Influenza (real flu) in children – everything you need to know now
- Johanna
- 5 days ago
- 4 min read
The current flu wave is affecting many families in Germany. Children, in particular, are frequently falling ill with influenza, the "real flu." Pediatricians are seeing a similar picture again and again: children with very high fevers, severe malaise, and illnesses that last significantly longer than a common cold.
Acute respiratory infections, flu-like infections: Many viruses, similar symptoms
Respiratory infections are a common occurrence in families during autumn and winter. They are caused by many different viruses and often begin with similar symptoms. However, the subsequent course of the illness can differ significantly.
A common cold is caused by numerous different viruses, such as rhinoviruses, seasonal coronaviruses, RSV, or parainfluenza viruses. Typical symptoms include a runny nose, cough, sore throat, and sometimes an elevated temperature or fever. These symptoms arise from irritation of the mucous membranes and the body's immune response. They are not specific to any one particular virus.
It is important to make a clear distinction: A common cold, also called a flu-like infection, has nothing to do with the real flu (influenza) .
What is influenza and how does it manifest itself?
Influenza, often referred to as "the real flu," is an acute viral infection caused by influenza viruses (usually type A or B). It differs significantly from a common cold. Symptoms often begin suddenly and are usually more severe.
Many families are currently experiencing exactly this: children who suddenly seem very ill, develop a high fever, and need significantly more time to recover.
Not every child shows all symptoms , but the following complaints frequently occur:
Sudden onset of fever (often above 38.5–40 °C)
severe fatigue and pronounced exhaustion
Headache and body aches
significantly reduced general condition
dry, irritating cough
Loss of appetite
It is noticeable that symptoms such as a runny nose or sore throat are sometimes barely present or completely absent.
Additionally, the following may occur:
Nausea or vomiting
Middle ear infections
In younger children, symptoms similar to croup may occur.
persistent cough even after the fever has subsided
Compared to a common cold, children with influenza often feel significantly weaker and are severely affected for several days.
The pronounced symptoms at the beginning are an expression of an active immune response. High fever and a strong feeling of illness indicate that the immune system is working.
Important to know: Influenza can also have a milder or atypical course.
How long does influenza last in children?
Many parents are worried because the illness lasts longer than expected. This is typical for influenza.
Fever often lasts for several days
The duration of the illness is often 7–10 days or longer.
Fatigue and coughing can persist even afterwards.
This is not a sign of neglect , but rather fits the clinical picture.
Influenza, COVID-19 or a common cold – can you tell the difference?
In short: no, not definitively based on symptoms alone. All three diseases can have similar beginnings.
For doctors, therefore, it is usually not crucial which virus is present, but rather:
how sick the child is
how the course develops
whether warning signs occur
This will then be treated symptomatically.
During periods when certain viruses are circulating widely, the probability is correspondingly higher. The RKI (Robert Koch Institute) regularly publishes updated situation reports on this.
Testing: useful or not?
Many pediatricians do not routinely test for influenza, as treatment for mild to moderate cases is symptomatic. Rapid influenza tests (e.g., combination tests) are commercially available and can help to better assess the course of the illness.
A positive test result does not automatically mean that you have to take your child to the doctor. The specific virus name is often secondary for medical decisions.
However, this knowledge can be very helpful for parents: it explains why the fever lasts so long, why the child is unusually exhausted, and can help them wait more calmly. Especially when fever is the main symptom, this understanding often brings relief.
Is influenza dangerous?
Most healthy children recover well from influenza. However, it can be serious, especially in cases of:
Infants under 6 months
Children with chronic illnesses
immunocompromised children
Influenza is currently contributing significantly to severe acute respiratory illnesses, and some children therefore require hospitalization.
How is influenza treated in children?
Influenza is a viral infection and is not treated with antibiotics . Antibiotics are only useful in cases of bacterial complications.
If the general condition is stable, support can be provided at home:
plenty of rest and sleep
Drink enough fluids
Fever and pain-relieving medication as recommended
Proximity, security and relief
Many children recover well from the illness.
When should you see a doctor?
Please seek medical advice if one or more of the following warning signs occur:
Your child hardly drinks or refuses fluids.
It seems significantly worse or unusually apathetic.
It has shortness of breath or noticeably rapid, labored breathing.
Very high fever persists despite measures taken.
There is a significant deterioration after initial stabilization.
Signs of dehydration (low urine output, dry mucous membranes)
Prevention: Vaccination and hygiene
The annual flu vaccination is the most effective protection against severe cases. It is administered in the autumn. The Standing Committee on Vaccination (STIKO) particularly recommends it for children with pre-existing conditions, immunocompromised children, pregnant women, people aged 60 and over, and close contacts of high-risk individuals . For many of these groups, the vaccination is free of charge.
If you don't belong to the recommended group, you can get vaccinated as a self-payer. It's best to ask at your doctor's office.
Simple hygiene measures also help:
regular handwashing
Cough and sneeze into your elbow.
Protect and separate sick family members as much as possible.
Conclusion
Influenza is more than just a bad cold. It can significantly affect children and take time to heal. At the same time, knowledge helps to realistically assess its course, reduce unnecessary worry, and recognize warning signs early. Lots of love, Johanna :)
As of January 2026
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