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 

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.

-----------------------------------------------------------------------------------------------------------------------------------------------------------------

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)

The doctor’s office should not be a Haunted House.

The “evil nurse” lurks around the corner with their pointy needle, ready to stab anyone who comes across their path.

We might as well put on some eerie music and serve hot chocolate.

Is your child afraid of shots? Are you?

Here are some things that you should NOT say to your child about shots:

1. “I promise you are not getting shots today.”
2. “If you don’t behave, you are going to get a shot today!”
3. “Shots don’t hurt.”

Why not? Recommendations change and sometimes we get our flu shots in early. Shots are live-saving, not punishment. Shots hurt, period. For some kids they seem to hurt worse than others, but pretending they feel great isn’t helpful.

Here are some easy ways you can help your child’s shot hurt less:

1. Prepare them - If you know they are getting shots, please let them know ahead of time but you don’t have to give them all the details either. “It will hurt but only for a second” is usually enough. You don’t have to go on to say, “It’s a little needle and they only stick it in this far and push this hard, blah blah blah.”
2. Distract them - You can talk to them, show them a movie, read a book; whatever takes their mind off of things.
3. Relieve them - As soon as everything is over, hold them. For babies, nurse or feed them.
4. Reward them - Stickers or stamps are my favorite rewards…why do kids love them so much?

About the author

Justin Smith, M.D., is a Cook Children's pediatrician in Lewisville . View more from The Doc Smitty at his Facebook page. He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joins Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.