Viral illnesses

  • A virus is a germ that causes infections such as the common cold, bronchiolitis, tonsillitis, ear infections, influenza, mumps and chickenpox. There are hundreds of different viruses.

    Colds are very common in healthy children and on average, preschool children get at least six colds per year. It is common for healthy children to have up to 12 viral illnesses per year in the first few years of life. It is also common for children to get sick from one virus shortly after getting better from a different one, so it can seem they are sick all the time. As children get older, the frequency of catching viral illnesses usually reduces.

    Viruses can easily spread when children have close contact with each other. Most viruses are mild, and the best treatment is rest at home.

    Signs and symptoms of viruses

    If your child has a virus, they may show a variety of symptoms, including:

    • a blocked or runny nose
    • red, watery eyes
    • a sore throat
    • fever
    • rashes that turn white (blanch) for a second or so after you push on them with a finger (you could also press the side of a clear drinking glass over the rash and watch to see if it blanches)
    • coughing or sneezing
    • vomiting and/or diarrhoea
    • wanting to sleep more (lethargy)
    • not wanting to eat
    • feeling generally unwell.

    While most viruses are mild in children, infants under three months of age may become very ill quickly and need to be assessed by a doctor.

    Care at home

    Viruses cannot be treated with antibiotics. The best treatment is rest at home to allow your child’s immune system to fight the virus.

    Here are some simple measures that can make your child more comfortable:

    • Give your child small amounts to drink frequently when awake, such as a mouthful of water every 15 minutes or so. This helps to ease a sore throat by keeping it moist, and replaces the fluid lost due to having a fever, vomiting or diarrhoea. Water is best, but rehydrating icy poles are also a good way of providing fluids to your child.
    • Giving enough fluid is particularly important in infants – this should be breastmilk or formula, or rehydration fluids such as electrolytes. See our fact sheet Dehydration.
    • Do not be concerned if your child does not eat for a few days. When they feel better they will start eating again.
    • Allow your child to rest.
    • Use saline nasal (nose) drops to help clear a blocked nose in babies.  A baby with a clear nose will find it easier to feed.
    • Give your child paracetamol or ibuprofen for pain, or if your child is miserable, irritable or lethargic. See our fact sheet Pain relief for children. Do not give your child aspirin. Carefully check the label for the correct dose and make sure you are not already giving your child any other products containing paracetamol or ibuprofen (such as some cough medicines and cold-and-flu preparations).
    • Do not use paracetamol or ibuprofen just to reduce fever. Fever helps the body get better naturally.
    • Do not use other remedies unless advised by a doctor or health care professional.

    Your child is likely to feel better in a few days, but may be unwell for up to two weeks. A cough can linger for several weeks.

    Most rashes are mild and do not cause your child any distress, although some rashes can cause a lot of itching. Talk to your local pharmacist about treatments that can help relieve itchy rashes. A rash often lasts a few days before going away on its own. Sometimes a rash appears when a fever goes away. When this rash appears, it means the child is getting better. See our fact sheet Rashes.

    When to see a doctor

    If your child is not improving after 48 hours, or is getting worse, take them to see your GP. Also see your GP if your child has any of the following:

    • pain that does not improve with paracetamol or ibuprofen
    • persistent vomiting and diarrhoea (see our fact sheet Gastroenteritis)
    • a high fever that is not improving after 48 hours
    • refusal to drink or have an icy pole for six hours
    • a rash or spot that does not blanch when you push on it
    • less than half the usual number of wet nappies
    • they are giving you concern for any other reason
    • Poor feeding or fever in an infant aged three months or younger

    Seek immediate care from your doctor or a hospital emergency department if your child:

    • is very pale or hard to wake
    • has trouble breathing
    • has a rash and gets a headache, stiff neck or back pain
    • is unwell with a fever and a skin rash (small bright red spots or purple spots or unexplained bruises) that does not turn to skin-colour (blanch) when you press on it (see our fact sheet Meningococcal infection)
    • Poor feeding or fever in an infant aged one month or younger

    Sometimes viruses can trigger asthma (if your child has a diagnosis of asthma) or a wheeze (whistling sound while breathing). If this happens, treat the asthma as you normally would. If the wheeze is new and your child is having difficulty breathing, take them to see your GP.

    How are viral illnesses spread?

    A virus can spread from person to person in tiny droplets from the nose (sneezing or a runny nose) and mouth (saliva or a cough). Viruses can also spread via vomit or faeces (poo), especially when someone has diarrhoea.

    There is usually a delay between when a child is exposed to the virus and when they develop the illness. This delay is generally a few days, but some viruses may take up to two or three weeks before symptoms appear.

    Good hygiene reduces the chance of getting viruses or passing them onto others. Good hygiene includes:

    • regularly washing hands thoroughly
    • not sharing cups or cutlery
    • encouraging children to cough or sneeze into their elbow
    • using tissues instead of hankies – teach your child to throw tissues into the bin as soon as they have used them and to wash their hands afterwards.

    If your child is unwell with a virus, keep them home from child care, kindergarten or school until they are well again.

    It is just about impossible to prevent your child from catching viruses, but you can help keep your child’s immune system in good shape by ensuring they have a balanced diet and plenty of sleep. Most children do not need to take vitamins on a daily basis. It is important to be up to date with your child’s immunisations to prevent viruses such as measles, mumps, rubella and chickenpox (varicella).

    Key points to remember

    • Viral illnesses are very common in children and are easily spread around child care, kindergarten or school.
    • It is common for children to have up to 12 viral infections a year in the first few years of life, and it can seem like they are sick all the time.
    • The best treatment is rest at home.  Antibiotics will not help treat viral illnesses.
    • If your child does not improve after 48 hours, or their symptoms get worse, see your GP.

    For more information

    Common questions our doctors are asked

    Do I need to see a doctor to have my child’s virus diagnosed?

    If your child is only experiencing mild symptoms that are relieved by paracetamol or ibuprofen, and they seem to be getting better after 48 hours, there is no need to visit a doctor. Often, it is very difficult to determine which particular virus your child has, and it doesn’t matter anyway, as treatment is the same – rest at home, and no antibiotics, as antibiotics do not help viruses.

    What natural remedies can I give my child to help them feel better when they have a cold?

    We do not recommend giving treatments – whether medical or natural – to children without professional medical advice. As outlined in this fact sheet, you can usually care for your child at home when they have a cold by giving them plenty of fluids, allowing them to rest and providing simple analgesia (e.g. paracetamol) if they are uncomfortable.

    Over-the-counter products such as vitamins or supplements (e.g. vitamin C, multivitamins) are not necessary. These products generally have no or limited scientific evidence to prove their effectiveness in preventing or treating viruses such as colds.

    Remedies that are usually passed down in families (e.g. staying warm, avoiding going to bed with wet hair, not going outside with bare feet or wet hair and staying indoors) have not been proven to prevent colds. These were developed before it was discovered that colds are caused by viruses.


    Developed by The Royal Children's Hospital General Medicine and Infectious Diseases departments and Victorian Department of Health and Human Services. We acknowledge the input of RCH consumers and carers.

    Reviewed July 2020.

    Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit  www.rchfoundation.org.au.


Disclaimer  

This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.