SPRINGFIELD, Ill. -- With widespread flu activity occurring in Illinois, many parents are rightly concerned about when they should seek medical care for their ill children.

"Parents know their children best and can tell when they are not responding to an illness as expected," said Dr. Eric E. Whitaker, state public health director. "Whenever parents are concerned about their children's health, they should call their pediatrician for advice."

The most common symptoms of the flu include fever (usually 100 degrees F in adults and often higher in children), dry cough, runny or stuffy nose, headache, muscle aches and extreme fatigue.

"If children have these symptoms, parents should keep them home from school or daycare to prevent the spread of disease," Dr. Whitaker advised.

According to recommendations of the American Academy of Pediatrics, parents should take their child to a pediatrician or to an emergency department if he or she displays any of the following symptoms:

• Rapid or labored breathing, bluish skin color,
• Not drinking enough liquids to maintain hydration,
• Not waking up; not interacting,
• So irritable that he or she does not want to be held,
• Flu symptoms improve, but then the child becomes ill again with fever and a worse cough, or
• Fever or flu that lasts more than five days

The single best way to prevent the flu is to get vaccinated. However, an unusually large demand for the flu vaccine this season has led to shortages of vaccine in some areas. It is recommended that remaining vaccine be used for individuals who are at high risk for complications from influenza, which includes children 6 months to 23 months of age and children age 2 and older who have chronic health conditions. Those chronic conditions include:

• Cardiac and pulmonary disorders, including asthma
• Metabolic diseases such as diabetes
• Kidney dysfunction
• Immunosuppression from any cause
• Children on long-term aspirin therapy

Household members of high-risk children also should be vaccinated. If you are unsure if you or your children fall into one of these groups, contact your pediatrician or primary health care provider.

Parents should talk with their pediatricians about the current vaccine supply in their area and about recommendations for their children. Vaccine is still available at many doctor's offices, so be persistent.

If vaccine is not available and flu is present in your area, anti-viral medication may be an option for children with certain conditions that place them at higher risk. Antiviral medications must be taken within two days of onset of symptoms. All of these medications are prescription drugs, and a doctor should be consulted before the drugs are used to prevent the flu.

Although supplies of injected vaccine are limited, supplies of the live vaccine, which is available as a nasal mist known as FluMist, are more plentiful. This vaccine can be given to healthy children age 5 and older and health care providers are encouraged to give it to healthy children ages 5 to 9 who need a second dose of flu vaccine. The first flu immunization ever for any child 6 months to 9 years of age requires two doses of vaccine.

Even without being vaccinated, there are steps that can be taken to reduce transmission of flu:

• Wash your hands frequently with soap and warm water. Teach children the same healthy habit.
• Cover your nose and mouth when you cough and sneeze, preferably with a facial tissue or your arm, not your hands. Promptly discard used facial tissues.
• Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick.
• If you are sick with cough or fever, stay home from work or school until you recover.
• Contact your medical provider if you are experiencing severe symptoms that you believe require medical attention.
• Do not share things that go into the mouth, such as drinking cups, straws, etc.
• Frequently clean commonly touched surfaces (door knobs, refrigerator handle, phone, water faucets) if someone in your house has a cold or the flu.
• Avoid touching your eyes, nose or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose or mouth.

Those who develop flu-like symptoms should drink fluids, rest and stay home. Those who have the flu may also take over-the-counter drugs such as acetaminophen and ibuprofen, but aspirin should be avoided because taking it for some forms of flu has been associated with Reye's syndrome, a serious disease in children that can occur following a viral illness and that causes swelling of the brain.

At this point in the flu season, the U.S. Centers for Disease Control and Prevention has indicated it is unclear whether influenza is impacting children more severely than other years or if a heightened awareness of severe influenza disease in children has led to increased testing and reporting of pediatric cases.