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 

When people hear that I’m a pediatrician they often ask if my own children are vaccinated and I always answer with a resounding yes! The next question I’m asked is why I chose to get my kids vaccinated. Here are just a few of my reasons why:

1. Vaccines are safe!

• Millions and millions of vaccines are administered every year with minimal side effects.
• The most common side effects are a low-grade fever, some redness around the vaccine site and maybe some muscle aches.
• Every vaccine went through the same process to ensure they are safe. Side effects and potential reactions are reviewed by multiple agencies including the Centers for Disease Control and Prevention and the Food and Drug Administration.

2. Vaccines are effective!

• Across the world, diseases like smallpox have all but been eradicated because of vaccines!

3. Vaccines save lives!

• Vaccines prevent diseases and illnesses that have serious consequences, even in otherwise healthy children.
• Vaccines prevent diseases that can lead to hospitalizations, pneumonia, potential hearing loss, potential loss of an arm or a leg, brain damage and even death.

4. Vaccines do not cause autism.

• Science and research has proven again and again that there is absolutely no link between vaccines and autism.

5. Vaccines are recommended by my kids’ own pediatrician.

• Vaccines are also recommended by the American Academy of Pediatrics, the American Academy of Family Physicians, the CDC and others.

6. Vaccines help keep my community safe.

• Vaccines protect more than just kids. They protect your child’s grandparents, their classmates, your neighbors, and the community at large.
• Vaccines can help prevent your child from spreading illnesses to at-risk individuals such as your parents who have diabetes, your child’s classmate who is undergoing chemotherapy for cancer, your neighbor who just received a kidney transplant or the cashier in the grocery store who has an autoimmune condition.
• We rely on everyone to get their vaccines to keep the community safe!

7. I want my kids to give their grandparents a big hug at Thanksgiving!

• My father has multiple medical conditions including rheumatoid arthritis and Type 1 Diabetes. We get our vaccines so every time we see him, my kids can run and give their Pap the BIGGEST hug in the world without worrying about giving him the flu!

If you have any questions or concerns about vaccines, please reach out to your pediatrician or primary care provider. We would love to talk to you more and answer all of your questions and concerns! 

Flu cases continue to increase at Cook Children's Health Care System. From March 13 to March 19, there were 275 positive cases of influenza A and zero cases of influenza B.

Positive flu cases have steadily increased every week since mid-January.

For the week of March 6 through March 12, lab data showed that there were 242 positive and 511 negative cases of influenza A. There were zero positive cases of influenza B.

By this time of year, typically cases decline.

“But what we have seen over the last week or two is cases are actually on the rise,” said Pediatrician Alice Phillips, M.D. of Cook Children's Pediatrics Cityview.

There has been more activity during the 2021-2022 flu season compared to 2020-2021. Typically, the flu season starts in November and the spike can be in December or January, Dr. Phillips said.

Why is there a current increase in cases? One potential contributing factor comes from people wearing their masks less frequently and returning to pre-pandemic activities. On Feb. 25, the Centers for Disease Control and Prevention issued new masking guidance for areas of low transmission of COVID-19.  These guidelines can be read here.

With students out of school for spring break, it could potentially stop the spike of cases, but pediatricians will have to wait and see the data when kids return to the classroom, Dr. Phillips said.

What are the symptoms? What should I do?

It’s a good idea to get your child tested if you believe they have the flu, Dr. Phillips said. The symptoms are similar to COVID-19 because both have symptoms of fever, cough and a sore throat. Both illnesses could potentially pose a risk to someone who is immunocompromised.

If you have the flu, you should isolate. You can stop isolating once you’re fever-free for 24 hours without fever-reducing medicine.

Common flu symptoms are:

• Fever or feeling feverish/chills
• Cough
• Sore throat
• Muscle or body aches
• Headaches
• Fatigue (tiredness)
• Vomiting and diarrhea are more common in children than adults

When should we go to the doctor?

