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Content on this page was developed during the 2009-2010 H1N1 pandemic and has not been updated.

  • The H1N1 virus that caused that pandemic is now a regular human flu virus and continues to circulate seasonally worldwide.
  • The English language content on this website is being archived for historic and reference purposes only.
  • For current, updated information on seasonal flu, including information about H1N1, see the CDC Seasonal Flu website.

Action Steps for Parents of Children at Higher Risk for Flu Complications

February 17, 2009 1:00 PM ET

Children younger than 5 years old, but especially children younger than 2 years old; people aged 65 years or older; pregnant women; adults and children who have asthma, neurological and neurodevelopmental conditions; chronic lung disease; heart disease; blood disorders; endocrine disorders, such as diabetes; kidney, liver, and metabolic disorders; weakened immune system due to disease or medication; and people younger than 19 years of age who are receiving long-term aspirin therapy are all at higher risk for flu-related complications. If you are not sure if any of your children are at higher risk for flu complications, please check with your health care provider. For more information on people at higher risk for flu complications, visit

Keep children at higher risk for flu complications from getting sick with the flu

  • Get your children over the age of 6 months vaccinated for seasonal flu and 2009 H1N1 flu.
  • Have your child cough and sneeze into a tissue or into his or her elbow or shoulder if a tissue is not available. Make sure your child throws tissues away right after use and washes his or her hands.
  • Make sure your child’s hands are washed often – or help your younger child wash them – for 20 seconds with soap and water. If soap and water are not available, use an alcohol based hand rub. Alcohol-based hand rubs can be toxic if swallowed, so keep them in a place that only you can access when you need to use it.
  • Keep your child away from people who are sick.
  • Clean surfaces and objects that your child frequently touches. Wipe these surfaces with a household disinfectant that is usually used, following the directions on the product label. Additional disinfection of these surfaces beyond routine cleaning is not recommended.
  • When there is flu in your community, consider your child’s risk of exposure if they attend public gatherings. In communities with a lot of flu, people who are at risk of complications from flu should consider staying away from public gatherings such as sporting events and concerts.
  • If flu is severe in your community, talk to your health care provider and child’s school or early childhood program to develop a plan on how to handle your child’s special needs.

Recognize if your children are sick.
Some children may not be able to tell you about their symptoms, which can result in a delay in responding to their illness. It is important to watch carefully for the signs and symptoms of flu or unusual behavior that may be a sign your child is sick. Symptoms of flu include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and tiredness. Some people may also have vomiting and diarrhea. People may be infected with the flu, including the 2009 H1N1 flu and have respiratory symptoms without a fever. A fever is a temperature measured by mouth with a thermometer that is equal to or greater than 100 degrees Fahrenheit (37.8 degrees Celsius). If you are not able to measure a temperature, signs and symptoms that may indicate your child has a fever include chills, feeling very warm to the touch, having a flushed appearance, or sweating.

Watch for emergency warning signs that need urgent medical attention. These warning signs include one or more of the following:

    • fast breathing, trouble breathing, shortness of breath, or stopping breathing;
    • bluish, purplish, or gray skin color especially around the lips and the inside of the mouth, or around the nails;
    • not drinking enough fluids, refusing to drink;
    • not urinating, decreased number of wet diapers, or no tears when crying;
    • severe or persistent vomiting;
    • not waking up or not interacting (e.g., unusually quiet and inactive, no interest in playing, no interest in favorite toy);
    • being so irritable that the child does not want to be held, or cannot be consoled;
    • pain or pressure in the chest or stomach;
    • sudden dizziness;
    • confusion; and
    • flu-like symptoms improve but then return with fever and worse cough.

Follow these tips for taking care of high risk children with the flu.

  • Contact your health care provider immediately if your child is sick. This is important because the antiviral medicines used to treat flu work best when started within the first 2 days of getting sick. Your health care provider will tell you what special care is needed for your child. 
  • Keep your sick child at home until at least 24 hours after your child no longer has a fever or signs of a fever (without the use of a fever-reducing medicine). Keep your child home unless they need to go to the health care provider.
  • Make sure your child gets plenty of rest and drinks clear fluids (such as water, broth, sports drinks) to prevent dehydration. For infants, use electrolyte drinks such as Pedialyte®.
  • If your child has a fever, use fever-reducing medicines that your health care provider recommends based on your child’s age. Aspirin (acetylsalicylic acid) should not be given to children or teenagers; this can cause a rare but serious illness called Reye’s syndrome.
  • Keep your sick child in a separate room (a sick room) in the house as much as possible to limit contact with household members who are not sick. Consider designating a single person as the main caregiver for the sick child.

Additional information about caring for sick household members can be found at


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