The current season, which began Sept. 28, 2025, and runs through May 23, 2026, continues to see a steady increase in cases across Cook Children’s Health Care System, primarily within primary care and urgent care offices. 

During the first week of February, the positivity rate for the flu hovered at approximately 30% in urgent care clinics, according to Kara Starnes, D.O. medical director of Urgent Care at Cook Children’s. 

Pediatricians encourage caregivers and families to take preventive steps, noting that a previous infection does not mean immunity for the season. 

“Even if you have already tested positive for the flu this season, it is worth getting your flu shot to protect against other strains,” said Phillip Scott, M.D., pediatric hospitalist, medical director for the Nelson Ku High Risk Asthma Clinic. 

While Cook Children’s Medical Centers in Prosper and Fort Worth have not seen a significant spike in hospitalizations, the system reports an increase in visits for the common cold. 

Don’t Let the Flu Stall Your Spring Break 

With Spring Break just a few weeks away, medical experts share tips to ensure families spend their vacation making memories instead of making visits to urgent care.  

“If you are traveling and will be in large crowds such as at the airport or at a large event, it is worth getting your flu shot for protection against the flu,” said Dr. Scott. 

Beyond prevention, the flu vaccine can significantly reduce the severity of symptoms if an individual does become sick, lowering the risk of hospitalization. 

Pediatricians also recommend the following: 

• Wash your hands
• Get a flu vaccine for you and your child
• Avoid touching your nose, mouth and eyes
• Cover your nose and mouth when sneezing and coughing
• Avoid close contact with people who are sick
• Keep your children at home and away from public areas if they are not feeling well 

Signs and Symptoms  

 Flu, RSV and COVID-19 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  

If your child is sick, call your pediatrician first who can help you decide whether the level of sickness escalates to the doctor's office, urgent care, or the emergency room. For many children, viral illnesses like the flu, RSV, and COVID-19 can be managed at home with supportive care. Over-the-counter medications like acetaminophen or ibuprofen can help reduce fever and discomfort. Avoid ibuprofen in infants younger than 6 months.  

Maintaining hydration is crucial. Please encourage your child to drink fluids and consider giving them electrolyte drinks or popsicles. Saline nasal drops and cool-mist humidifiers can help alleviate congestion.  

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.  

 When to Seek Medical Attention  

While most cases can be managed at home, it's essential to recognize the signs of respiratory distress or dehydration, which require immediate medical attention.  

 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
• Grunting sound during exhale
• Nose flaring
• The chest appears to sink in with each breath
• Head bobbing when breathing in
• Change in alertness  

Signs of dehydration:  

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

If your child exhibits any of these signs, seek immediate care at an urgent care facility or the emergency department. Reserving visits to urgent care or the emergency department for truly urgent needs helps ensure timely care for those who need it most, reduces waiting times for everyone, conserves resources, and limits your child’s exposure to other viruses.  

Related Stories: 

• Is it Flu? What Parents Need to Know This Flu Season
• Know When to Use Telemedicine, Urgent Care, or the ER for Kids
• Top 10 Questions Parents Ask About Vaccines 

Last week, Cook Children’s saw 1,342 positive Influenza A cases at its medical centers in Fort Worth and Prosper. Across Cook Children’s seven urgent care centers (UCCs), 60% of the flu tests performed were positive for Flu A.

The influx is leading to over-crowded waiting rooms and long wait times across the board.

On Tuesday, Feb. 4, the emergency department in Fort Worth saw 534 patients, while 995 patients were seen at the UCCs. 

“This year is by far worse than previous years in regard to the flu,” said Stephanie Felton, D.O., associate medical director of the Cook Children’s Emergency Department. “Last year, we peaked at 800 positive patients in the month of January. This January we saw 1,200 positive patients. Please keep in mind how contagious the flu is.”

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. Roxana Narat, M.D., a hospitalist at Cook Children’s Medical Center – Prosper, says flu symptoms include fever, cough, congestion, fatigue and body aches.

