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Influenza, commonly called the ‘flu’, is an infection caused by influenza A or B viruses. It mainly affects the nose, throat and lungs, although it can involve other parts of the body. In healthy children, it is much like a bad cold, however influenza can cause more serious illness in very young children and those with chronic medical conditions.

Influenza occurs mainly during the winter months. Each year, infections are caused by slightly different strains of the virus. Occasionally, one of these strains can cause a more widespread or severe outbreak, similar to the 2009 H1N1 (swine flu) pandemic.

Symptoms and signs:

Influenza usually begins with a sudden onset of fever and at least two or three of the following symptoms:

  • general aches and pains
  • headache
  • cough or noisy breathing
  • sore throat and runny nose
  • low energy
  • nausea, vomiting and/or diarrhoea

Children at risk of severe illness:

Influenza can be more serious in children with chronic medical conditions including:

  • chronic respiratory conditions (including asthma)
  • chronic heart disease
  • chronic neurological or metabolic conditions
  • chronic kidney or liver problems
  • diabetes mellitus
  • a lowered immune system, due to medicines or illness

Warning signs of severe illness include poor feeding, dehydration, difficulty breathing and decreased responsiveness to caregivers/their surroundings.


Most children recover within seven days without any treatment. Ensure your child has plenty of bed rest, encourage them to drink lots of fluids and use paracetamol for pain or discomfort. Give your child the dose that is recommended on the packaging for their age and weight. Do not give aspirin to your child if they have influenza as this can lead to serious side effects.

Antibiotics are not helpful for influenza and will not be prescribed unless your child also has a bacterial infection. Antiviral medications (such as ‘Tamiflu’) are generally not given to children who have influenza and who are otherwise fit and healthy. This is because they do not usually make a significant difference to the duration of the illness.

When to seek medical treatment:

If you child’s symptoms are getting worse instead of better, it is best to see a doctor. Seek urgent medical advice if your child experiences chest pain, is having breathing difficulties, is dizzy or confused, or is vomiting a lot or not drinking enough. Similarly, seek medical advice if your child has a chronic condition and is at risk of severe illness.

How is it spread?

Influenza is very infectious. It can spread through the air by coughing and sneezing and by touching objects that have been in contact with an infected person’s mouth or nose. A person with influenza is contagious from the day before symptoms begin, until a few days after.


The best way to prevent influenza is the influenza vaccine (see below).

Good hygiene habits can also reduce the chance of getting influenza or passing it to others. These include:

  • regular hand washing
  • not sharing cups or cutlery
  • covering your mouth when you cough or sneeze

Influenza vaccine (the flu shot):

The influenza vaccine can be given to any child over six months of age to reduce the chance of becoming sick with influenza. Vaccination is voluntary but vaccination is encouraged for everyone.

If your child has a chronic medical condition, it is strongly recommended that they have an annual influenza vaccination. All household members should also be vaccinated to decrease the chances of your child being exposed to influenza.

Because the influenza virus changes (or mutates) slightly from year to year, your child will need a new and updated influenza vaccine at the beginning of each influenza season.

Side effects of the vaccine include pain and redness at the site of injection. Less commonly, children may develop fever or aches and pains which last one to two days. The vaccine cannot cause influenza as it contains killed or inactivated influenza virus. There are now studies suggesting children with egg allergy can be safely immunised for influenza. These children recommended for influenza immunisation should be referred to a specialist clinic.

Key points to remember:

  • Vaccination is the best way to prevent influenza
  • Influenza is very infectious so good hygiene is important
  • Influenza is caused by a virus so antibiotics cannot be used to treat it
  • Influenza can be more serous in children with chronic medical conditions
  • Contact your family doctor if your child has influenza and has a chronic medical condition, or signs of severe illness 

Where can I find more information?

Written by the Emergency Department, The Children’s Hospital at Westmead

References: Royal Children’s Hospital Melbourne Influenza fact sheet

NSW Government Influenza fact sheet.

The Sydney Children's Hospitals Network
Hunter New England Kids Health

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