Teaching Children 

About the Flu

Lesson Plans and Activities for Child Care and 

Early Childhood Programs

CS219678-A

U.S. Department of Health and Human Services

Centers for Disease Control and Prevention
 Teaching Children About the Flu 

Teaching Children About the Flu

Lesson plans and activities for child care and 

early childhood programs.

As a child care provider, you play a very important role. You nurture 

and teach the children in your care. You offer a safe atmosphere 

where the children can learn and have fun and where parents can 

feel good about the care their children are receiving. 

In addition to providing good child care, you also want to make sure 

the children in your facility stay healthy. Young children and your 

staff members can get sick with the seasonal flu. Use the lessons and 

activities in this booklet to teach children about the flu, hand washing, 

and cough and sneeze etiquette. 

Hang the colorful and informative posters to remind children and 

staff about good hygiene habits to use now and during flu season. 

We’ve also included handouts for parents to help them reinforce 

good hygiene habits at home.

Help all the children in your child care facility 

make good hygiene a habit.

For more information about flu:

Visit www.cdc.gov or www.flu.gov.

Or call CDC 24 hours a day:

■ 1 (800) CDC-INFO (232-4636). Services in English 

and Spanish.

■ TTY: 1 (888) 232-6348
Table of Contents

Background Information for All Lessons

■ General information to share with children 

Lesson Plans and Activities for Children in Child Care and Early 

Childhood Programs

■ Lesson 1: Hand Washing 

Ages 3 to 7 

■ Lesson 2: Cover Your Cough and Sneeze

Ages 3 to 7 . 

■ Lesson 3: How Germs Spread 

Ages 8 to 10 . 

Posters for Child Care Facilities and Handouts for Parents

To Post in Your Facility:

■ Good Habits poster to display for the children .

■ Cover Your Cough poster for your office, 

staff lunch area, or staff bathroom .

■ Did You Get Your Flu Vaccine Yet?

poster for staff and parents to see .

To Give to Parents:

■ Help Your Child Be a Germ Stopper . 

■ 5 Steps to Good Hand Washing .
 Teaching Children About the Flu 

Background Information for All Lessons

You will find lessons for children ages 3 to 10 in this resource guide. 

Use the information you learn to teach children about the flu, the 

importance of hand washing, and reasons to cover their coughs 

and sneezes. 

General information to share with children 

■ Germs can make you sick. People can pass colds and flu 

through germs. 

■ Germs are everywhere. They are so small that you cannot see 

them without a microscope.

■ Cover your mouth and nose with a tissue when you cough or 

sneeze so you don’t pass germs on to others. Throw the tissue in 

the trash after you use it. 

■ Wash your hands the right way to get rid of germs and lower the 

chance of spreading germs. Wash your hands often with soap and 

water, especially after you cough or sneeze. Use alcohol-based 

hand rubs or wipes when soap and water are not available. 

■ Don’t touch your eyes, nose, or mouth until your hands are clean 

because germs spread that way. Keeping your hands clean is one 

of the best ways to keep from getting sick and spreading illness.

Wash hands: 

■ After you cough or sneeze

■ After using the toilet

■ After you play outside 

■ After shaking hands with other people

■ After you touch animals, including your pet

■ Before you eat or touch food

General information to share with children 

about how flu spreads

■ The flu spreads mostly from person to person through the 

coughs and sneezes of people who are sick with the flu. You may 

also get sick by touching something with flu viruses on it and then 

touching your mouth or nose. 

■ Tell children to let an adult know if they feel sick. 

2
 Teaching Children About the Flu 

Help the children in your child care facility 

practice good hygiene and lower the spread 

of germs.

Reinforce hygiene habits with children ages 3 to 7 by:

■ Encouraging younger children to cover their cough with a 

tissue or cough into their sleeve. Encouraging children to wash 

their hands.

■ Asking children discussion questions found in Lessons 1 and 2 

(pages 6 and 17).

■ Placing a check sheet with each child’s name near the sink. Ask 

a staff member to oversee hand washing. Give a sticker 

to children who wash their hands the right way.

■ Posting children’s hand washing and cough/sneeze etiquette art 

work and pledges on the wall (Handout #6). 

Reinforce hygiene habits with children ages 8 to 10 by:

■ Encouraging older children to cover their cough with a tissue or 

cough into their sleeve. Encouraging children to wash 

their hands.

■ Placing stickers on the children’s handouts.