Kara Starnes, D.O., medical director of Urgent Care at Cook Children’s, encourages parents to practice prevention when it comes to flu and other respiratory illness:

• Keep your children at home and away from public areas if they are not feeling well
• Wash your hands
• Cover your nose and mouth when sneezing and coughing
• Avoid touching your nose, mouth and eyes
• Avoid close contact with people who are sick
• Get a flu shot

“The flu vaccine provides the best chance at preventing the more serious complications of the flu,” said Dr. Starnes. “While a flu vaccine may not always completely prevent the flu, it typically makes the illness much less severe and of a shorter duration. It is not too late to get a flu shot, even if you or your child has had the flu.”

Managing Symptoms

If your child is sick, call your pediatrician first. They can help you decide if your child needs to visit their office or go to an urgent care or emergency room. 

For many children, viral illnesses like the flu, RSV, and COVID-19 can be managed at home with supportive care. Over-the-counter medications like acetaminophen or ibuprofen can help reduce fever and discomfort. Avoid ibuprofen in infants younger than 6 months.

Maintaining hydration is crucial. Encourage your child to drink fluids and consider giving them electrolyte drinks or popsicles. Saline nasal drops and cool-mist humidifiers can help alleviate congestion.

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.

When to Seek Medical Attention

While most cases can be managed at home, it's essential to recognize the signs of respiratory distress or dehydration, which require immediate medical attention.

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  
• 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 (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)
• Sleepy and unresponsive  

If your child exhibits any of these signs, seek immediate care at an urgent care facility or the emergency department. Reserving visits to urgent care or the emergency department for truly urgent needs helps ensure timely care for those who need it most, reduces wait times for everyone, conserves resources, and limits your child’s exposure to other viruses.

Last week, Cook Children's saw more than 900 positive flu cases at its medical centers in Fort Worth and Prosper. Mostly driven by Influenza A cases, this flu season is quickly shaping up to surpass the past several years.

This surge in illness is also triggering high volumes of patients across the health care system, and that means high wait times. 

“When large numbers of children are coming into the emergency department, wait times go up,” said Natalie Carpenter, director of Emergency Services at Cook Children's. “We have to treat patients in order of the severity of their illness, so that means kids with mild symptoms may be in the waiting room for long periods.”

On Monday, Jan. 27, the emergency department in Fort Worth saw 696 patients, while 1,030 patients were seen across Cook Children's seven urgent care locations. For context, an average of 379 patients are seen during a normal day in Cook Children's Fort Worth emergency room.  

“Unfortunately, this is a trend we’re seeing year after year,” said Mary Suzanne Whitworth, M.D., medical director of Infectious Diseases at Cook Children’s. “The rates of respiratory illness among children in our community continue to rise. Many of these children need medical attention to control their symptoms.”

Dr. Whitworth encourages parents to practice prevention when it comes to flu and other viruses:

• Keep your child home when they are sick
• Avoid close contact with people who are sick
• Wash hands frequently
• Avoid touching nose, eyes and mouth
• Get a flu vaccine for you and your child

“The flu vaccine is the best prevention we have against the virus,” said Dr. Whitworth. “It’s not too late to get your vaccine. With the flu season ramping up, now is the time to get vaccinated if you haven’t already.”

There is some good news regarding RSV, the respiratory virus that was hitting kids hard this past fall. Last week we saw 124 RSV cases at the medical centers in Fort Worth and Prosper, a significant drop from the more than 400 cases per week reported in December.

Norovirus is also circulating, but not as widespread as RSV and flu. There were 36 cases of norovirus at Cook Children's - Fort Worth last week. 

Managing Symptoms at Home When Possible

If your child is sick, your first call should be to your pediatrician. They can help you decide if your child needs to come into the office or go to an urgent care or emergency room. 

For many children, viral illnesses like the flu, RSV, and COVID-19 can be managed at home with supportive care. Over-the-counter medications like acetaminophen or ibuprofen (avoid ibuprofen in infants younger than 6 months) can help reduce fever and discomfort.

Maintaining hydration is crucial; encourage fluids and consider electrolyte drinks or popsicles. Saline nasal drops and a cool-mist humidifier can help alleviate congestion.

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.

