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 

Cook Children’s Medical Center – Fort Worth continues to see more than 900 positive influenza A cases, a record high compared with previous years. 

More than 1,900 patients were tested for influenza A, B, and RSV during the week of Feb. 2 - 8. At Cook Children's Medical Center at Prosper, 310 patients have been tested for influenza A with 41.9% testing positive.

While data shows a slight decline, the positivity rate for influenza A remains at 47%. On Feb. 11, Cook Children's Emergency Department in Fort Worth saw 410 patients. The department's average daily patient volume is 379.

Cook Children’s encourages families to take precautions, as flu cases remain high.

Flu and Respiratory Illness Prevention Tips:

• 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

Managing Symptoms

If your child is sick, call your pediatrician first. They can help you decide whether to take your child 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 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 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.