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 

August is a chaotic month for any busy parent. Between back-to-school preparations and the last days of summer, it's easy to get overwhelmed. On top of that, August is also National Immunization Awareness Month—a perfect time to make sure your children are up-to-date on their vaccinations.

When people learn that I’m a pediatrician they often ask if my own two children are vaccinated and I always reply with a resounding yes. My children are vaccinated for several reasons: 

Vaccines are safe! 

• Every vaccine that is currently in use has gone through a rigorous testing phase to make sure that the vaccine is safe. Side effects and potential reactions are closely reviewed by multiple agencies at the federal level. Even after the vaccine has been approved, the Vaccine Adverse Effect Reporting System (VAERS) continues to monitor for additional side effects. 
• Millions upon millions of vaccines will be administered this year with minimal side effects. The most common side effects are low-grade fever, redness around the injection site or maybe some mild muscle aches. 

Vaccines are effective! 

• Vaccines have led to the eradication of previously fatal diseases like Smallpox. 

Vaccines save lives!

• Vaccines have saved the lives of nearly 200 million people in the past century. Many of those lives saved are of young children and babies. 
• Vaccines prevent diseases and illnesses that have serious consequences, even in 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. 

Vaccines do not cause autism. 

• Decades of research has shown again and again and again that there is no link between vaccines and autism. 

The ingredients in vaccines are safe. 

• Just as the individual vaccine is studied, the ingredients in vaccines are also rigorously studied. 
• Some vaccines contain ingredients like aluminum, which can be found in fruits and vegetables. Aluminum helps the body produce an immune response and is perfectly safe. 
• Vaccines can be preserved with very small amounts of formaldehyde, so small that it is not harmful at all. 
• These ingredients are like baking powder when you’re making cookies. By itself, baking powder does not taste good but in small amounts, it’s needed for your cookies to come out looking and tasting great! 

Vaccines are recommended by my children’s doctors.

• My kids’ pediatrician - along with the American Academy of Pediatrics, the American Academy of Family Physicians, the Infectious Disease Society of America, the American College of Physicians, the American Medical Association, and the American Nurses Association - all support routine childhood immunizations. 

Vaccines help keep my community safe. 

• My children are vaccinated because doing so protects them and our community. 
• 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 has a newborn at home, your neighbor who is undergoing chemotherapy for cancer, your co-worker 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. 

And the most important reason to me is that I want to protect my dad. My dad has type 1 diabetes and is immunocompromised. My kids will always get their flu vaccines every year so we can give him the BIGGEST hug without worrying about making him sick. 

So, this month, in between back-to-school shopping, meet the teacher nights and the ever-exciting first day of school, please call your child’s pediatrician and make sure that they are up-to-date on their vaccines. We would love to talk to you more and answer all of your questions and concerns! 

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As COVID-19 cases rise at Cook Children's, the Food and Drug Administration has approved an updated COVID vaccine.

The Centers for Disease Control and Prevention recommends that anyone 6 months and older should get the new shot to protect against serious illness.

COVID cases at Cook Children’s Medical Center have been steadily increasing since early July. From the week of Sept. 17 through Sept. 23, the positivity rate is 10% or 69 positive cases out of 679 patients tested.

The new vaccines from Pfizer and Moderna are matched to protect against the most common COVID variants circulating now. Please contact your pediatrician's office to schedule an appointment.

The fall and winter months are a common time for respiratory illnesses to spread in our community; in addition to COVID-19, there is typically a rise in flu and RSV cases.

Schedule you and your child’s flu shot as soon as possible to help prevent severe illness and spread of the flu.

Respiratory syncytial virus (RSV) is a common respiratory virus that usually causes mild, cold-like symptoms. It is the leading cause of hospitalization for infants, who are much more susceptible to the disease.