"It is safe to manage your child’s symptoms at home as long as they are not displaying signs of severe illness, respiratory distress or dehydration," Dr. Whitworth added.

When to Seek Medical Attention

While most cases can be managed at home, it's essential to recognize the signs of respiratory distress or dehydration, which require immediate medical attention.

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  
• 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 (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)
• Sleepy and unresponsive  

If your child exhibits any of these signs, seek immediate care at an urgent care facility or the emergency department. Reserving visits to urgent care or the emergency department for truly urgent needs helps ensure timely care for those who need it most, reduces wait times for everyone, conserves resources, and limits your child’s exposure to other viruses.

From Nov. 27 to Dec. 3, there were 533 flu A cases, a positivity rate of 33.8%. Protect yourself and your family by getting vaccinated against the flu and COVID. The flu vaccine works to prevent you from catching the flu or by reducing the severity if you do come down with the illness.

In addition to causing respiratory symptoms, the flu can also cause myositis, which results in significant muscle pain and requires admission for IV hydration and pain management. The best way to prevent influenza-associated pneumonia and influenza-induced myositis is to get your flu vaccine.

Respiratory syncytial virus (RSV) cases are declining compared to previous weeks, but remain high. We are also seeing positive cases of COVID and rhinovirus in our patients.

“There are not any current treatments for RSV,” said Laura Romano, D.O., Hospitalist at Cook Children’s Medical Center. “There is also currently not a vaccine available. We can use Synagis, a monoclonal antibody, to help prevent severe infections but that is reserved for certain patients such as our premature infants, our infants with congenital heart or lung disease, infants with compromised immune systems, or some infants with certain neurological conditions."

Cook Children’s has expedited our winter staffing plan in preparation for peak flu season. Our census is full, including beds, the Emergency Department and Urgent Care Centers. Wait times are extremely long. We ask parents and caregivers to contact their pediatrician unless their child has a moderate or severe illness or injury.

Patient Census

In the last 24 hours, 560 patients went to the Emergency Department, which is equivalent to one check in every 2 minutes. This is causing long wait times (8-10 hours) to transfer patients to the Pediatric Intensive Care Unit.

Across our seven Urgent Care Centers, we saw 654 patients on Friday, 653 patients on Saturday, 677 patients on Sunday and 528 patients in the last 24 hours.

There are steps families can take to avoid getting sick. Parents and caregivers can remind their children to continue the healthy habits learned in the pandemic, including hand hygiene, coughing into a tissue or your elbow and staying home if you or your child feel sick. Face masks add increased protection, especially in public spaces.

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 among the many children who are getting sick.

Positive Influenza A cases at Cook Children’s Health Care System:

Oct. 9 – Oct. 15: 47 cases

Oct. 16 – Oct. 22: 75 cases

Oct. 23 – Oct. 29: 170 cases (14.6% positivity rate)

Oct. 30- Nov. 5: 333 cases (22.6% positivity rate)

Nov. 6 - Nov. 12: 483 cases (27.5% positivity rate)

Nov. 13 - Nov. 19: 630 cases (35.4% positivity rate)

Nov. 20 - Nov. 26: 812 cases (42.3% positivity rate)

Nov. 27 - Dec. 3: 533 cases (33.8% positivity rate)

RSV cases at Cook Children’s Health Care System:

Oct. 2 – Oct 8: 210 cases (24% positivity rate)

Oct. 9 – Oct. 15: 288 cases (29% positivity rate)

Oct. 16 – Oct. 22: 246 cases (24% positivity rate)

Oct. 23 – Oct. 29: 263 cases (23% positivity rate)

Oct. 30 - Nov. 5: 337 cases (23% positivity rate)

Nov. 6 - Nov. 12: 342 cases (19% positivity rate)

Nov. 13 - Nov. 19: 267 cases (15% positivity rate)

Nov. 20 - Nov. 26: 222 cases (12% positivity rate)

Nov. 27 - Dec. 3: 174 cases(11% positivity rate)

Pediatrician Offices

Call your pediatrician first if children are experiencing mild symptoms or injuries (ear pain, sore throat, diarrhea or vomiting, rash, cough or other non-urgent health concerns). The pediatrician’s office can help you decide what steps to take.

