Flu, cold, allergies: How to tell what's keeping your kid down

On these late winter days and nights, plenty of parents around here are greeted with a multiple choice pop quiz that goes something like this.

Posted 2:00 a.m. Mar 8, 2017 — Updated 5:44 p.m. Mar 8, 2017

Sarah Lindenfeld Hall

On these late winter days and nights, plenty of parents around here are greeted with a multiple choice pop quiz that goes something like this.

Your child wakes up with a runny nose and a cough. Could it be ...

A. The flu? The Centers for Disease Control and Prevention reported not long ago that the illness was widespread in North Carolina.

B. The common cold? Their best friend has been fighting one for the last few days.

C. Allergies? The windshield, after all, is starting to turn yellow from pollen.

Nobody wins when you pass this test. Regardless of the cause, you might have a miserable kid on your hands for a few days with the cold and a week or more with the flu.

But, how do you tease out the answer when your child is standing before you, stuffed up and snotty?

I checked in with Dr. Adam Ottley and Dr. Jill Wright with UNC Pediatrics of Garner to get some details about how to know exactly what's ailing your child.

They both agreed that it's important to be mindful this time of year that the flu could be the culprit. Both said they're seeing high numbers of patients with flu-like symptoms.

"We are seeing a lot of flu," Wright said. "We just got last week a flu report from one of the nurses in the UNC system that indicated that the week prior was one of the busiest weeks as far as flu activity that they’ve seen in recent years. And we are still seeing lots of patients. The patient I saw before I was talking with you was positive for the flu."

And, "unfortunately," added Ottley, "we don't know the tide has turned until a few weeks after."

So how can you know why your child is so sick ... and whether you should send them to school or keep them home?

It could be the flu ... if there is extreme fatique; headache; aches and pains; dry, hacking cough; chills and shakes; congestion and a high-grade fever of up to 104 degrees that appears within about a day of symptoms appearing. (It's not too late to get a flu shot, which is recommended this year over the flu mist for children).

It could be a cold ... if there is cough, congestion, fatique, sneezing and a sore throat. A fever might not appear until a few days later because of a secondary bacterial infection such as an ear infection.

It could be allergies ... if there is sneezing or coughing, along with itchy nose and eyes, which are not common features of either the cold or flu. Ottley also says he asks parents if the same symptoms appear about the same time every year. If the answer is yes, then it's probably allergies.

If parents suspect the flu, Wright and Ottley recommend visiting your family's pediatrician for an evaluation and a simple swab test to determine if it is, indeed, influenza. A quick diagnosis - within a day or so of those first symptoms - will allow kids to start Tamiflu sooner. The medication can shorten the duration of flu symptoms for one to two days (though it can cause nausea in some, which I can attest to during my bout with the flu a couple of years ago).

At home, make sure the child gets plenty of rest and liquids. If they're eating food, Ottley said just water is fine. But, if they're not eating anything, Pedialyte is a good option. (Ottley recommends staying away from Gatorade and other sports drinks because they are high in sugar).

And don't go out and about. Both Wright and Ottley stressed that anybody with the flu should stay home so they don't share their germs far and wide. That includes school, sports practices, dance rehearsals, art class and trips to the grocery store.

The CDC has a great online resource with more information about flu treatment and recovery.

Kids can return to school and regular activities 24 hours after they are fever free. But, be cautious. Their immune system has been hard at work fighting an illness. Just because the fever is gone doesn't mean they are ready to get back to their usual activities. Take it slow.

"They need to be feeling well enough to do the activity to learn and participate and focus," Wright said. "You don't want to send them back when their immune system isn't quite back up to par and then they get the stomach flu."

Because that's going around too ...

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