■ Asking children discussion questions found in Lesson 3 (page 23).

■ Posting children’s signed pledges on the wall (Handout #11).

SOAP

3
Lesson Plans and Activities for 

Children Ages 3 to 7 

You will find Lessons 1 and 2 

in this section.

4
Hand Washing Lesson Plan 1

for Children Ages 3 to 7 Lesson 1

Read the background information for all lessons on page 2 of this 

guide. Teach the children about how germs spread and about the flu. 

Throughout the next week, check to see if children are practicing 

good hygiene. Give stickers to children who wash their hands the right 

way. Sing our hand washing version of the “If You’re Happy and You 

Know It” song on page 7. Sing with children several times each week 

for three or more weeks to help children get in the habit of correct 

hand washing.

Reasons for this lesson: 

■ To teach children that keeping their hands clean is one 

of the best ways to keep from getting sick and spreading illnesses 

such as the flu

■ To teach children the right way to wash their hands

■ To stop spreading germs and have better health

Time: 

■ 15 minutes for circle time to teach the lesson and 

practice singing. 15 minutes for completing the handouts. 

Supplies:

■ Alcohol-based hand rub with pump for circle time. Or use 

unscented hand lotion if you don’t use alcohol-based hand rub in 

your childcare setting.

■ Handouts #1 to #6. Offer handouts based on the age and skill level 

of the children in your childcare facility. 

■ Crayons or colored markers for Handouts #1 to #6

■ Scissors, glue stick and construction paper for Handouts #3 and #4

Activities: 

■ Circle time—singing, questions and answers, practicing hand washing

■ Coloring, connecting the dots, cutting, gluing a puzzle

5
 Teaching Children About the Flu 

Use these questions about hand washing and cough 

etiquette when you present the Lessons 1 and 2 to 

children ages 3 to 7.

Question: Why is it important to use soap and running water 

when you wash your hands?

Answer: To make sure the dirt and germs go away.

Question: Why is it important to get the germs off 

your hands?

Answer: So you don’t get sick or make others around 

you sick.

Question: How long should you rub your hands together 

when washing your hands?

Answer: You should rub your hands together for 20 seconds—

long enough to sing the “Happy Hand Washing” song twice or 

our version of “If You’re Happy and You Know It.” You can 

find these songs on page 7 in this lesson.

Question: How are germs (like viruses) passed?

Answer: Germs are passed when you cough or sneeze into your 

hands and touch other objects, or when you don’t cover your 

mouth and nose when you cough or sneeze.

Question: How can we keep from spreading our germs to 

other people and making them sick?

Answer: Cover your mouth and nose when you sneeze or 

cough using a tissue. Then throw the tissue away. When there 

is no tissue, cough or sneeze into your sleeve. If you cough or 

sneeze into your hands, wash them for 20 or more seconds. 

Germs get on your hands and then on other objects (doorknobs, 

toys, desks, etc.). 

6
7

 LESSON 1  Hand Washing 

Lesson

Plan

Lesson

Plan

Circle time and singing

■ Ask children to sit in a circle. Explain to the children 

that during circle time they will be learning more 

about washing their hands to get rid of germs. 

■ Teach one or both of the following hand washing songs.

Happy Hand Washing

(sung to the tune of “Happy Birthday”)

Wash hands well each day,

To keep germs away,

Scrub with soap and water,

And be on your way!

If You’re Happy and You Know It, 

Scrub Your Hands

(sung to the tune of “If You’re Happy and You Know It”)

If you’re happy and you know it, scrub your hands.

If you’re happy and you know it, scrub your hands.

If you’re happy and you know it, then your face will surely show it.

If you’re happy and you know it, scrub your hands.

If you’re happy and you know it, rinse them off.

If you’re happy and you know it, rinse them off.

If you’re happy and you know it, then your face will surely show it.

If you’re happy and you know it, rinse them off. 

CHA CHA CHA!!!

7
 Teaching Children About the Flu 

Demonstrate hand washing

■ Squirt some alcohol-based hand rub or unscented hand lotion 

into your palm. Remind the children that you are using the 

alcohol-based hand rub or lotion as “pretend” soap. 

■ Show the children how to “wash” their hands the right way using 

the alcohol-based hand rub or lotion. Sing one of the songs as 

you pretend to wash and rinse. Make sure to wash the tops, palms, 

in between the fingers, and under your nails as you demonstrate 

good hand washing. 