As we prepare for the flu season to worsen, make an appointment with your pediatrician to get updated flu and COVID vaccines. Vaccines help prevent infection and can prevent serious outcomes in people who are vaccinated but still get sick with the flu. The vaccines also reduce the risk of hospitalization.

RELATED: Doctor's Note is Not Required for Excused Absence at Fort Worth ISD

Urgent Care Centers

If your child is ill, please contact your pediatrician's office first if it is not a moderate or severe illness or injury. If you cannot get to your provider’s office or it’s after hours, go to an urgent care center. Urgent care centers manage the same problems as your regular health care provider plus services such as X-rays, stitches and splints.

Understand that kids with more severe issues will be seen first and that means long wait times for those with minor illnesses. Staff are overwhelmed and they’re encountering a lot of frustrated parents. Please be nice to the people working – they need kindness!

Emergency Department

Bring your child to the emergency room if they have trouble breathing, unusual sleepiness or confusion, poison ingestion, head injury with vomiting, serious burn or another life-threatening condition.

Seek immediate medical care if your child is experiencing:

• 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.
• Please understand that kids with more severe issues will be seen first and that means long wait times for those with minor illnesses. 

Preparation/Prevention

As we prepare for the flu season to worsen, make an appointment with your pediatrician to get updated flu and COVID vaccines. Vaccines help prevent infection and can prevent serious outcomes in people who are vaccinated but still get sick with the flu. The vaccines also reduce the risk of hospitalization.

Get updated flu and COVID vaccines – these will help prevent infection and reduce the risk of hospitalization. You can call your pediatrician to schedule an appointment to receive vaccinations.

• 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.

RELATED: 

• Prepare Now for Flu Season with Vaccine Protection
• Get Immunized for a Healthy School Year (checkupnewsroom.com)
• Does My Kid Have Allergies, COVID, a Cold or the Flu? (checkupnewsroom.com)

The Cook Children's Health Care System census is full across the board, including beds, the Emergency Department and Urgent Care Centers. The sheer volume has made finding a bed for our patients a daily logistical puzzle.

In the last 24 hours, 487 patients went to the Emergency Department, which is equivalent to one check in every 2 minutes. This is causing long wait times (8-10 hours) for patients to be transferred to the Pediatric Intensive Care Unit and is putting unnecessary strain on the health care system.

Across our seven Urgent Care Centers, there were 763 patients on Friday, 668 patients on Saturday and 754 patients on Sunday. Cook Children’s has expedited our winter staffing plan in preparation for peak flu season.

We ask parents and caregivers to contact their pediatrician first if it’s not a moderate or severe illness or injury. Other hospitals and children's hospitals around the country are also experiencing high number of RSV and respiratory illnesses.

RSV cases at Cook Children’s Health Care System:

Oct. 2 – Oct 8: 210 cases (24% positivity rate)

Oct. 9 – Oct. 15: 288 cases (29% positivity rate)

Oct. 16 – Oct. 22: 246 cases (24% positivity rate)

Oct. 23 – Oct. 29: 263 cases (23% positivity rate)

Oct. 30 - Nov. 5: 337 cases (23% positivity rate)

Nov. 6 - Nov. 12: 342 cases (19% positivity rate)

Nov. 13 - Nov. 19: 267 cases (15% positivity rate)

Positive Influenza A cases at Cook Children’s Health Care System:

Oct. 9 – Oct. 15: 47 cases

Oct. 16 – Oct. 22: 75 cases

Oct. 23 – Oct. 29: 170 cases (14.6% positivity rate)

Oct. 30- Nov. 5: 333 cases (22.6% positivity rate)

Nov. 6 - Nov. 12: 483 cases (27.5% positivity rate)

Nov. 13 - Nov. 19: 630 cases (35.4% positivity rate)

Urgent Care Centers

If your child is ill, please contact your pediatrician's office first if it’s not a moderate or severe illness or injury. If you can’t get to your provider’s office or it’s after hours, go to an urgent care center. Urgent care centers manage the same problems as your regular health care provider plus services such as X-rays, stitches and splints.