“I think anytime a parent has a concern about their child, they should call their provider because if you're worried, your instincts as a parent are very strong,” Dr. Phillips said.

She said also it could be good to bring them to the doctor if:

• They’ve had a high fever that you can’t control
• Showing signs of dehydration, such as dry mouth, no tears in their eyes
• If your kid looks sick and you want them checked

Typically, a child can recover at home. You can call and get guidance over the phone if they’re keeping fluids down, and they’re resting and can control the fever.

Remember, it is not too late to get your flu shot. This serves as your best defense against the flu when combined with good handwashing.

As of Dec. 5, hundreds of children have been tested for flu and RSV at Cook Children’s Medical Center, and none have come back positive. Ramon Kinloch, M.D., a pediatrician at Cook Children’s, believes this has to do with social distancing and masking due to COVID-19.

“A lot of it does have to do with the precautions we have been taking for COVID-19. When we are wearing a mask, we are less likely to spread those respiratory droplets that transmit RSV and flu viruses,” Kinloch said.

Dr. Kinloch says another reason he believes there haven’t been cases is that people aren’t around each other as much right now. With limited contact with those outside of our family units, the physical spread of the virus’ droplets is less likely to happen.

Though there haven’t been any cases yet, Dr. Kinloch believes infections will begin to rise, especially with families gathering for the holidays.

“We are beginning to see people get a little more relaxed, especially with there being a COVID-19 vaccine on the horizon. With that, we will probably begin to see a rise in the flu and RSV numbers,” Dr. Kinloch said.

Dr. Kinloch explained that in years past, Cook Children’s typically sees a slow start and then a huge spike of infections, and he doesn’t expect this year to be any different.

If you believe your child has the flu or RSV, you should look for symptoms such as a fever for more than two or three days, body aches, running or stuffy nose, and coughing. For infants specifically, one sign that could indicate RSV is fast breathing and retractions.

Dr. Kinloch says differentiating between the flu, RSV and COVID-19 can be tricky. While the symptoms are very similar, one distinguishing factor is the loss of taste and smell, which primarily accompany the COVID-19 virus.

“If a child says, “I can’t smell anything,” we have to distinguish if that’s a stuffy nose or if they literally can’t smell or taste anything. If that is the case, we would more likely be dealing with a COVID-19 situation,” Dr. Kinloch said.

The only way to know for sure if you or your child has either illness is by getting tested. Dr. Kinloch says even testing has its limitations and it all comes down to when you get tested, what symptoms you have, and your exposure. He warns that each case is different and parents should always reach out to their physician if symptoms are worsening and fever will not break.

“They are with them and they know them better than we do. If a parent is uncomfortable with how their child looks or they have a gut feeling, it’s always important to call their doctor and have them evaluated. I believe that parents are equipped to know when something is wrong with their child,” Dr. Kinloch said.

So how do I know if my child needs to be seen? Call your pediatrician if your child:

• Has more than three or four days of fever (temperature over 100.4 degrees)

• Has any type of sustained and fast breathing

• Is lethargic or limp

Dr. Kinloch says his best advice is to ensure you’re following all CDC guidelines and to remember, it’s about keeping each other safe. He advises all families to get the flu vaccine, wash your hands, and be sure to remember the guidelines amid the pandemic.

Last week, eight children tested positive the flu at the medical center, according to Laboratory results from Cook Children’s. What’s interesting is that seven children tested positive for influenza B and only one for the A strain.

Morgan Pence, Ph.D., a clinical microbiologist at Cook Children’s, says this occurrence is a bit odd because the A strain usually precedes B. Pence adds that the majority of flu cases reported nationwide have been influenza B.

Since Sept. 29, 2019, the Centers for Disease Control and Prevention (CDC), found that 68.1% (289) of positive tests gathered from clinical laboratories nationwide were for influenza B.