This year, infants will have a better chance of protection if they receive the new monoclonal antibody injection for the prevention of severe RSV, which has been shown to reduce the risk of hospitalization and health care visits in infants. This one-time injection was recently approved by the FDA and recommended by the CDC. The treatment will be available at Cook Children's pediatrician offices soon.

Laura Romano, D.O., a hospitalist at Cook Children’s Medical Center, answers some of the top questions from parents regarding these respiratory illnesses, treatment and prevention.

COVID

What are COVID cases like right now? Why should my child get the new COVID vaccine?

Positive COVID cases at Cook Children’s Medical Center have been steadily climbing since the end of June and early July. Across the country, there are higher rates of COVID hospitalizations in both adults and pediatrics. Your child should get a yearly COVID vaccination because we know that this will protect them. People who are vaccinated against COVID have a significantly decreased risk of hospitalization, ICU admission, and death.

What are the symptoms of most COVID cases right now?

Symptoms are mainly upper respiratory symptoms (cough, nasal congestion, sore throat). It’s also causing fevers, muscle aches, and fatigue. And yes, these symptoms are very similar to the flu! 

Should my children and I be wearing face masks? 

You should consider wearing a mask if you, your child, or anyone in your home is at high risk for severe COVID-19 infection. This includes people who are 65 years and older and people with certain medical conditions such as heart conditions, lung disease, diabetes, sickle cell, or a neurologic condition.

During flu, RSV, and COVID-19 seasons, it is very reasonable to wear a mask whenever you are in crowded indoor spaces. This includes pediatric office and emergency room waiting rooms!

My child is involved in many in-person activities this fall. What can we do to protect against COVID?

• Consider wearing a mask
• Get the latest vaccine
• Stay home if you are sick

My child’s classmate tested positive for COVID. What should I do?

• If your child is having symptoms, test immediately. If the initial test is negative, repeat in 48 hours if your child is still symptomatic.
• If your child does not have symptoms, wait five days and take another test.

If my child received a COVID vaccine more than six months ago, should they get the new vaccine?

Yes, they should! The CDC recommends that anyone 6 months and older who is two months out from their last COVID vaccine get the new vaccine.

Will it protect my child against the latest variant?

Yes, the newest vaccine was designed for the currently circulating variants so it should help protect your child.

FLU

What are flu cases like now? When is flu season?

Flu cases are currently low at Cook Children’s. Flu season typically begins in the late fall and stretches into the winter. However, last year we saw unprecedented numbers of influenza very early in the season.

Why should my child get a flu shot?

 Flu vaccines help protect against severe cases of the flu. If your child gets the flu vaccine, they may still get the flu, but they will have more mild symptoms and should not need to be hospitalized with a severe infection.

When will flu shots become available?

Flu shots are currently available at many Cook Children’s pediatrician offices. Check with your pediatrician’s office. Many local pharmacies have them as well.

RSV monoclonal antibody shot

What age groups can get the RSV monoclonal antibody injection?

Infants under 8 months during their first respiratory season and children who are at high risk up to 24 months of age. Talk to your pediatrician about your child’s risk, especially if they have a history of prematurity, heart disease, or chronic lung disease.

What should parents consider with this antibody treatment?

Our babies and infants are the most vulnerable population during cold and flu season so this will give them some protection and lower the chances of having a severe infection.

RSV can cause symptoms ranging from a runny nose to respiratory failure, requiring an ICU admission. It usually causes mild, cold-like symptoms, but it can be serious, especially for infants.

RSV causes bronchiolitis, which can be very serious and sometimes fatal in babies. The new antibody treatment has been shown to reduce the risk of hospitalization by nearly 80%, according to the CDC.

When will the new antibody be available?

The new antibody treatment will be available soon. For newborns, it may be given in the nursery prior to your infants discharge after birth. For older infants, families should reach out to their pediatrician about availability.

Will my child show symptoms once they receive the antibody shot?

Your child may still get symptoms of RSV after receiving the treatment but they are expected to be less severe.