Understand that kids with more severe issues will be seen first and that means long wait times for those with minor illness. Staff are overwhelmed and they’re encountering a lot of frustrated parents. Please be nice to the people working – they need kindness!

Emergency Department

Bring your child to the emergency room if they have trouble breathing, unusual sleepiness or confusion, poison ingestion, head injury with vomiting, serious burn or another life-threatening condition. Please understand that kids with more severe issues will be seen first and that means long wait times for those with minor illnesses. 

Pediatrician Offices

Call your pediatrician first if children are experiencing mild symptoms or injuries (ear pain, sore throat, diarrhea or vomiting, rash, cough or other non-urgent health concerns). The pediatrician’s office can help you decide what steps to take.

As we prepare for the flu season to worsen, make an appointment with your pediatrician to get updated flu and COVID vaccines. Vaccines help prevent infection and can prevent serious outcomes in people who are vaccinated but still get sick with the flu. The vaccines also reduce the risk of hospitalization.

Preparation/Prevention

The increase in RSV and influenza began much earlier than usual this year, but we have yet to reach peak flu season. With Thanksgiving approaching, we want to help parents understand what they can do to prevent the spread of illnesses.

As we prepare for the flu season to worsen, make an appointment with your pediatrician to get updated flu and COVID vaccines. Vaccines help prevent infection and can prevent serious outcomes in people who are vaccinated but still get sick with the flu. The vaccines also reduce the risk of hospitalization. Get updated flu and COVID vaccines – these will help prevent infection and reduce the risk of hospitalization. You can call your pediatrician to schedule an appointment to receive vaccinations.

Remind your children to continue the healthy habits learned in the pandemic, including hand hygiene, coughing into a tissue or your elbow and staying home if you or your child feel sick. 

There is a nationwide shortage of RSV tests. RSV testing doesn’t change the way in which most children are treated/managed.

RELATED: 

• Prepare Now for Flu Season with Vaccine Protection
• Get Immunized for a Healthy School Year (checkupnewsroom.com)
• Does My Kid Have Allergies, COVID, a Cold or the Flu? (checkupnewsroom.com)

A surge in flu cases is often correlated with Thanksgiving and the approaching holiday season, so it’s important that everyone 6 months and older get the flu vaccine now. Along with a spike in RSV cases, North Texas is currently a hotspot for flu activity.

“The influenza vaccine is a very safe and effective way to avoid getting sick with the flu,” said Mary Suzanne Whitworth, M.D. “One quick shot can potentially prevent a week of fever and feeling miserable. This is a no brainer.”

Parents and caregivers can remind their children to continue the healthy habits learned in the pandemic, including hand hygiene, coughing into a tissue or your elbow and staying home if you or your child feel sick. Face masks add increased protection, especially in public spaces. 

Be sure that you and your family are updated on your COVID vaccines. As flu cases increase due to the holidays and travel, COVID cases often go up as well. Patients are still experiencing COVID. On Oct. 18, the rolling 7-day average was 2.3% positivity rate.

Why should I get the flu vaccine in response to the spike in RSV cases?

Our goal is for our community, our patients and our patient families to stay as healthy as possible. Our Emergency Department and Urgent Care Centers are currently overwhelmed with patients and resulting in extremely long wait times.

Vaccination against the flu helps prevent infection and can prevent serious outcomes in people who are vaccinated but still get sick with the flu. The vaccine reduces the risk of hospitalization.

Our emergency department is seeing more than 500 children each day. Our Urgent Cares are seeing nearly 800 children each day. This is the equivalent of a child being checked in to see a provider every 2 minutes and is resulting in extraordinarily long wait times for those who are not severely ill.

Additionally, Cook Children’s pediatric ICU remains near capacity with about half of patients diagnosed with RSV.

Parents should not go to Cook Children’s Urgent Care Centers or Emergency Department for only a flu or a COVID test. See your pediatrician, who can test for flu, RSV, strep throat and COVID. You can also use at-home COVID tests or tests from a pharmacy.

What are flu cases like now?