Practice hand washing

■ Squirt a small amount of alcohol-based hand rub into each child’s 

hand. For large groups, have two or three students show the 

others how to wash their hands.

■ Ask children to pretend they are at a sink with soap and warm 

running water. 

■ Ask children to sing the song as they pretend to wash their hands 

with the alcohol-based hand rub.

■ During daily restroom breaks and hand washing routines, 

encourage the children to practice hand washing with soap and 

water while singing one of the hand washing songs.

Coloring/cutting activities

After explaining the importance of hand washing, offer handouts 

based on the skill level of the children in your facility. Offer children:

■ Handouts #1 and #2 to color. 

■ Handouts #3 and #4 to color and cut. Then have children 

cut out the puzzle and paste it back together on a piece of 

construction paper. 

■ Handout #5 to connect the dots and color.

■ Handout #6 to color. Display these hand washing pledges on 

the wall to reinforce good hygiene.

8
Color

Me

9 Handout #1
Color

Me

10 Handout #2
11

SOAP

Cut me

out

Handout #3
Cut me

out

Handout #4

12
13

SOAP

1

2

3

4

5

6

7

8

9

10

11

12

13

15 14 16

17 18

19

20

B A

C

D

E

F

G

H

I

J

K

L

Connect

the

Dots

Handout #5

13
Handout #6

My Pledge

I pledge to cover my 

mouth and nose when 

I cough or sneeze. 

I pledge to wash my 

hands in a sink.
Cover Your Cough and Sneeze 

Lesson Plan Children 

Ages 3 to 7

Read the background information for all lessons on page 2 of this 

guide. You may want to go over once again how germs spread and 

about the flu. 

Reasons for this lesson: 

■ To teach children correct coughing and sneezing etiquette 

■ To teach children that covering their mouth and nose when they 

cough or sneeze can lower the risk of spreading flu germs that 

make other people sick

Time: 

■ 10 minutes for circle time

■ 15 minutes for completing the handouts 

Supplies:

■ Tissues to glue to the handout

■ Construction paper to trace 

their hand

■ Scissors

■ Glue 

■ Handouts #7 and #8

Activities: 

■ Circle time—teaching and singing

■ Cover cough handout—tracing, 

cutting, coloring 

2

Lesson 2

15
16

 Teaching Children About the Flu 

Lesson 2:

Circle time and singing

■ Ask children to sit in a circle. Teach the children general 

information on how to cover their mouth 

and nose when they cough or sneeze. Let students know 

that when they don’t have a tissue, they can cough into their sleeve 

(teacher shows). Or they can cover their mouth and nose with 

their hands, and then wash their hands. Teach children not to wipe 

their nose on their sleeve.

■ Explain that we cover our mouth and nose because little drops of 

moisture (droplets) come out when we cough or sneeze, and they 

have germs in them. Germs can make the people around us sick 

if we are sick. Explain that the flu passes from person to person 

through the coughs and sneezes of people who are sick with 

the flu.

■ Finally, teach the cough/sneeze song below. Then hand a tissue to 

each child. Ask children to place the tissue in front of their mouth 

and nose when the song tells them to—but not really cough. 

Ask them to throw their tissues away after the activity and wash 

their hands.

We Need to Cover Our Cough

(sung to the tune of “The Farmer in the Dell”)

We need to cover our cough. We need to cover our cough. 

Hi ho the deri-o, we need to cover our cough. 

We need to cover our sneeze. We need to cover our sneeze. 

Hi ho the deri-o, we need to cover our sneeze.

We need to use tissue. We need to use tissue. 

Hi ho the deri-o, we need to use tissue.

We need to toss it out. We need to toss it out. 

Hi ho the deri-o, we need to toss it out.

We need to wash our hands. We need to wash our hands. 

Hi ho the deri-o, we need to wash our hands.

(Say together:) No tissue? I’ll cough or sneeze in my sleeve! 

Lesson

Plan

Lesson

Plan

16
17

 LESSON 2  Cover Your Cough and Sneeze 

Ask children these questions about hand washing and 

cough etiquette when you present Lesson 2 to children 

ages 3 to 7.

Question: Why is it important to use soap and running water 

when you wash your hands?

Answer: To make sure the dirt and germs go away.

Question: Why is it important to get the germs off your hands? 

Answer: So you don’t get sick or make others around you sick.

Question: How long should you rub your hands together?