Your doctor will monitor for any signs of a reaction during the infusion and after with your assistance.

How long is it effective?

Since this is an antibody and not a vaccine, it is designed to provide a temporary boost in immunity only. It will provide short-term protection lasting about 5 months which should cover the 2023-2024 RSV season.

If my child previously had RSV, do they have antibodies?

Yes, but the antibodies your body’s immune system makes to RSV last only two to three months. It is very possible for a child to get RSV multiple times in one respiratory season.

Related stories:

• Fighting RSV: Physicians Say New Antibody Shot Could be Game Changer 
• CDC Recommends RSV Shot for Infants. Infectious Disease Doctor Shares What Parents Need to Know 
• Curious About Health and Safety Requirements at Day Care? We Have Answers
  
   

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)

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)

Two children tested positive for the Influenza A virus from the week of Sept. 16 through Sept. 22, 2018, according to Laboratory results from Cook Children's.

For the week, 85 children were tested for the flu, with 83 tests coming back negative. Interestingly, the first case of the flu was confirmed during the same (Sept. 21) in 2017.

The goods news is that flu vaccines are available at our Cook Children’s pediatrician's offices now.

Getting the flu vaccine is one of the most important things you can do for your child this time of year. Yes, hand washing and avoiding ill contacts are good ideas but that’s not going to be what ultimately protects your child from flu.

No one likes getting a flu shot, kids and parents included, but it’s essential to your child’s health. Here are 5 important facts about the flu shot you should know:

1. Get your child the shot. The American Academy of Pediatrics is recommending flu shots for every child over 6 months of age. Children and elderly adults are the most at risk for serious illness, hospitalization and death from the flu. Children under 2 and those with chronic medical conditions are at higher risk, but healthy children are hospitalized and die from the flu every year!
2. Get your own flu shot. Getting yourself protected helps to prevent the spread of flu in your house. It will decrease the risk of you contracting it, even if someone in your house gets it … and taking care of sick kids while you are sick is one of the hardest things I’ve ever done as a parent. If you have a child under 6 months with whom you have frequent contact (who cannot receive the vaccination) it is extremely important.
3. Ignore any early data about the effectiveness of the flu vaccine. Last year, early data about flu vaccine effectiveness caused many to skip their shot. But, at the end of the year, protection rates ended up being average (and any protection is better than none). Just get it done.
4. Choose the injectable vaccine. Nasal flu vaccines will be available again at some offices this year. However, based on past years, I am strongly recommending that patients get the injectable vaccine. After giving nasal flu vaccine for years before studies showed it wasn’t working, I’m not taking that risk with my children or my patients until we know more about how it’s working over the next few years.
5. Go ahead and get your child scheduled. Pediatric studies have not shown a decrease in effectiveness during a flu season because of getting the shot done early. Getting the vaccine at least 2 weeks before the season starts is critical to making sure they are protected and we never know what vaccine supplies will be when the season hits.

All About the Flu

• Influenza (flu)
• Is it a cold or the flu?
• Is the flu vaccine a good idea for your family?
• Frequently asked questions about immunizations
• How can I comfort my baby during shots?
• Immunization schedule
• Is the Flu vaccine a good idea for your family?
• Your child's immunizations: influenza vaccine

“Vaccinations are still the best answer to preventing the flu and protecting your children from the upcoming season,” Dr. Whitworth said.

The flu shot is recommended for children ages 6 months and older. However, the Centers for Disease Control says only 47 percent of the nation’s eligible population received a flu shot. The only age group that met the CDC’s coverage goal of at least 70 percent was children 6 months to 23 months of age with 75 percent getting their shot.

It’s important for babies to get their shots beginning at 6 months of age. Flu shots are not approved for younger infants,” Dr. Whitworth said. “Because these younger babies cannot be protected by getting flu shots, their caregivers and household contacts must get theirs. If those individuals who are around the baby don’t get infected with influenza, the baby is much less likely to be exposed. It’s especially important for pregnant women to get their vaccines in order to protect their newborns.”