At Cook Children’s, flu cases are increasing earlier this year; the flu numbers we are currently seeing are equal to what we saw near the end of November 2021. There were 47 cases of Influenza A and one case of Influenza B at Cook Children’s Health Care System during the week of Oct. 9 – Oct 15.

RSV cases at Cook Children’s Health Care System:

• Oct. 2 – Oct 8: 210 cases
  • (24% positivity rate)
• Oct. 9 – Oct. 15: 288 cases
  • (29% positivity rate)
• Oct. 16 – Oct. 22: 246 cases
  • (24% positivity rate)

Influenza A cases at Cook Children’s Health Care System:

• Oct. 9 – Oct. 15: 47 cases
• Oct. 16 – Oct. 22: 75 cases

Most of the United States is seeing an early increase in seasonal flu activity, according to the Centers for Disease Control and Prevention. The southeast region and south-central region, which includes Texas, are reporting the highest levels of flu activity, the CDC said.

Everyone ages 6 months and older should get a flu vaccine. The flu vaccine is the best way to protect your child and family from potentially serious complications from flu.

Texas is at a high activity level for respiratory illness, including fever plus a cough or sore throat. The map shows ILI (influenza-like illness), which includes patient visits due to other pathogens that cause similar symptoms. The cases reflected in the map are not all confirmed flu cases.

RELATED: 

• Prepare Now for Flu Season with Vaccine Protection
• Get Immunized for a Healthy School Year (checkupnewsroom.com)
• Does My Kid Have Allergies, COVID, a Cold or the Flu? (checkupnewsroom.com)

Getting a flu shot every year is the best way to fight off the influenza viruses that can cause serious complications, especially for children ages 5 and younger.

The flu vaccine works to prevent you from catching the flu – or, reduce the severity if you do come down with the illness. Adults and children as young as 6 months old are urged to get the flu shot by the end of October.   

Brandi Falk, M.D. at Cook Children’s Pediatrics McKinney emphasizes the importance of coming in for a flu vaccine before the flu typically starts spreading. Flu season generally extends from November through May. Shots are available now by appointment at pediatrician offices, neighborhood clinics and pharmacies.   

“The flu is a virus, and we actually pass it through tiny droplets that we make when we cough or sneeze or talk,” Dr. Falk said. “It's important that parents know that everyone is at risk.”

Flu is a contagious respiratory infection that can cause fever, chills, headache, muscle aches, dizziness, loss of appetite, tiredness, cough, sore throat, runny nose, nausea or vomiting, weakness, ear pain or diarrhea. Dr. Falk pointed out that it can last two weeks or more, and it’s worse than having a cold. Sinus problems, ear infections, dehydration and difficulty breathing also can develop, potentially requiring hospitalization.

“A question I get asked from parents a lot is, ‘Why do I need to do the flu vaccine?’ I tell them that it can lead to life-threatening symptoms like pneumonias and inflammation around your heart, around your brain and your muscles,” she said.

In the 2021-2022 flu season, the U.S. Centers for Disease Control and Prevention (CDC) recorded 31 pediatric deaths caused by flu. Most of those cases -- ranging in age from 2 months to 16 years -- involved at least one underlying medical condition that put those patients at higher risk for flu severity, such as asthma, heart disease or weakened immune system.

Last year saw a drop in the percentage of children and teens protected against the flu. The CDC reports that 55.3% of those eligible received their flu shots, down from 57.3% previously. 

Dr. Falk explained a few key points: 

• You can’t catch the flu from the flu shot. “The flu shot is an inactive vaccine. So that means that the viruses inside it are killed.”
• Potential side effects, usually mild, include soreness, redness or swelling in the arm or leg where the injection went in. The vaccine might also cause brief headaches, fever, nausea and muscle aches. 
• After the vaccine, it takes two weeks to build up the antibodies that fight off the flu. That’s why it’s important to get immunized early. “By the time the flu starts getting more prevalent, you're already protected,” Dr. Falk said.

It’s important for the whole family to receive a flu vaccine annually, she said. Patients can receive the vaccine in combination with other vaccines at their checkup or by scheduling a nurse visit. First-timers who are younger than age 9 will need two doses, a month apart.  Kids 9 and older need only one dose.

