Fort Worth, TX,
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RSV Cases Spiking Higher and Earlier so far This Year at Cook Children's

Our emergency department and urgent care facilities are still overwhelmed with patients.

Jeff and Zoe Green with baby Lindy, hospitalized at Cook Children's for RSV.

Cook Children’s is experiencing a high rate of patients with a respiratory syncytial virus (RSV), which infects the lungs and breathing passages. Our emergency department and urgent care facilities are overwhelmed with patients.

This is resulting in longer wait times. Our emergency department is seeing between 400-500 children each day. Our Urgent Cares are seeing 600-700+ children each day.

A high number of our hospital admissions are RSV cases. RSV can range from mild upper respiratory tract infections to severe lower respiratory tract disease, including bronchiolitis or pneumonia. The increase in RSV and influenza A is happening much earlier this year.

From Oct. 2 to Oct. 8, there were 210 positive RSV cases at Cook Children’s, a positivity rate of 24%. RSV cases at Cook Children's

One week later (from Oct. 9 to Oct. 15), there were 288 positive RSV cases, a positivity rate of 29%. During the same time period, there were 47 positive influenza A cases, a 4.7% rate.

RSV cases normally spike much later in the respiratory season, such as in December or January. Flu A

RSV is a very common respiratory virus. Some children require hospitalization, but most do not.

Parents should not go to the Urgent Care or Emergency Department for only a flu or a COVID test. See your pediatrician, who can test for flu, RSV, strep throat and COVID. Adults can also use at-home tests or tests at a pharmacy.

Laura Romano, D.O., a hospitalist at Cook Children’s, urges parents to keep their children at home when they are sick to prevent the spread of illness, especially to vulnerable populations. Flu, COVID and rhinovirus are also circulating in our community.

Last year, more people were wearing face masks and children were more likely to stay home while sick. This year, parents are sending their children to daycare and school for the first time following two years of the pandemic, Dr. Romano said. Children who haven’t been previously exposed to respiratory viruses are getting sick.

There are limited treatments for RSV; most are available for premature infants, infants with other lung diseases, infants who are considered immunocompromised, or patients with a congenital heart disease.

What are the symptoms of RSV?

In infants younger than six months, RSV infection may result in symptoms of irritability, poor feeding, lethargy, and/or episodes where they stop breathing with or without fever.

In older infants and young children, a runny nose and decreased appetite may appear one to three days before cough, often followed by sneezing, fever, and sometimes wheezing. RSV, COVID, and the flu can all worsen a child’s asthma and lead to an increase in asthma symptoms such as wheezing, waking up at night coughing, and shortness of breath.

Symptoms in adults are typically consistent with upper respiratory tract infections, including runny nose, sore throat, cough, headache, fatigue, and fever. RSV can be a very serious illness for anyone who is immunocompromised. But for most children, it is a minor upper respiratory infection.

If parents begin to see any RSV symptoms in their child, it is important to keep them well hydrated.

Call your pediatrician if:

  • You are concerned that your child might have been exposed to either the flu, RSV, or COVID.
  • If your child is experiencing mild respiratory symptoms but is not having difficulty breathing and is well-hydrated.
  • If you need to have your child tested for RSV, the flu, or COVID.

Seek immediate medical care if:

  • Persistent fever for more than two or three days. However, any temperature greater than 100.4 in an infant under two months of age is considered a medical emergency.
  •  Concerns for dehydration.
  •  In dehydrated babies, parents will see fewer wet diapers or a lack of tears. Their flat spot can also appear more sunken.
  • Breathing faster than usual or can see the skin between the ribs being sucked in.
  • If your child is requiring frequent use of their albuterol rescue inhaler or is having worsening asthma symptoms.


  •  Get the flu vaccine and stay up to date on the vaccine schedule from the Centers for Disease Control and Prevention.
  • Get the COVID vaccine.
  • Teach your children to cough or sneeze into their elbow.
  • Use hand sanitizer.
  •  If you’re sick, wear a mask in public and stay home.

About Cook Children's

Cook Children’s Health Care System embraces an inspiring Promise – to improve the health of every child through the prevention and treatment of illness, disease and injury. Based in Fort Worth, Texas, we’re proud of our long and rich tradition of serving our community. Our not-for-profit organization is comprised of nine companies, including our Medical Center, Physician Network, Home Health company, Northeast Hospital, Pediatric Surgery Center, Health Plan, Health Services Inc., Child Study Center and Health Foundation. With more than 60 primary, specialty and urgent care locations throughout Texas, families can access our top-ranked specialty programs and network of services to meet the unique needs of their child. For 100 years, we’ve worked to improve the health of children from across our primary service area of Denton, Hood, Johnson, Parker, Tarrant and Wise counties. We combine the art of caring with leading technology and extraordinary collaboration to provide exceptional care for every child. This has earned Cook Children’s a strong, far-reaching reputation with patients traveling from around the country and the globe to receive life-saving pediatric care. For more information, visit