Answer: Rub your hands together for 20 seconds—long 

enough to sing the “Happy Hand Washing” song twice or our 

version of “If You’re Happy and You Know It.”

Question: How are germs (like viruses) passed?

Answer: Germs are passed when you cough or sneeze into your 

hands and touch other objects, or when you don’t cover your 

mouth and nose when you cough or sneeze.

Question: How can we keep from spreading our germs to other 

people and making them sick?

Answer: Cover your mouth and nose when you sneeze or cough 

using a tissue. Then throw the tissue away. When there is no tissue, 

cough or sneeze into your shoulder or elbow. If you cough or 

sneeze into your hands, wash them the right way. Germs get on 

your hands and then on other objects (doorknobs, toys, desks, etc.). 

Wash your hands the right way for 20 or more seconds.

Offer handouts to children

Ask children to choose Handout #7 or #8. Have them trace their 

hand on a piece of construction paper and cut it out. Ask children to 

color the picture. Next glue the tissue to the mouth and nose on the 

picture. Then glue the cut out hand on the tissue.

■ Younger children may be content with coloring the handouts or 

may need some help from you with cutting and gluing.

17
18 Handout #7
Handout #8 19
20

Lesson Plans and Activities for 

Children Ages 8 to 10 in Before 

and After School Care

You will find Lesson 3 in this section.
How Germs Spread Lesson 3

Plan for Children Ages 8 to 10 Lesson 3

This lesson plan for children ages 8 to 10 teaches how germs spread 

and correct hand washing and cough/sneeze etiquette. Read the 

background information for all lessons on page 2 of this guide. 

Teach the children about how germs spread and about the flu. Post 

the children’s pledges (Handout #11) to reinforce good hygiene. 

Reasons for this lesson:

■ To show how germs spread

■ To teach children the right way to wash their hands 

Time: 

■ 15 to 20 minutes

Supplies:

■ Glitter

■ Unscented hand lotion

■ Bucket or trash can

■ Soap

■ Water

■ Handouts #9 (Word Search), #10 (Word Scramble) 

and #11 (My Pledge)

Activities: 

■ Circle time—teaching, glitter activity, discussion

■ Coloring

21
 Teaching Children About the Flu 

The Lesson:

Circle time:

Ask children to sit in a circle. Teach children general 

information about germs. Teach correct hand washing 

techniques using actual soap and water. Instruct children to hum or 

sing the “Happy Hand Washing” song twice or count slowly to 20. 

Teach correct cough and sneeze etiquette. This means to sneeze or 

cough into a tissue or their sleeve, then toss out the tissue.

Glitter activity:

■ Ask for a volunteer. Put a drop of unscented lotion the child’s 

hands. Ask the child to rub his or her hands together to spread 

the lotion evenly. Have the child place his or her hands over a 

bucket or trash can. Place a pinch of glitter in the palm of 

one hand.

■ Ask the child to make a fist (over the bucket or trash can). 

Then ask the child to spread their fingers out. Say, “What do 

you notice?”

■ Ask the child with glitter to rub his or her hands together and 

then touch another child’s hand. 

■ Ask both children to wipe their hands clean with a paper towel in 

front of the group. Ask, “What do you notice?”

■ Ask both children to wash their hands with soap and water. Ask, 

“Did all the glitter come off?”

Discussion:

Lead a discussion about what happened. The children should have 

noticed that the glitter spread from hand to hand and to the other 

child. The paper towel did not remove all the glitter, but hand 

washing the right way should have. 

Of course, real germs are so small that they can be seen only with a 

microscope. However, explain that germs are like glitter—there are 

a lot of them, they spread easily, and it takes proper hand washing to 

get rid of them. Explain that it is important to wash hands the right 

way to get rid of germs and to lower the chance of getting sick or 

making someone else sick.

Lesson

Plan

Lesson

Plan

22
23

 LESSON 3  How Germs Spread 

Use these questions about hand washing and 

cough/sneeze etiquette when you present Lesson 3 

to children ages 8 to 10.

Question: How are germs (like viruses) passed?

Answer: Germs are passed when you cough or sneeze into your 

hands and touch other objects, or when you don’t cover your 

mouth and nose when you cough or sneeze.

Question: How can we keep from spreading our germs to 

other people and making them sick?

Answer: Cover your mouth and nose when you sneeze or 

cough using a tissue. Then throw the tissue away. When there 

is no tissue, cough or sneeze into your sleeve. If you cough or 

sneeze into your hands, wash them the right way. Germs get on 

your hands and then on other objects (doorknobs, toys, desks, 

etc.). Wash your hands the right way for 20 or more seconds.

