An image of a sleeping child with a hand on her forehead.

Since the beginning of October, 32 children have died from the flu, according to the Centers for Disease Control and Prevention. 

That's high for this point in the season. For the same time period last year, the CDC had 16 recorded pediatric deaths from flu. And at this stage in the especially severe 2017–2018 season, 20 youngsters had reportedly died.

This isn’t cause for panic, however, says Scott Epperson, D.V.M., an epidemiologist with the CDC. This year’s flu season began sooner than many do. “Given the fact that we’ve had influenza viruses circulating earlier this year than we’ve seen in previous years, it’s not necessarily surprising or alarming to see this number of deaths,” he says.

It's important to remember that the vast majority of kids who get the flu recover quickly. However, some children—those who are younger than 5 or have an underlying condition such as asthma or diabetes—are at high risk for serious flu complications such as pneumonia and sepsis. More than half of the children who've died from the flu this season had a high-risk condition, and about half were below age 5. 

More on flu season

Also, the immune systems of healthy young children are only moderately effective at fighting infection, says pediatrician Wendy Sue Swanson, M.D. That's because children haven’t had time to build up any immunity to flu, which is acquired over years of getting flu shots and being exposed to influenza. 

But several steps can reduce kids' risks of flu. Here’s what every parent should know.

Make Sure They’re Vaccinated

Typically, about three-quarters of youngsters who die from the flu received no flu shot. “Most children who are hospitalized or become critically ill or die from flu are unvaccinated,” Swanson says.

The flu vaccine is the most important step in protecting kids, and it’s not too late to get the flu shot for them (and yourself) if you haven’t already. Call your doctor’s office or pharmacy to make sure the vaccine is available. You can also use the CDC’s Vaccine Finder tool for pharmacies in your area that still have the flu shot. Note that only some states allow children to receive vaccines in pharmacies. Call your doctor’s office or your local health department if you’re unsure.

Epperson says we don’t yet know how effective this year’s shot is against the flu. But even though the flu shot doesn’t absolutely guarantee that kids won’t get the flu, if they do catch the virus, the shot can reduce their chances of a serious complication. A 2016 study looking at recent flu seasons in Ontario, Canada, found that vaccinations reduced the likelihood that a child would be hospitalized with the flu. 

Here are key details on the flu shot for children at different ages:

Babies younger than 6 months shouldn't receive a flu shot. But pregnant women can and should. Not only are they at higher risk for flu complications, but the vaccine also gives them immunity they can pass on to their newborn.

Also, anyone who comes in contact with children of any age—but especially infants—should get the flu shot, says Elizabeth Murray, D.O., a pediatric emergency physician at the University of Rochester. That includes family members, caregivers, relatives, and friends.

Children between 6 months and 8 years old should get two doses of the flu shot, given 28 days apart, if it’s their first time receiving the vaccine. Kids should also have two doses if they were vaccinated once before but received only one dose. (Children in this age group who received two doses in the past need only one dose this season and going forward.)

Children older than 8 years old need a single-dose flu shot every year, according to the CDC.

Follow These Important Hygiene Habits

Keep those hands clean. If the flu vaccine is the best way to protect against the flu in children, “the second best way is diligent hand-washing,” Murray says. Encourage kids (and grown-ups) to wash their hands before eating meals and to keep their hands away from their eyes, nose, and mouth. Murray suggests making it a routine for everyone to wash their hands when they return home from school or errands. And teach children to wash their hands properly, for at least 20 seconds with soap and water.

Cough the right way. Parents should try get kids in the habit of coughing into their elbows and covering sneezes with tissues to avoid spreading germs (and should do the same themselves).

If Kids Get Sick With the Flu

Symptoms of the flu in children are largely the same as they are in adults, including a fever, coughing, a sore throat, a runny nose, head or body aches, and fatigue. But children are more likely than adults to experience vomiting or diarrhea with the flu, the CDC says.

Most children recover from the flu in a week or two with rest, fluids, and medication to reduce fever, such as acetaminophen (Tylenol and generic), ibuprofen (Advil and generic), and naproxen (Aleve and generic), without needing a doctor’s care.

But some, particularly those who are younger than 5 or have underlying medical problems, may benefit from from treatment with prescription antiviral drugs such as oseltamivir (Tamiflu and generic) or zanamivir (Relenza). These medications have been found to shorten the illness and reduce the likelihood of hospitalization.

Because antivirals need to be started within 48 hours of the beginning of flu symptoms for maximum effectiveness, call your doctor right away if your child is in one of the categories above and you suspect the flu.

And be on the lookout for the following, which may signal that your child needs medical care right away:

For very young infants—younger than 60 days old—fever higher than 100.5° F from any illness is an emergency, Murray says. So if a child’s rectal temperature is 100.5° F or higher, take him or her to a doctor’s office or an emergency room for evaluation. (For children older than 60 days, fever alone isn’t a sign of a medical emergency.)

Other symptoms that warrant a trip to an ER for children of any age: fever with rash, dehydration (signs include crying without tears, sunken eyes, dry and cracked lips, lethargy or fatigue, and, in babies, much less frequent wet diapers and a sunken soft spot on the top of the head), seeming unresponsive, severe vomiting, pain or pressure in the chest or abdomen, and confusion.

Both children and adults who have the flu and experience difficulty breathing should get to an ER. In children, you may notice bluish skin color, or skin that appears to be pulling in around the rib cage when they take a breath. They may also resist lying down because it makes breathing more difficult. An infant's heads may bob slightly as he or she breathes, Murray says.

And last, people of all ages should contact a doctor or go to an urgent care facility or ER if an illness seems to be subsiding but then suddenly worsens, with symptoms such as a newly high fever or cough. These could be signs of a secondary infection, such as pneumonia.

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