Treatment Guideline Chart
Influenza may present as a mild respiratory illness similar to the common cold or it may present without characteristic signs and symptoms.
The main type of influenza virus are types A, B & C virus. Types A&B are the main causes of influenza outbreaks.
Patient may appear flushed and have pain on eye movement. Non-exudative pharyngitis, scattered rales or rhonchi may be present.

Influenza%20(pediatric) Signs and Symptoms



  • The main types of influenza virus are types A, B and C virus
  • Types A and B are the main causes of influenza outbreaks

Follow local program for control of priority diseases, if available

Timing of Vaccination

  • All children 6 months-18 years are recommended to be given Influenza vaccine annually
    • Safe for school-aged children
    • Influenza substantially affects school-aged children and their contacts
  • Must be administered yearly because vaccines decline in efficacy with time and in the emergence of newly circulating strains
    • For the 2022-2023 recommendation, the Advisory Committee on Immunization Practices (ACIP) recommend that complete immunization should start as soon as the vaccines become available, preferably by the end of October
    • Children scheduled to receive their 1st dose of influenza vaccine should be inoculated as soon as possible, to ensure immunization by the end of October
    • No preference was given whether to use inactivated trivalent or quadrivalent vaccine
  • Attack rates of influenza are higher in children during outbreaks and are a major cause of transmission within communities

Northern Hemisphere

  • Typically administer annual vaccinations to high-risk individuals and their close contacts between October-February

Southern Hemisphere

  • Typically administer annual vaccinations to high-risk individuals and their close contacts between March-September

Tropical or Subtropical Regions

  • Laboratory confirmed influenza can occur anytime throughout the year
    • Peaks of influenza activity can occur 1-2x/year, during rainy/winter season
  • Public health programs where high-risk individuals and their close contacts are vaccinated should be performed at the same time each year if >1 peak of influenza activity occurs within a year
    • Latest available vaccine formulation should be used


Signs and Symptoms

Most Commonly Presented Clustered Symptoms

  • Abrupt onset of fever (37.7-40°C)
  • Severe myalgia and/or arthralgia
  • Severe dry cough
  • Loss of appetite
  • Headache

Other Common Symptoms

  • Chills
  • Malaise
  • Weakness
  • Fatigue
  • Chest discomfort

Symptoms that Occasionally Occur

  • Stuffy nose
  • Sore throat
  • Sneezing

Risk Factors

  • High-risk groups are more likely to suffer severe illness and premature death related to influenza

Targeted Pediatric Populations

  • <5 years especially children <2 years of age
  • Patients ≤18 years on long-term Aspirin therapy due to increased risk of Reye’s syndrome
  • Patients with chronic pulmonary, cardiovascular (CV), renal, hepatic, hematologic or metabolic diseases
  • Immunocompromised children
  • Children with neurologic and neurodevelopment conditions
  • Children with conditions that compromise respiratory function or handling of secretions
  • Obese children and adolescents
  • Children living in the community with ≥1 of the above disease states

Caregivers or Other Individuals Who Live with High-Risk Individuals

  • Healthy household contacts and caregivers of children ≤5 years
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