Community Update: Flu at Cook Children's

Flu cases remain high across Cook Children’s Health Care System. Last week, Tarrant County Health Department reported the first pediatric death from the flu. 

The flu is an infection of the respiratory tract (nose, throat, and lungs) that is caused by a virus. It can spread easily from person to person. Usually during cold and flu season, most children will experience very mild symptoms that normally self-resolve within a few days, said Cook Children’s hospitalist Laura Romano, D.O.

Flu activity is considered widespread in Tarrant County, according to Tarrant County Public Health. This flu season, we are admitting larger numbers of older, previously healthy children with difficulty breathing and flu-related pneumonia at the Cook Children’s Medical Center - Fort Worth, Dr. Romano said.

Most are requiring supplemental oxygen and some require ICU admission. While this has not been uncommon during prior flu seasons, this is now becoming the norm for admissions rather than the exception, Dr. Romano said.

“Overall, it seems that the flu is not going away anytime soon this season,” Dr. Romano said.

From Feb. 4 to Feb.10, out of 1,593 tests conducted, 16% were positive for flu A and 21% were positive for flu B, according to lab data at Cook Children’s Medical Center - Fort Worth.

This is a decrease compared to the prior week (Jan. 28 to Feb. 3), which showed a 22% positivity rate for flu A and 24% positivity rate for flu B.

High Patient Volume

Cook Children’s Urgent Care Centers and the Emergency Department at Cook Children’s Medical Center - Fort Worth are experiencing high volumes from circulating viruses such as COVID, flu and respiratory syncytial virus (RSV).

From Jan. 9 to Feb. 5, Cook Children’s Urgent Care Centers saw 6,806 patients, and the Emergency Department in Fort Worth saw 3,437. These numbers are almost double what they were in early January and leading to crowded medical facilities and long wait times.

On Friday, Feb. 9, our UCCs saw 760 patients in 24 hours and the Emergency Department at Cook Children’s Medical Center – Fort Worth saw 435 patients.

“We are seeing tons of flu,” said Kara Starnes, D.O., medical director of Cook Children’s Urgent Care Centers. “I have three kids of my own, so I know having a sick child can bring some anxiety but, in many cases, children with upper respiratory illnesses like COVID, flu and RSV do just fine being cared for at home and do not require a visit to urgent care or the ER.”

Dr. Starnes says it is safe to manage your child’s symptoms at home as long as they are not displaying signs of respiratory distress or dehydration. Reserving visits to urgent care or the emergency department for truly urgent needs will help reduce wait times, conserve resources and limit your child’s exposure to other viruses.

Signs and Symptoms

COVID-19, flu and RSV are caused by different viruses, but all are upper respiratory illnesses that share similar symptoms such as:

• Fever
• Cough
• Fatigue
• Sore throat
• Runny or stuffy nose
• Muscle pain and body aches
• Headache
• Vomiting and diarrhea
• Loss of appetite, taste or smell
• Shortness of breath

Managing Symptoms

There are a few things you can do to keep your child comfortable while the illness runs its course.

Over-the-counter medications such as ibuprofen and acetaminophen can help reduce fever, aches and pains. Ibuprofen should not be given to infants younger than 6 months.

A fever is defined as a temperature of 100.4 or above. A temperature above 100.4 in babies less than 2 months old is a medical emergency and needs to be evaluated in the emergency room. Any fever lasting longer than four to five days, or one that continues to climb and does not break with fever reducers, should be evaluated by a physician. Otherwise, it’s safe to manage fever at home.

Keep your child hydrated by encouraging fluids every few hours. Electrolyte drinks can be helpful if you suspect your child is dehydrated or at risk of becoming dehydrated. If they aren’t interested in drinking, have them suck on a popsicle.

To help reduce congestion, keep the sinuses moist with saline drops and a cool-mist humidifier. This is especially helpful during sleep times.

If your child appears to be in respiratory distress or severely dehydrated, it’s time to go to urgent care or the emergency department.

●      Signs of respiratory distress:

• Increased number of breaths per minute
• Increased heart rate
• Bluish color around the mouth, on the lips or on the fingernails.
• Pale or grayish skin
• A grunting sound during exhale
• Nose flaring
• Chest appears to sink in with each breath
• Head bobbing when breathing in
• Change in alertness

●      Signs of dehydration:

• Urine output significantly below the child’s normal (Your child should be producing urine at least once every 8 hours.)
• Not producing tears when crying and eyes appear sunken
• In infants, the soft spot on top of their heads looks sunken
• Dried mucus membranes (lining within the nostrils, mouth, throat, ears, genitals and anus)
• Sleepy and unresponsive