Does a dry cough with intermittent fever indicate the flu?

Posted on Tue, 23 Oct 2018
Question: Hello, two days ago my 9 year old son (who is otherwise healthy) said he had a sore throat. He had no other symptoms until that evening when I could hear him coughing a little after he went to bed. Yesterday morning he woke up with a barky, dry cough. He often gets a barky cough when he has a cold so he is always given puffers to use until the cold ends, but does not require them when he is healthy. He said his throat still hurt and he had a stuffy nose. He had a decreased appetite but still ate and drank (but he did not eat as much as normal). He had no fever until the evening when he began to run a very low fever that did not even get up to 100F.

This morning he said his throat still hurt, he was still coughing and had a stuffy nose. My husband took him to our clinic. The doctor checked his temperature (no fever), listened to his lungs, checked his ears and throat, and did a rapid strep test. She said that his glands were swollen in his neck and that his throat and symptoms made her suspicious it might be strep. However the strep test came back negative. She told my husband that if his symptoms get worse or if he still has the sore throat in 2 days to come back. She did not treat him today. Overall he has been himself and still has energy, although not quite as much as usual. He has eaten today although not as much as usual. This evening he said his stomach hurt and did not want to eat supper. Two hours later he asked for his supper and ate two helpings so I guess his appetite is just not as consistent.

We live in a mid-size city in XXXXXXX Canada. The flu has been going around and although it has not been as bad as the United States, we have recently had 1 child in our area and 2 children 80km from our city die from the flu. Our children, my husband and myself all had the flu shot back in October. We have heard many reports in the news to bring your child to your doctor if they are showing symptoms of the flu. We have also been told that if they start to improve and then become ill again, especially if they are worse, to go to the ER. I was concerned that our son may have the flu but my husband said the doctor did not even mention that our son might have it while they were there today. I have bad anxiety, especially over my children's and my health so my son having these symptoms has caused me to worry a lot. I think all of the news about the flu being so bad this year has scared me quite a bit.

I have heard that children will often have a fever, sore throat, dry cough, runny nose, lethargy, aches and chills with the flu. I have also heard that they can have stomach ache, vomiting or diarrhea. Since my son has sore throat, dry cough, slight fever and stuffy nose and has complained about sore stomach a few times tonight (but eventually ate his dinner), I am worried about him having the flu. I guess I just feel very confused about what I need to be looking for and what I need to be doing. For instance, how high does a child's fever normally get with the flu? Do they often have a similar amount of energy as usual or is it really decreased with flu? Does their appetite suffer a lot? Should we be taking him back to the doctor to let them know he has had a sore stomach? If he vomits or has diarrhea, should we be taking him to the ER or just take him to the doctor's office when it is open? I guess I just feel confused and worried about what my son has (a cold, strep throat, the flu??) and what to do.
Thank you so much. Any advice would be appreciated.
Answered by Dr. Chobufo Ditah (2 hours later)
Brief Answer:

You shouldn’t be that worried!

Detailed Answer:


Sure, every parent really worries about the health of their children. Your reaction is normal and rightly so.

1. Influenza comes with high fever. More than 50% of children will have fever more than 102. I am sure your child hasn’t reached such a temperature. This is often associated with symptoms of muscle pain, general malaise, stomach disorders like vomiting, diarrhea and respiratory such as cough, sore throat etc. Your child really doesn’t fit this profile.

2. Even if this were the flu, the severity is so so minute that mortality of any significant complications is almost inexistent. Also, most flu, even without treatment are often on the decline after 48hours. Therefore, you child would certainly get better and not worse, even if this were the flu. I am not the least convinced he has a flu.

3. I am of the opinion that your child has a viral upper respiratory tract infection. Not caused by the flu virus. H need snow antibiotics. Recovery would be spontaneous. Monitor him only, encourage increased fluid and fruits intake, let him stay active and monitor the temperature. If he gets above 102, call the doctors up and administer Tylenol for control.

Hope I have answered your query. Let me know if I can assist you further.

Brief Answer:

You are welcome!!

Detailed Answer:


Keep me updated with his progress. I wish your son a speedy and full recovery.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Kampana
Follow up: Dr. Chobufo Ditah (25 minutes later)
Thank you so much for your detailed response and for your reassurance. It makes me feel much better. I think hearing the worst case scenarios on the news has frightened me over the last couple of weeks and made me question what I need to look for as far as symptoms go and what to do. I really appreciate your help and advice. I will monitor my son and take him for follow up if his sore throat persists or fever worsens. Thank you!

Hi Dr. Ditah,
As of Sunday my son started doing much better and only has a slight cough now. Thank you for your advice about how to care for him.

My concern now is my 4 year old daughter who is otherwise healthy. Yesterday she woke up with a cough, very runny nose and low fever. I would give her Tylenol through the day but it did not really bring the fever down too much. She says her throat hurt too. Last night I took her to our clinic. The doctor said her lungs were clear and her throat looked fine. He said she had symptoms of a cold and figured she picked up the germs from her brother since she got sick so close to the time he did. He told me to bring her back if her fever increases. Last night she continued to have a fever around 100F. At 4am I have taken her temperature as her body feels very warm and it is 102.4F. I have given her Tylenol but I am concerned about her fever getting this high. I am wondering if I should take her to the hospital or wait to take her to the clinic in the morning. It is currently 4:30am and our clinic opens at 8:30am. A friend of mine took her baby to the hospital yesterday with high fever and was told it would be an 8 hour wait so I am concerned about taking my daughter to the ER and having to wait so long and expose her to more germs. I know it is possible she caught this from my son but his fever did not get this high. I forgot to mention that yesterday my daughter ate and drank and has been urinating.

I would appreciate your advice. Thank you
Answered by Dr. Chobufo Ditah (2 days later)
Brief Answer:

Tylenol only and monitor her!

Detailed Answer:


I hope you still find this response timely to help. There is no need going to the ER at this time.

Continue tylenol and monitor her breathing and general state. Also, if she keeps eating and drinking well, there is nothing to be concerned about.

Ultimately, this is an identical germ to that her brother had. All will soon be okay.

Hope I have answered your query.

Take care

Dr Chobufo Ditah, General & Family Physician
Above answer was peer-reviewed by : Dr. Prasad
Answered by
Dr. Chobufo Ditah

General & Family Physician

Practicing since :2009

Answered : 6255 Questions


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