Question: How long should you rub your hands together?

Answer: You should rub your hands together for 20 seconds—

long enough to count slowly to 20 or to sing the “Happy Hand 

Washing” song twice.

Activities for children ages 8 to 10:

■ Offer children Handout #9 (Word Search).

■ Offer children Handout #10 (Word Scramble). 

■ Ask children to sign Handout #11 (the My Pledge page). Post 

signed pledges on the wall to reinforce good hygiene.

23
Teacher Answer Key: Word Search

Teacher Answer Key: Hand Washing Word Scramble

24
25 Handout #9
26 Handout #10
27 Handout #11
28

Posters and Handouts

You will find posters to hang in your 

facility in this section. You will also find 

handouts to give to parents.

To Post in Your Facility:

■ Good Habits poster to display for the children....................29

■ Cover Your Cough poster for your office, 

staff lunch area, or staff bathroom........................................30

■ Did You Get Your Flu Vaccine Yet?

poster for staff and parents to see ........................................31

To Give to Parents:

■ Help Your Child Be a Germ Stopper ...................................32 

■ 5 Steps to Good Hand Washing ...........................................33

28
Good Habits

29

Talk to your doctor 

about getting the 

seasonal flu vaccine

Did you know:

People who work with children

have a greater chance of getting

the flu?

Getting a flu vaccine lowers your chance of 

catching the flu this season. Talk to your 

doctor today about getting a flu vaccine.

31
Handout #12

Help Your Child 

Be a Germ Stopper!

How germs spread

People catch the flu by:

People who have the flu usually cough, sneeze, and have a runny 

nose. This makes droplets with virus in them. Other people can 

get the flu by breathing in these droplets or getting them in their 

nose or mouth. You can also get the flu by touching a hard surface such 

as a desk, doorknob, phone, or toy that has germs on it from a cough or 

sneeze and then touching your eyes, mouth, or nose before you wash your 

hands. We know that some viruses and bacteria (germs) can live for 2 or 

more hours on these hard surfaces.

What can you do to stop the spread of germs? 

Take these 3 simple steps today!

Step 1: Cover your mouth and nose when you cough or sneeze. 

Teach your children to do the same.

How? Cough or sneeze into a tissue and then throw it away.

No tissue? Cough or sneeze into:

• Your sleeve (elbow) or shirt (shoulder)

Step 2: Clean your hands often. Teach your children to 

do the same

Wash your hands with soap and warm water. Do it for 20 seconds. 

How long is 20 seconds? 

• Count slowly to 20. Or wash long enough to sing the 

“Happy Hand Washing” song twice or our special 

version of “If You’re Happy and You Know It.”

No soap around? 

• Use hand gel or hand wipes. 

Step 3: Remind your children to use good hygiene.

Follow up with your children to make sure they follow the rules 

of good hygiene: 

• Set a good example. 

• Praise children when they practice these ways to stop germs 

in their tracks.
Handout #13

5 Steps to

Good Hand Washing!

Do you know the right way to wash your hands? 

Take these 5 simple steps to good hygiene.

Step 1 – Turn on the warm water and let it run.

Turn on the warm water. If you have 2 faucets, turn on the 

cold first and then the hot until the water is warm. 

Step 2 – Wet your hands and soap up.

Get your hands wet by quickly running both hands under the 

warm water.

Turn one palm up flat under the soap nozzle and pump out 

some soap with your other hand. Or wet the bar of soap. Then 

rub the soap between your palms to make bubbles. 

Rub your palms, the back of your hands, in between your 

fingers, and under your nails. Quickly dip your hands under 

the running water to make more bubbles and suds.

Step 3 – Sing while you wash!

Lather up for at least 20 seconds. Sing the “Happy Hand 

Washing” song twice, the alphabet song, or the version of “If 

You’re Happy and You Know It” in this guide. The 20 seconds 

will seem to fly by!

Step 4 – Rinse off your hands.

Point your hands down into the sink so that the soap runs 

from your wrists to your fingertips. Make sure all the soap 

comes off. 

Step 5 – Dry off your hands.

Grab the paper towel and dry your hands. Then use the paper 

towel to turn off the faucet, and throw the paper away. At 

home, you can use a cloth towel and use bare hands to turn off 

the faucet.

33