Influenza in children: Its Diagnosis, Causes, and Treatment

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What is influenza?

Flu (influenza) is an illness of the respiratory system, specifically the nose, throat, and lungs. Contrary to popular belief, influenza is not the same as stomach “flu” viruses that cause vomiting and diarrhea.

Epidemiology of influenza

Numerous population-based studies conducted in various regions have consistently demonstrated that influenza attack rates during annual epidemics are highest among preschool- and school-aged children, where rates of influenza infection may surpass 30%. Attending a daycare is thought to increase the chance of getting the flu, and during typical influenza seasons, daycare children have had attack rates of up to 50%.

One-third of the infants in a study that tracked them from birth to one year of age had influenza. Over 7% of all pediatric respiratory infections in the winter were caused by influenza, which was culture-confirmed in 19% of prospectively monitored children under the age of 13 during the flu epidemic of 2000–2001, which was generally regarded as mild or moderate.

Clinical manifestations of influenza

The spectrum of influenza illness includes mild, asymptomatic infections as well as serious, life-threatening diseases. Children who have influenza often experience comparable clinical symptoms as adults, such as a quick onset of fever, coughing, and sore throat.

It is likely that complaints like headaches, myalgia, malaise, or dizziness that are generally connected to influenza in adults also affect children, but it might be challenging to diagnose these symptoms in young children because of their weak verbalization skills.

However, compared to adults, children are more likely to experience gastrointestinal issues and rhinorrhea.

Influenza’s clinical effects extend beyond respiratory tract virus infections. Infection with the influenza virus can infrequently impact other organ systems and frequently results in bacterial complications. Acute otitis media is the most frequent influenza complication in children, occurring in 20% to 60% of cases depending on the child’s age and other risk factors.

Pneumonia and sinusitis are less common consequences in children, but acute asthma exacerbations are frequent in children with asthma who also have influenza.

Adenovirus and parainfluenza virus infections are not linked to a higher risk of febrile seizures than influenza infections are.

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Although several other assays based on antigen detection and molecular methods are available for laboratory confirmation of the illness, a culture of influenza viruses remains the gold standard for the diagnosis of influenza. However, the best use of influenza-specific antiviral medications necessitates a rapid diagnosis to be made at the point of care during the visit to a doctor. Several quick tests for influenza can yield findings in 15 minutes or less, but the sensitivity and specificity of the ones that are currently on the market vary greatly.


When an infected person coughs, sneezes, or talks, influenza viruses are spread through the air in droplets. Direct inhalation of the droplets is possible. You can also get germs from a surface, like a phone or a computer keyboard, and then put them in your mouth, nose, or eyes. The virus is most likely communicable from a day or so before symptoms start to four days or so after they do. Children and those with compromised immune systems may spread germs for a little while longer.

Risk factors

1.    Age

Children under the age of two and people over 65 are likely to fare worse from seasonal flu than other age groups.

2.    Living or working conditions

Flu cases are more common in those who live or work in large communal settings, such as nursing homes or military barracks. Additionally, hospital patients are more vulnerable.

3.    Weakened immune system

The immune system can be weakened by HIV/AIDS, blood cancer, anti-rejection drugs, long-term steroid usage, organ transplant, cancer therapies, and anti-rejection drugs. This may increase the chance of contracting the flu and make complications more likely.

4.    Chronic illnesses

The risk of influenza complications may be increased by chronic illnesses. Asthma and other lung ailments, diabetes, heart disease, diseases of the brain system, metabolic disorders, issues with the airways, and kidney, liver, or blood diseases are a few examples.

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Children with simple influenza have historically merely needed to rest and receive symptomatic care. Pediatric usage of these medications has been uncommon, even though the antiviral medicine amantadine has been available since the 1960s for the treatment of influenza, even in young children (and rimantadine in some countries for teenagers). Amantadine use in this age group is likely low due to a general underestimation of the prevalence of influenza in children, but there are also other issues with this medication, including side effects, ineffectiveness against influenza B viruses, and*most importantly* the rapid evolution of resistant influenza virus strains while receiving treatment.

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