Guidelines
Pediatric

Pediatric

General Information on Influenza and Management

  • Differentiating influenza from other viral respiratory illnesses is difficult clinically, since the symptoms of influenza are not highly specific
  • As a result, routine diagnoses of influenza on a clinical basis will likely lead to over diagnosis and treatment of many children who have non-influenza viral respiratory illness
  • While patients can have severe illness, the vast majority will have a mild, self-limited course
  • Acute otitis media is a common complication and influenza can trigger asthma exacerbations in patients with known asthma
  • Pneumonia is a less common complication and encephalitis is very rare
    • Vomiting and diarrhea can also occur more commonly in children

Anti-viral treatments have a marginal effect on shortening the duration of influenza illness symptoms in children (up to 29 hours on average)

  • Side effects of Oseltamivir (Tamiflu) are not common and are usually not severe
  • The most common side effect is vomiting, which occurs in about 5% of patients

Pediatric patients at "High-risk" for influenza complications (per CDC) include those with chronic medical conditions such as:

  • Pulmonary (asthma, cystic fibrosis),
  • Cardiovascular
  • Renal
  • Hepatic
  • Hematological (sickle cell disease)
  • Metabolic disorders (including diabetes mellitus)
  • Neurologic
  • Immunosuppression
  • Obesity
  • On chronic aspirin therapy

Note: Determination of "high risk" status in the less than 2-year-old age group is left to the judgment of the clinician since the data does not clearly support that children in this age group are at higher risk for mortality or severe illness.

Testing & Treatment (Select Risk Status)