New guidance issued by the chief medical officer has urged parents of children aged between two and four to have them vaccinated against flu, not only to protect them, but in particular their grandparents who could die from underlying conditions.

The risk that a major flu outbreak see thousands of frail elderly people in hospital is a big fear each winter, not least this one when A&Es are already under unprecedented pressure.

Toddlers are more likely to spread the influenza virus because they tend to have a lot of close human contact, and are less likely to wash their hands or cover their faces when they cough or sneeze.

However, despite children aged two, three and four being eligible for free nasal spray flu vaccinations from their GP, the Department of Health said today that only a quarter of toddlers have received it so far.

“Flu can be really nasty for toddlers, leading to time of nursery, which has a big impact on mums and dads and sometimes even a stay in hospital,” said Professor Dame Sally Davies, the chief medical officer. “They also spread the virus easily and often pass flu to grandparents and other relatives who become very ill, fast.”

Emergency admissions to hospitals in England have already hit record levels before the onset of very cold weather, which exacerbates the spread of flu, as well as winter vomiting bugs.

New figures on A&E performance against the four hour target waiting times will be released today. The Health Secretary Jeremy Hunt has said the NHS is facing “unprecedented demand”.

Flu can lead to serious complications, especially for people with an underlying condition health condition such as heart disease, diabetes or a respiratory illness.

Additional hospital admissions because of winter illnesses means fewer beds for emergency patients, leading to queuing at A&E. In the past hospitals have had to redirect patients elsewhere, or cancel routine operations to make way for emergency cases.

Dame Sally said that flu leads to tens of thousands of hospital admissions each year, and that it was “a myth” that it only amounted to “a bad cold”.

“Particularly unpleasant for children, flu can cause a fever, sore throat, aching muscles, extreme tiredness and even complications such as bronchitis and pneumonia,” she said.

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