Last year, a lot of talk focused on how ineffective the flu vaccine was, with the CDC saying it was less than 23 percent effective against the dominant strain. The CDC says the vaccine will be more effective this year based on data from early detected cases.

Dr. Whitworth says it’s too soon to predict what the flu season will bring as far as severity and it’s difficult to say how effective the vaccine will be because different strains circulate each year. But vaccines are still the most effective way to fight against the flu.

During the 2014-2015 flu season, 145 children died in the United States from influenza-related illness and the American Academy of Pediatrics says many of those children had no underlying medical condition. The AAP states that an estimated 90 percent of pediatric deaths have occurred in unvaccinated children.

Two types of influenza vaccines are available for children this year, according to the AAP:

• The inactivated influenza vaccine (IIV) is given by injection and is approved for children 6 months of age and older. It is available in two types, one which protects against three strains and one which protects against four strains of influenza.
• Also available is the live attenuated influenza vaccine (LAIV), which is given by intranasal spray. It is approved for healthy patients 2 through 49 years of age and protects against four strains of influenza.

 The AAP also recommends:

• Everyone who is 6 months of age and older should receive annual influenza vaccine.
• Children ages 6 months through 8 years need two doses this flu season, if they have had less than 2 doses of flu vaccine before July 2015.
• Special efforts should be made to vaccinate household contacts and out-of-home caregivers of children with high-risk conditions, and all children under the age of 5.
• Parents should not delay immunization in order to receive a specific vaccine formulation. It is more important to be vaccinated at the earliest opportunity.
• Pregnant women, who are at high risk of influenza complications, can safely receive influenza vaccine at any time during pregnancy. This also provides protection for their infants during their first 6 months of life.
• Mandatory influenza immunization programs for all health care personnel should be implemented nationwide.

About the source

Mary Suzanne Whitworth, M.D. is the medical director of Infectious Diseases at Cook Children’s, which offers care for children and teens with diseases caused by bacteria, parasites, fungi or viruses. Our team provides a broad range of services including diagnosis, inpatient and outpatient consultations, immune deficiency evaluations and treatment of recurring infections.

The short answer is yes because your child is still more protected than without one.

Donald Murphey,M.D., medical director of Infectious Disease at Cook Children’s, was on a conference call with the CDC the morning of Thursday, Dec. 4, to discuss the advisory.

The dominant influenza strains at present in the US are influenza A, H3. There are two of these strains present this year:

• One is a good match for the vaccine currently in use.
• The second, accounting for about half of the samples tested, is a new flu A, H3 strain that was not seen until March 2014.

This new strain is not included in the current vaccine, but Dr. Murphey says it will likely be included in the vaccine for next year.

“This strain has drifted from other similar strains seen in the last few years. This new flu A could be associated with more severe influenza cases, and a more severe flu season in general, Dr. Murphey said.

But he stresses that parents and their children should still get a flu shot.

The CDC recommends:

• Treatment with antivirals for influenza more emphatically this season in hopes of preventing severe disease, hospitalization and death. Antiviral drugs are prescription medicines (pills, liquid or an inhaled powder) that fight against the flu in your body. Antiviral drugs are not sold over-the-counter. You can only get them if you have a prescription from your doctor or health care provider. Antiviral drugs are different from antibiotics, which fight against bacterial infections.

• Staying home if you have flu-like symptoms.

• Cover your cough.

• Frequent hand washing.

“We should still be using flu vaccine, as it is our best way to prevent this potentially serious illness,” Dr. Murphey said. “People's best chance of avoiding influenza and complications of influenza is to be immunized every year. That’s how we build up a community that can protect themselves from new strains, even when we did not have a vaccine for it yet.”