The good news is Flu B is usually less severe than Flu A. The bad news is the flu season is just beginning. And while it remains to be seen what the flu season holds in store for the area, one thing is for sure: it’s time to get your flu shot.

“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 Diseases. “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.”

Speaking about the early flu season, the CDC reports:

• Nationally, flu activity is low and similar to what has been observed during recent previous seasons at the same time, but Louisiana and Puerto Rico are experiencing high levels of influenza-like-illness.
• Severe flu outcomes have been reported, including the first two pediatric deaths of the 2019-2020 season.
• Flu vaccination is always the best way to prevent flu and its potentially serious complications. Most flu vaccines protect against 4 different flu viruses. Get vaccinated now.

Other flu prevention tips include:

• Try to avoid close contact with sick people.
• While sick, limit contact with others as much as possible to keep from infecting them.
• If you are sick with flu-like illness, the CDC recommends staying home for at least 24 hours after your fever is gone except to get medical care for other necessities. Your fever should be gone for 24 hours without the use of fever-reducing medicine.
• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Wash your hands with soap and water. If soap and water aren’t available, use an alcohol-based hand rub.
• Avoid touching your eyes, nose and mouth. Germs spread this way.
• Clean and disinfect surfaces and objects that may be contaminated with germs like the flu.

The flu season is upon us once again ... what do you need to know as a parent?

1.What are symptoms of the flu?

The flu may start like the common cold with symptoms of cough, congestion and runny nose, but may also be associated with prolonged fever, muscle and body aches and fatigue. It is spread from person to person when an infected person, coughs, sneezes or talks and droplets are released into the air. It can also be spread less often from touching surfaces where drops are present. The flu virus is contagious from up to 1 day before the person presents with symptoms and up to 5-7 days after the symptoms resolve.

2. How can you protect yourself?

The best way to protect yourself is by getting the flu vaccine as soon as it becomes available. Most doctors’ offices and clinics currently do have the flu vaccine available. Last year, flu activity peaked at the end of December to the beginning of January, but you may start seeing it as early as September-October this year.

Other means to protect yourself are effective hand washing and wiping down surfaces with anti-bacterial/viral cleansers.

3. Why get the flu vaccine?

In the United States each year, more than 200,000 people are hospitalized from seasonal flu-related complications. Last year, there were more than 105 pediatric flu related deaths in the United States. On average the effectiveness of the flu vaccine last season was about 61 percent.

4. Who should get the flu vaccine?

• Everyone over the age of 6 months.
• Higher risk populations include those between the ages of 6 months to 5 years, children with asthma or other chronic disease, pregnant women, people with immune problems and adults  more than 65 years old.
• Children under the age of 8 MAY require 2 doses of the vaccine 4 weeks apart from each other depending on their previous immunization status.

5. Which flu vaccine is recommended?

There are several options for flu vaccines this year. For 2014–15, U.S.-licensed influenza vaccines will contain the same vaccine virus strains as those in the 2013–14 vaccine.

Trivalent flu vaccine protects against two influenza A viruses (an H1N1 and an H3N2) and an influenza B virus. This is only available in the injectable form.

The quadrivalent flu vaccine protects against two influenza A viruses and two influenza B viruses. The quadrivalent form is available as an injection and a nasal spray.

Specific Age Recommendations

• 6 months to 2 years: injectable flu vaccine only.
• 2 years to 8 years: nasal form is preferable according the Centers for Disease Control and Prevention (CDC). There was 50 percent more effectiveness with the nasal form vs. the injectable form in this age group. If the child is between the ages of 2 and 4 and has asthma or wheezed in the last year, then the injectable form is recommended.
• 8 years and above: either form is acceptable.

6. What happens if you get the flu?

See your health care professional as soon as possible because if it is treated with anti-viral medications in the first 48 hours, the duration as well as the severity of the illness can be decreased. The CDC does not recommend treatment of healthy individuals with anti-viral drugs, but certain high risk populations will benefit from treatment.