Influenza FAQ for parents and caregivers

What is the flu and are there different types of flu? The National Institute for Communicable Diseases (NICD) made the following Frequently Asked Questions and answers about influenza available to parents and caregivers.

1. What is the flu?

The influenza virus causes influenza (also known as flu). It is a contagious respiratory tract illness. Illness can range from mild to severe and may require medical attention in small children or children with underlying health problems.

2. Are there different types of flu?

The influenza virus has two main types in humans: A and B. Influenza A is classified into different subtypes influenza A(H1N1)pdm09 and A(H3N2). Influenza A(H1N1)pdm09, which has colloquially been called “swine flu”, is the human influenza strain that emerged globally in 2009. This strain behaves like any other strain of seasonal influenza and infected patients should be treated like any other seasonal influenza case. There are no specific public health interventions required for patients or contacts of patients infected with influenza A (H1N1)pdm09. The term “swine flu” should not be used, because this term refers to influenza in pigs.

3. What symptoms should you look out for?

Sudden onset of fever and acute respiratory symptoms (cough, sore throat, runny nose, shortness of breath). Some general symptoms experienced are extreme tiredness and weakness, headache, muscle pain and body aches, cold shivers and hot sweats. Some people may experience vomiting and diarrhoea which is more common in children.

4. What is the difference between a cold and the flu?

The common cold and flu are both respiratory illnesses but they are caused by different viruses. It can be difficult to tell the difference between colds and flu based on symptoms alone as they may present similarly. Flu symptoms are often worse than the common cold. People with flu are more likely to have a fever and body aches. People with a cold are more likely to have congested or runny noses and generally colds do not result in severe complications such as bacterial infections or pneumonia. There are laboratory tests available to test for flu; these are best done in the first few days of illness.

5. How serious is flu?

The majority of people with flu will recover in 3-7 days, but some people will develop complications because of flu, some of which can be life threatening. Examples of complications from flu are sinus infection, ear infections and pneumonia. Pneumonia is an infection of the lungs caused either by the influenza virus alone or from co-infection with bacteria. Other possible serious complications following by flu can be inflammation of heart, brain or muscle tissue. In some cases, multi-organ failure may occur (this is when the flu virus causes an inflammatory response throughout the body causing organ failure such as respiratory and kidney failure). Children under the age of 5 years and any child with other health problems (such as asthma, chronic lung conditions, disorders of the brain or nervous system and diabetes) are at a higher risk of flu complications such as pneumonia, bronchitis, ear and sinus infections.

6. What do I do if my child gets sick?

Make sure your child drinks plenty of fluid and gets lots of rest. Medication for fever and nasal congestion can be administered for symptom relief. Keep your child home from school.

Antiviral drugs are prescription medicines that can be used to treat flu illness. They are given to treat flu in people who are very sick (admitted in hospital) or people who are at high risk of complications. They work best when given within 2 days of onset of illness.

If you are worried about your child, contact your doctor early. Children younger than 5 years or children with long-term health problems are at higher risk of complications from the flu and you may have to take them to the doctor. A baby under 12 weeks of age with a fever should be seen by a medical professional as soon as possible.

In young children, you should seek urgent medical attention if any of the following are present: Fast breathing with ribs pulling in with each breath, bluish tinge of lips, severe muscle pain (child refuses to walk), dehydration (no urine for 8 hours, no tears when crying, dry mouth, sunken eyes), severe chest pain, seizures, fever (> 40°C or in children <12 weeks any fever), not alert or interacting when awake, symptoms that improve and then worsen or worsening of a chronic medical condition.

In older children and adults you should seek medical attention if the following are present: difficulty breathing, persistent pain or pressure in the chest or abdomen, seizures, confusion, persistent dizziness, severe muscle pain, not urinating, symptoms that improve but then worsen or worsening of a chronic medical condition.

7. How is flu spread?

Flu is spread mainly by respiratory droplets (when people with flu cough, sneeze and talk) these droplets can land in the mouths or noses of people in close proximity. You can also catch

the flu by touching an object or surface that has flu virus on it and then touching your mouth, eyes or nose.

8. For how long is a person contagious?

A person with flu may be contagious 1 day before symptoms appear and for about 3-7 days after the onset of symptoms. The interval from when a person is exposed to the flu virus to onset of symptoms is about 1 to 4 days (average 2 days).

9. How do I reduce the spread of flu?

Infected children and staff should stay home and limit contact with other people. If your child is sick, keep him or her at home. You and your child should stay away from people who are sick.

Teach your child to:

  • Cover his or her nose and mouth when coughing/sneezing (e.g. cough into a tissues, cough into a sleeve)
  • Discard used tissues and to wash his/her hands with soap
  • Avoid touching his or her eyes, nose, or mouth
  • Wash hands frequently

Surfaces that are commonly touched (e.g. door handles) should be cleaned thoroughly.

10. Should I get the flu vaccine?

The flu vaccine is developed every year with the strains predicted for that year. The vaccine is effective after 10-14 days and should thus be administered yearly before the start of the flu season. In South Africa the flu season typically starts around May and thus the optimal time for vaccination is around March/April. No live virus is present in the vaccine and thus your child cannot ‘catch’ the flu from the vaccine. It is safe to administer the flu vaccine from 6 months of age.

The flu vaccine is recommended for the following groups:

  • Pregnant women at any stage of pregnancy (including 2 weeks after delivery)
  • Persons over 6 months with medical conditions such as chronic respiratory (asthma, tuberculosis), cardiac diseases, chronic renal diseases, diabetes mellitus, individuals who are immunosuppressed (e.g. HIV) or obese.
  • Persons aged 6 months to ≤18 years on long-term aspirin therapy
  • Children aged 6 months to 59 months
  • Persons aged≥65 years
  • Healthcare workers
  • Residents of old-age homes and chronic care and rehabilitation institutions
  • Adults and children who are family contacts of high-risk cases
  • Any persons wishing to minimize the risk of influenza acquisition

Although older children are at low risk of severe complications from influenza by receiving the vaccine they minimize their risk of influenza infection and missing school as well as spreading the virus. By vaccinating yourself and your child, you also can protect others who may be more vulnerable to serious flu illness, like babies and young children, older people, and people with certain long-term health problems.

11. When can I send my child back to school?

Your child should stay home for at least 24 hours after the fever (temperature > 37.8°C) has subsided without the use of fever-reducing medicine.


Last updated on 10 June 2019 (NICD)

National Institute for Communicable Diseases (NICD)

This content was made available by the NICD website and can be accessed directly by visiting

Detailed information about Influenza can also be accessed by visiting the diseases index on the NICD website.