For those who want to avoid needles, the nasal spray flu vaccine might be an option.  The flu mist cannot be given to children under age 2 or to people with asthma, certain chronic illnesses or weakened immune systems.

Flu vaccines protect against two influenza A viruses, and two influenza B viruses. The vaccine’s composition is updated each year to protect against what is expected to be the most common viruses in circulation.   

In addition to vaccination, Cook Children’s recommends these hygiene practices for flu prevention:

• Wash hands with soap thoroughly and often, especially after using the bathroom, after coughing or sneezing, and before eating or preparing food.
• Never share cups and eating utensils.
• Cover your mouth and nose with a tissue when you cough or sneeze, then put the tissue in the trash.
• Cough or sneeze into your upper arm, not your hands, if a tissue isn't handy.

And … If your child is sick, stay home from daycare or school. Make sure your child drinks lots of liquids, gets plenty of sleep and takes over-the-counter meds to alleviate symptoms.

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There’s no guaranteed way to avoid the flu. But getting the vaccine every year can help. At Cook Children’s, we believe that flu vaccinations are the safest, easiest way to protect everyone age 6 months and older from serious flu symptoms. And a flu vaccination during pregnancy helps protect your newborn baby from flu for several months after birth.

Immunizations and other services are available at Cook Children’s neighborhood clinics and primary care sites across Fort Worth and beyond. Find a location near you: Primary Care Offices/Neighborhood Clinics (cookchildrens.org)

RELATED: Get Immunized for a Healthy School Year (checkupnewsroom.com)

Does My Kid Have Allergies, COVID, a Cold or the Flu? (checkupnewsroom.com)

Flu Makes a Return (checkupnewsroom.com)

Once school was back from the Christmas break, kids returned to share their germs with one another. To make things worse, the brutally cold weather when they got back ensured that everyone stayed in an enclosed environment. All a perfect storm to see our flu numbers climb higher.

“We typically see an uptick in flu a couple of weeks after kids go back to school following the winter break,” said Jason Terk, M.D., a pediatrician at Cook Children’s in Keller. “Right now, we are seeing an increase in Flu B, but still see plenty of Flu A cases. Our patient volumes are still very high.”

Last week, 403 flu cases were confirmed at Cook Children’s, up from 345 the week prior. What makes this week different is the amount of Flu B cases seen. Last week saw 104 confirmed Flu B cases, up from 60 a week earlier.

“It’s expected that Flu B will follow or peak after Flu A, but it’s still earlier than expected this season,” said Morgan A. Pence, Ph.D., clinical microbiologist at Cook Children’s. “This is the earliest we’ve seen Flu B in the last four flu seasons and it looks like Flu A and B are overlapping more this year than in the past.”

The good news is that Flu B is usually less severe than Flu A. The bad news is it means a continuation of a flu season that is already looking to be the worst since the 2014-2015 season. The Centers for Disease Control and Prevention reports the death of 30 children nationally as a result of the flu.The CDC stated that all U.S. States except Hawaii have reported widespread flu activity.

“It’s important for people to take care of themselves and others to prevent the spread of the flu as much as possible,” said Mary Suzanne Whitworth, M.D., medical director of Infectious Disease. “The flu vaccine continues to be recommended for everyone 6 months of age and older. Make sure to practice washing your hands and please keep your children home if they are sick.”

OK. Tamiflu. Let's talk about some facts.

At Cook Children's, 921 kids were tested for the flu the week before Christmas and 353 kids were positive (314 Flu A, 39 Flu B). So the flu has arrived in our area.

Every year our office gets inundated with phone calls about Tamiflu. Who can take it? Will it help my kiddo? Will it help me? Will it prevent contraction of the flu?

Let me try to spell a few things out so it makes some simple sense:

1. If you got your kiddo the flu vaccine this year, I want you to give yourself a big old fat kiss in the mirror because congrats on making a great decision for your child! While we aren't sure how good of a match it is until the season is over, way to give your child a fighting chance! The kids in the office that I've seen with the flu who have been vaccinated have typically been less sick than those who haven't.

