The viral infections can be especially hard on infants and children. Because a tot can't say what's wrong, parents need to recognize the signs.

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Dr. Steve Muething, associate director of clinical services at Cincinnati Children's Hospital Medical Center, says parents should look for signs of disorientation and dehydration, along with fever and flu symptoms, when trying to determine how serious their child's illness is. Children 6 to 23 months old are in a high-risk group to develop complications from flu.

Flu symptoms include fever, muscle aches, fatigue, headache and congestion. Children also may suffer nausea and vomiting.

Question: When is a baby's fever considered dangerously high?

Answer: Everyone wants to know the number. But the height of the fever doesn't tell you when to worry; how the child is acting does. Danger signs: very unusual actions, profuse vomiting and difficulty breathing in addition to fever. Those are the main alarms. If a baby is younger than 2 months and has a fever, call the doctor. Consider a fever to be a temperature above 100.4.

Q: What is the best way to take a baby's temperature?

A: The most accurate way is rectal. The underarm temperature is pretty good, but leave the thermometer in place two or three minutes. If a child is younger than 3, ear thermometers are not accurate.

Interestingly, tests have shown that experienced moms who gauge a fever by putting a hand on their children's foreheads are accurate in telling when a fever exists. They're not accurate in knowing the number.

Q: What's the best way to bring the fever down?

A: The standards are acetaminophen and ibuprofen. Giving children aspirin for fevers puts them at risk for Reye's syndrome, which can kill. These over-the-counter drugs usually work in about one hour. If the child is feeling better, that's a good sign. Focus more on the symptoms than the number.

Things that don't work: Alcohol baths, cold baths and cold washcloths. They make the child much more uncomfortable and don't bring the temperature down.

Q: When is it time to get medical help?

A: Talk to your doc when the child gets sick. He or she can give you more precise advice.

Go to the emergency room if the child has fever and difficulty breathing, is not alert and not aware of surroundings, and the medicine's not improving their symptoms.

Q: How can you reduce your child's risk of getting the flu?

A: The two big things we talk about are avoiding crowded areas where people will want to hold, kiss and touch the baby, and the other is hand washing, hand washing, hand washing.

It's hard when we tell people to say no to people because everyone wants to show off the baby, but that's really the best thing.

Q: Dehydration is a big worry when little ones are sick. How can you tell when your child is dehydrated?

A: They'll look dry to a parent: sunken eyes, dry mouth, a decrease or stopping in the number of wet diapers. And they become very lethargic. They lose interest in play or even looking around or drinking. That's a definite time to call the doctor or go to the emergency room, and that's with or without fever.

When to get help

Take your child to the pediatrician or emergency room if he or she shows any of the following symptoms:

• Rapid or labored breathing, bluish skin tone.

• Not enough drinking to prevent dehydration.

• Changes in mental or emotional status; for example, not waking up, not interacting.

• Intense irritability, so much so that he or she doesn't want to be held.

• Relapse in flu symptoms after improvement; the child becomes ill again with fever, worse cough.

• Worsening of underlying medical conditions, such as heart or lung disease, diabetes, etc.

Source: American Academy of Pediatrics

Facts about the flu

• Influenza is a virus that attacks the respiratory tract, including the nose, throat and lungs.

• The flu is different from a cold and often includes high fever, headache, extreme tiredness, dry cough, sore throat, nasal congestion and body aches. Nausea, vomiting and diarrhea are more common in children than adults.

• If you get the flu, rest, drink plenty of liquids, avoid using alcohol and tobacco, and take medicine to relieve flu symptoms. But never give aspirin to children or teen-agers who have flu-like symptoms - particularly fever - without first speaking to your doctor; it can lead to Reye's syndrome, which can be fatal.

• If taken within two days of getting flu, a prescription anti-viral drug can reduce symptoms and shorten the sickness by one or two days. The drugs also can make a person less contagious. Ask your doctor if anti-viral drugs are right for you because the drugs have side effects.

• Because influenza is a virus, antibiotics won't cure it or lessen its severity.

• Most people who get the flu will recover in one to two weeks, but some will develop life-threatening complications, such as pneumonia.

• Nationwide, 10 percent to 20 percent of the population will get the flu each year.

• An average of 36,000 people a year in the United States die from flu and flu complications, and more than 200,000 have to be admitted to the hospital every year because of complications.

• People age 65 and older, people of any age with chronic medical conditions and very young children are more likely to have flu complications. Older adults account for nine of 10 flu deaths.

• Pneumonia, bronchitis, and sinus and ear infections are three examples of complications from flu. The flu also can worsen chronic medical conditions.

--Gannett News Service