When to treat sick kids at home and avoid gatherings as hospitals hit with flu surge

Visitors skate on the opening night of the annual Cavalcade of Lights at Nathan Phillips Square, in Toronto, on Saturday, Nov. 29, 2025. THE CANADIAN PRESS/Sammy Kogan

TORONTO — Health providers are asking parents to treat kids with mild flu symptoms at home and avoid large gatherings as influenza cases spike ahead of the holidays, pushing hospital emergency departments over capacity.

The daily number of confirmed flu patients was up by 150 per cent in Ontario last week, with an 84 per cent increase in hospital admissions. Cases are up nationally as well, but the province has been hit especially hard, with three children dying in the last two weeks of influenza complications.

Anthony Dale, president and chief executive officer of the Ontario Hospital Association, says Influenza A positivity is now higher than any of the last three seasons, with increases across all age groups. He said the increase of hospital admissions over the last couple of weeks has been massive.

“No one really knows if it will peak anytime soon or if this will continue. What we have here is a very unpredictable situation and our main message to the general public is please do consider vaccination as soon as possible.”

Some events are being cancelled in the Prairies in an effort to protect vulnerable people from flu spread, and officials in the Northwest Territories have issued an advisory asking those with symptoms to stay home.

When to head to the emergency?

In Quebec, children’s hospitals say a rise in viruses and respiratory infections is driving their emergency departments well over capacity.

With 40 per cent of those visits for minor ailments, Montreal Children’s Hospital and CHU Sainte-Justine are asking parents to keep their kids home unless symptoms are severe.

“Emergency services should be reserved for people whose condition requires immediate care,” Dr. Harley Eisman, medical director of the MCH’s emergency department, said Tuesday.

Eisman says parents can call 8-1-1 to speak to a nurse who will help triage a patient or book an appointment for them if their child is not seriously ill.

However, they say any child in need of medical care will not be turned away.

An MCH release highlights several cases and symptoms that do require urgent care, including:

-Infants less than three months are especially vulnerable. If the baby has a fever, parents should take them to the emergency.

-Also head to the hospital if a child of any age is unusually sleepy, confused, having trouble breathing, if they’re vomiting or have diarrhea and can’t retain fluids, showing signs of dehydration (i.e. dry mouth or no urination).

These are not all the symptoms listed, so caregivers can also check out AboutKidsHealth for guidance on when to seek medical attention for influenza.

Emergency Department volumes at the Hospital for Sick Children have increased by 50 per cent over the past two weeks, which a spokesperson for the Toronto hospital said is at the high end of predicted volumes for respiratory illness season.

What are considered mild symptoms?

Mild flu symptoms can include fever, cough, muscle aches and pain, chills, tiredness, headache, sore throat, loss of appetite, runny or stuffy nose.

Some people, particular kids, may have diarrhea, nausea and vomiting.

Eisman said high fevers have been a common flu symptoms this season, which can last three to five days, or sometimes seven days. He said a particular height or duration of a fever does not translate to a hospital admission.

“I’m a parent as well and sometimes I get freaked out by numbers of a fever, but it’s really not the height of fever,” Eisman said, adding it won’t cause damage if a child doesn’t have a medical predisposition.

Exceptions also include if the child is three months or younger, or if they’re any age but won’t hydrate, are lethargic or their colour is off. Otherwise, they can be cared for at home, and it’s just about keeping them comfortable, eating and drinking, he said.

Flu symptoms are viral and do not require antibiotics. Saline wash can be used to clear a congested nose.

HealthLink BC says signs of a bacterial infection that can potentially be treated with antibiotics include a cough that lingers more than seven to ten days after other symptoms have cleared, and a cough that brings up yellow, green or rust-coloured mucus from the lungs, rather than from nasal passages.

The Public Health Agency of Canada recommends over the counter medication to reduce fever or aches.

Over-the-counter cough and flu medicine should not be given to children under the age of six, unless a health provider recommends it.

Vaccinations, public health measures

The death of the three children in the Ottawa area over the past two weeks is alarming, says Ontario Medical Association president Dr. Zainab Abdurrahman.

The highest percentage of influenza laboratory detections was among those who are nineteen and younger, according to PHAC’s latest respiratory surveillance report.

Abdurrahman said the only silver lining of the early spike of flu cases is there is room to intervene by boosting vaccination rates and public health measures.

“Staying home, wearing a mask, being cognizant that right now we’re heading into the holiday season where there’s just going to be so much more congregations of people, loved ones, across all the different age groups,” Abdurrahman said.

Toronto’s medical officer of health said influenza A has affected children more severely, but is also spreading to adults and in long-term care homes.

“As a parent myself, I know that parents and caregivers are concerned given the news of increased flu activity this year,” Dr. Michelle Murti said.

Murti encourages flu vaccination, staying home when sick, washing hands often, choosing well-ventilated spaces when possible, and wearing masks in crowded indoor spaces.

“It is not too late for vaccinations as the flu season typically lasts until the spring. These measures are especially important to protect children and those most vulnerable in our community, especially as we gather for the holidays.”

When are you contagious?

The Public Health Agency of Canada says the flu is contagious one day before and about five days after symptoms start, though children and people with weakened immune systems may be contagious for longer. The most infectious day is the third.

The federal agency says to stay home and avoid close contacts for at least the first three days and better to wait five days or for an overall recovery.

Given the fact that respiratory illnesses are quite contagious, Eisman recommends avoiding holiday gatherings during that contagion window.

“If they’re actively having a good cough, runny nose, runny eyes, then they’re contagious and they will spread the infection to other family members,” he said.

If a child is not sick, he said it’s safe to see loved ones, including grandparents.

Cancelling gatherings

Already, Chief and Council of the Beardy’s & Okemasis Cree Nation in Saskatchewan postponed all community Christmas dinners until the flu season subsides.

Northwest Territories’ chief public health officer also released a notice asking people who are feeling sick not to visit loved ones over the holidays, acknowledging that staying home this time of year can be difficult, but equally important.

“Even mild symptoms can put vulnerable people at risk. It could also have an impact on healthcare professionals who care for this population,” a notice Monday said.

A week earlier, the top doctor said two-thirds of influenza cases have been in children and teenagers, a trend that is expected to spread to the general population.

This report by The Canadian Press was first published Dec. 17, 2025.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

Hannah Alberga, The Canadian Press