​We've seen an early start to the influenza (flu) season in British Columbia and the number of flu cases seen in the BC Children's ED have been on the rise, particularly over the last few weeks.

"Family physicians, urgent care clinics, pediatricians and children's hospitals see many children with respiratory viral illnesses every fall," says BC Children's Infectious Disease Pediatrician, Dr. Laura Sauvé. "We've seen that young infants can get quite sick from respiratory virus infections. Those under age five are at the highest risk of severe illness from the flu, but teenagers can get serious infections too."

The majority of children visiting the BC Children's ED have a respiratory viral illness.

Top viral illnesses

The top viral illnesses in the BC Children's ED that children tested positive for recently include the flu, RSV, enterovirus/rhinovirus and COVID-19.

"All of these can cause similar symptoms in children; however, the flu does tend to cause more prolonged fevers and also has a higher risk of making children sick enough to need hospitalization," Medical Microbiologist and Pediatric Infectious Disease Physician Dr. David Goldfarb says. "Based on what we are seeing from B.C. as well as across Canada and the U.S., it appears as though this year is a bad year for flu for children of all ages."

As of December 15, the BC Centre for Disease and Control is aware of six reports of influenza-associated deaths among children and youth (under the age of 19) in B.C. this season. Early findings indicate some of the children experienced secondary bacterial infections contributing to severe illness, which can be a complication of influenza. It is important to know that death associated with influenza in previously healthy children continues to be rare. Public health is monitoring the situation closely.

This year's flu vaccine

B.C. has a vaccine that can help prevent children and their families from getting sick. It is provided free of charge can be given to children six months of age and older. This year's flu vaccine appears to be a relatively close match with the most common circulating flu strain (H3N2). In prior years, the flu vaccine has been shown to be at least 74 per cent effective in preventing children from needing intensive care.

"Many people don't recognize that the flu can cause severe disease in children, and even sometimes death ," says Dr. Sauvé.  "When we see many more children getting the flu, we can expect to see more severe cases – which is part of what is driving how busy pediatric care centres are, including BC Children's. While the flu vaccination does not prevent all cases of the flu, it can prevent the most severe cases."

One important thing to understand about both COVID-19 vaccines and flu vaccines, says Sauvé, is that these vaccines don't prevent other viral illnesses. A common misunderstanding is that the flu vaccine doesn't work because people still get other viruses after they get the flu vaccine.  

"There are things we know we can be vaccinated for, like the flu and COVID-19, but for the others, we're asking families to try their best to avoid catching these common viruses," Sauvé says.

Prevention strategies for all viral illnesses:

• Get all recommended vaccines including the flu and COVID-19 booster vaccine doses.
• Clean your hands regularly and avoid touching your face, especially your eyes, mouth and nose.
• Practice respiratory etiquette: consider wearing a mask in indoor public spaces, cough and sneeze in your elbow.
• Stay at home if you feel unwell and try to avoid spending time with people at higher risk of serious illness.

There are various ways to book a flu immunization for your child:

• Book an appointment at a health authority clinic or pharmacy through the provincial Get Vaccinated system.
• Book an appointment by phoning the provincial call centre (toll-free) at 1 833 838-2323.
• Book an appointment with your primary health-care provider, if they are providing flu shots. 
• Visit a pharmacy or health authority clinic offering walk-in appointments. Pharmacies can provide a flu shot for children aged five and older.
• If you have already received an invitation for influenza immunization for your child via email and/or text message, use it to book an appointment and get vaccinated.

Kids aged six months and up should be vaccinated for COVID-19. To register your child, you can also go to the BC Government's Get Vaccinated website.

Vaccination is safe. Side-effects are typically very mild and go away on their own within a few days.

If you are worried about your child with a viral illness, please take a look at the examples of when to go to the ED from top BC Children's Emergency Department physicians.