September 2, 2014
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Otitis Media

(Earache, Ear infection, Middle Ear Infection)

The Facts on Otitis Media

Otitis media is a middle ear infection that is most common in infants and young children, especially those between the ages of 6 months and 3 years. By the age of one year, most children will have had one or more middle ear infections. Although a middle ear infection can occur at any age, it's much less common in older children and adults. Ear infections do not spread from person to person and they most commonly occur with a cold. Antibiotics are often used to treat ear infections, but in certain circumstances, a doctor may suggest waiting for 2 to 3 days before starting antibiotics.

Feeling under the weather?

Could your symptoms be signs of the flu?

Answer a few quick yes-or-no questions to help get you on the road to diagnosis and recovery!


Do I have the flu?

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  • sudden onset of fever or
  • sudden onset of cough


  • fatigue (extreme tiredness)
  • sore throat
  • body or muscle aches
  • chills
  • headache
  • runny or stuffy nose
  • poor appetite
  • nausea, vomiting, diarrhea


  • people 65 years old or over
  • children under 5 years old
  • pregnant women
  • people who are obese
  • people living in a long-term care facility or nursing home
  • people with any of the following medical conditions:
    • asthma
    • cancer
    • chronic obstructive pulmonary disorder (COPD)
    • diabetes
    • heart disease
    • kidney disease
    • weakened immune system (e.g., HIV/AIDS)


YES YES      NO NO

It's unlikely that you have the flu.

You may have the flu.

You probably have the flu.

But you do have at least 1 risk factor that puts you at risk of flu complications. If you do experience any flu symptoms, talk to your doctor or visit a walk-in clinic as soon as possible.

And you may also have at least 1 risk factor that put you at risk of flu complications.

Talk to your doctor or visit a walk-in clinic if your symptoms concern you or if they get worse.

Talk to your doctor or visit a walk-in clinic as soon as possible.

Enter your postal code to find a clinic near you:  

Know the flu basics and how you can protect yourself and your family.

NOTE: If your symptoms still concern you, speak to your doctor or go to a walk-in clinic as soon as possible.

Flu complications include bacterial pneumonia, ear infections, or worsening of existing chronic conditions

If your doctor prescribes an antiviral medication, start the medication within 48 hours after your symptoms begin. Antivirals, when started within 48 hours after symptoms begin, can help relieve flu symptoms and make the flu less severe.

Home treatment options for the flu include getting plenty of rest, drinking lots of fluids, treating symptoms (such as using a pain reliever for body aches and fever), and avoiding contact with others.

Other treatment options for the flu include home treatments like getting plenty of rest, drinking lots of fluids, treating symptoms (such as using a pain reliever for body aches and fever), and avoiding contact with others.

Get the facts about the 2 main types of medications used to treat the flu and home treatments you can try.

If you experience any of these severe symptoms, seek medical help right away:

  • shortness of breath, rapid or difficulty breathing
  • chest pain
  • bluish or grey skin colour
  • bloody or coloured mucus/spit
  • severe or continuous vomiting
  • sudden dizziness or confusion
  • high fever that's lasted more than 3 days
  • low blood pressure
  • stiff neck, sensitivity to light

Other resources about flu:


Causes of Otitis Media

The middle ear is connected to the throat by a small tube called the eustachian tube. It's protected from the outside by a thin shield called the tympanic membrane, or eardrum. Viruses and bacteria that normally live in the throat can sometimes cross into the middle ear through the eustachian tube, causing an infection.

Winter is high season for ear infections. They often follow a cold. Some factors that increase a child's risk for middle ear infections include:

  • crowded living conditions
  • attending daycare
  • exposure to secondhand smoke
  • respiratory illnesses such as the common cold
  • close contact with siblings who have colds
  • having a cleft palate
  • allergies that cause congestion on a chronic basis
  • premature birth
  • not being breast-fed
  • bottle-feeding while lying down

Barometric trauma is another risk factor for a middle ear infection. The pressure in the middle ear rises when the airplane you are travelling on descends or when you ascend while scuba diving. If the eustachian tube is not open, the pressure in the middle ear cannot be equalized, and thus, may cause injury, which increases the risk of an acute ear infection.





Symptoms and Complications of Otitis Media

Middle ear infections can be categorized as acute, serous, or chronic.

Common symptoms of acute otitis media are fever, pain, and irritability. Other symptoms can include difficulty sleeping, tugging on the ear, and loss of or decreased hearing.

In children, the ear infection often begins after the child has had a cold for several days.

It's more difficult to detect signs of ear infection in young babies. You may notice a change in mood or feeding, and the infant will most likely have a fever. Because ear infections are usually painful, many babies will be irritable.

If fluid builds up in the ear, the infection is called serous otitis media. (That's serous, referring to fluid, not serious.) This occurs when the eustachian tube becomes blocked, and pressure in the middle ear drops. Under these circumstances, the child might experience hearing loss or impairment in the infected ear. This is usually only temporary. While this is usually no cause for alarm, anyone who experiences hearing loss or impairment should consult their doctor.

Chronic otitis media refers to a long-lasting ear infection. This is often complicated by (or caused by) a hole in the eardrum (perforation) from any one of the following:

  • acute infection
  • blocked eustachian tube
  • heat or chemical burns
  • injury from sudden air pressure changes
  • injury from an object entering the ear

Chronic ear infections often flare up after a cold, or, if the eardrum is perforated, when water enters the ear during swimming or bathing. Repeated or long-lasting infections can destroy the small bones in the middle ear, leading to long-term hearing loss. More serious complications include spread to nearby organs, appearing as inflammation of the inner ear, facial paralysis, and brain infections.

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