What should you know about croup and flu?

Croup swelling around the voice box and windpipe can produce a harsh, barking cough, a hoarse voice, and a high-pitched sound when breathing in. Flu-like illness may bring fever, chills, muscle aches, marked tiredness, headache, or a more general cough. These features can overlap, so the sound and effort of breathing matter more than trying to identify a virus at home.

Croup often becomes more noticeable at night or when a child is upset because crying increases airflow turbulence. A calm child who is drinking and breathing comfortably may be monitored closely, but symptoms can change.

Keep the child upright and calm, offer frequent fluids, and avoid smoke or strong scents. Follow the label or a clinician's instructions for any fever medicine; do not give adult preparations to a child. Do not use leftover antibiotics, and do not force food when breathing is difficult.

A clinician may assess the airway and decide whether a steroid or nebulised medicine is appropriate. A child health consultation can help distinguish croup from flu, a common cold, or another cause of noisy breathing.

Seek emergency help if the child is struggling to breathe, the skin between the ribs or at the neck pulls in, the lips look blue or grey, the child cannot speak or cry normally, drooling prevents swallowing, or the child is unusually sleepy or difficult to wake. Seek prompt medical advice if noisy breathing occurs while the child is resting, fluids are not staying down, or fever accompanies a clear deterioration.

Ask whether the pattern fits croup, flu, or another infection; whether an examination or testing is needed; which fever medicine is suitable for the child's age; and what changes should trigger urgent review.