted?
A) I think parents should worry about the flu every year. The flu can be dangerous with potential pneumonia, hospitalization and death as a result. This can be the case for otherwise healthy children, as well as children with underlying medical conditions.
Right now, being aware of the widespread nature of the flu is important so parents can make decisions on vaccinating their children and also instructing children on good hand washing. [The media attention] also helps them consider flu when their children get sick, keeping them home from school and calling the doctor.
The CDC does report a higher hospitalization rate for this season so far. The death rate is also slightly higher this year than in previous years. However, pediatric deaths specifically are fairly similar to the past few years.
Q) Are there reliable tests pediatricians can administer to diagnose kids with the flu? I've heard there is a nasal swab—how accurate is it?
A) The test we use in the office is a rapid test.
Some experts don't feel testing is even needed during an epidemic as the symptoms are pretty typical. I think if there is a question about the cause of someone's symptoms, then a test can be helpful, but it doesn't 100 percent rule out—or confirm—influenza infection.
Q) How is the flu treated in kids? Are antiviral meds typically given?
A) The only antiviral medication we would consider for the flu is Tamiflu. The CDC recommends using Tamiflu in children who are considered high risk, meaning with underlying health conditions or under age two.
While Tamiflu can reduce the length of symptoms by one to two days, it also has some side effects like stomachache and vomiting. As far as preventing complications of the flu, Tamiflu has not shown to be great in studies. However, in observational studies, there is some reduction in flu complications with Tamiflu.
Overall, the best way to reduce the risk of infection and complications of the flu with minimal side effects is with flu vaccination.