2. Tamiflu (oseltamivir) is a medication anyone can take within 48 hours of starting the symptoms of the flu to REDUCE THE NUMBER OF DAYS ILL BY 1-1.5 DAYS. Notice how I didn’t say "make the symptoms go away" or "make it less severe." It mostly just reduces the number of days sick....by about a day.

3. Notice how I didn't say it cures the flu. Nothing cures the flu. It is a virus, and thus has no cure.

4. These are the reasons the AAP and CDC think a person should take Tamiflu if diagnosed with influenza (and are at "high risk of complications"):

• If under 2
• If over age 65
• Anyone with a chronic illness (diabetes, asthma, chronic heart disease, epilepsy, amongst others)
• Anyone who is immunosuppressed (cancer treatment, immune system deficiency)
• Women who are pregnant or postpartum
• Anyone hospitalized with influenza
• Healthy kids who have documented influenza and have a baby sibling under age 6 months

5. TAMIFLU DOES NOT WORK FOR VIRUSES THAT ARE NOT THE FLU. Meaning - if you or your kiddo has a "flu-like illness," and there are only about 400 circulating our area right now, Tamiflu will do nothing for you.

6. Tamiflu DOES NOT work much at all if taken more than 48 hours after the first symptom of influenza. Studies have proven this time and again.

7. Tamiflu sometimes causes more problems than it helps. It is infamous for making kids puke, be nauseous, have diarrhea, and have stomach cramps. (I personally took one dose of it a few years ago and swore I'd never do it again)

8. Tamiflu can help prevent a child from catching influenza, but given its cost and side effects, and chance for failure, we usually mostly recommend this for children who are at "high risk of complications" or have a very young or chronically ill sibling (see that list above).

9. Any provider can prescribe Tamiflu for any child they deem to be experiencing severe symptoms. If your child is really sick, and they have a positive flu test, and it's been less than 48 hours, we will write the prescription. But remember that clinicians also always have resistance in the back of our minds. The flu virus will LEARN and REMEMBER Tamiflu. And someday, maybe soon, it will no longer work. So if we seem "stingy" with this medication - that's why.

If you want to get jiggy with the beautiful science of all of this, a good stop for you would be this VERY informative page by the AAP: https://redbook.solutions.aap.org/selfserve/ssPage.aspx….

(Have fun with the 8,000 links on that page. SCIENCE! YAY!). If you don't want to read all of this information, please talk to your pediatrician if you have questions.

People are always asking my opinion of it, and I think I'm very "meh" about Tamiflu. It is costly and it can cause a lot of side effects. I do think it benefits the very young, the very old, and those with chronic illness, and I think it's worth it in those cases. Your best protection against the flu every year is to get the vaccine and wash your hands.

The flu virus can live on some surfaces for up to 24 hours. Isn't that astounding? Think about that. A guy sneezes in his hand, touches a door handle, and someone 12 hours later could touch it, wipe an eye or nose....and boom. Flu.

Again - WASH YOUR HANDS!

Hugs, everyone! Hang in there!

Dr. Diane

With the upcoming season, now is the time to get your child’s flu vaccines.

Only flu shots will be given this year to protect kids from becoming sick. This is due to recommendations from the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) after last year’s FluMist was found to have failed against certain strains of the flu.

But parent’s shouldn’t worry, Cook Children’s has increased its doses of the Quadrivalent Influenza Vaccine (flu shot) for its primary care offices.

“Even in bad years, the flu vaccine continues to provide the best layer of protection against this deadly disease,” said Justin Smith, M.D., a Cook Children’s pediatrician. “Last year’s injectable flu vaccine was 50 percent effective in preventing disease which means thousands of people were protected.”

The AAP recommends children ages 6 months and older be immunized against influenza every year. Previously, the CDC and AAP had recommended either form of flu vaccine – the inactivated influenza vaccine (IIV) that is given by injection and is approved for all patients older than 6 months, or LAIV which is given by intranasal spray and was approved for healthy patients ages 2 through 49 years. But that is no longer the case. Only the injection is recommended.

To find a Cook Children's pediatrican in your area, click here.