More resources:

• Six ways to protect your family from the flu
• The danger of the flu
• It's only the flu that killed her
• Fever, headaches and tummy aches: when you should be concerned
• Is your child afraid of shots?
• CDC's flu page
• What You Should Know for the 2014-2015 Influenza Season
• Seasonal Influenza Q&A

They worried about their children, but it was the standard concerns of most moms and dads. Could their children swim? Were their car seats the right fit?

One issue that didn’t cross their mind was the flu. After all, in 2004, healthy toddlers weren’t even supposed to get their flu shots. A lot’s changed since then, much of it because of the death of Emily Claire Lastinger.

“One thing that was never on our radar, not even in the tiniest way, was influenza,” Joe Lastinger said. “Emily had just started preschool at the time. She loved it. Her two older brothers were always so helpful with her. They loved her so much. Emily was advanced for her age and absolutely fearless. She was the kind of kid you dropped off on the first day of preschool and she was fine. She just ignored you and went on about her business.”

Emily was an active child, definitely not a “napper.” But she came home one day from school, tired and wanting to sleep. Her parents thought she might be sick, but didn’t think it was anything serious. The following day, the Lastingers took their daughter to their pediatrician. Tests determined Emily had the flu. Joe and Jen were told she needed rest. They should keep her at home for a few days and monitor her fever.

Over the next couple of days, Emily went back and forth from being listless to showing signs of her old self with bursts of energy. On Super Bowl Sunday of 2004, she showed signs of dehydration and was vomiting. They called their doctor again and made an appointment for 10 a.m. Monday morning.

Joe stayed home to help care for Emily because Jen’s pregnancy prevented her from lifting her daughter. As Joe went upstairs to make some work calls, he heard his wife screaming for her husband. As he bounded up the stairs he saw his daughter wasn’t breathing. After being taken to an emergency room at an area hospital in their Grapevine hometown, Emily was transferred to Cook Children’s.

“Once we got to Cook Children’s, it was all hands on deck,” Joe said. “But it was too late. When night approached, about 8 o’clock that evening, the doctors said Emily was really, really sick. They couldn’t detect any brain activity and they had exhausted what they could do.”

At around 10 p.m., the Lastingers said their goodbyes and a little while later their daughter’s short, little life ended.

“It was just a shock to us,” Joe said. “I know it’s always a shock for parents to lose their child, but we just couldn’t come to grips that she died from the flu – and it happened so quickly, in just five and a half days.”

The Lastingers still believed there had to be an underlying condition or cause for their daughter’s death, but the autopsy showed that she was a perfectly healthy little girl before she became ill from the flu.

Amazingly, as they grieved for the death of one daughter, the Lastingers rejoiced at the birth of another. Thirteen days after Emily’s death, Jen gave birth to Alea. The birth of a new child also gave them more resolve to make sure their children would be safe against the flu.

“Our eyes opened to what was happening nationally and the number of kids who had died of the flu,” Lastinger said. “We wanted to help all the kids, but we had to focus on our family first. We wanted to make sure our kids were going to be alright and it wasn’t something that ruined their lives. Our younger son Andrew was there at home when Emily died. That’s something you don’t want your kids to experience. We took care of our family then, but in the back of our minds, we knew we had to do more to help kids just like our own children.”

With their eyes now opened to the dangers of the flu, the Lastingers made it their mission to stop other parents from losing their child to the illness.

They reached out to doctors both at home and the Centers for Disease Control and Prevention (the CDC). The Lastingers learned that more than 150 children died of the flu in 2004. They met other parents who lost their children that year and they fought for changes to be made in treating children with the flu.

It’s shocking to realize how far things have come since 2004. Flu vaccines weren’t recommended for healthy kids in Emily’s age group 10 years ago. It was only recommended for children between the age of 6 months and 2 years of age, and for children with underlying health conditions like asthma.

“If it had been recommended then for our children to get their flu shots, we would have gotten them,” Joe said. “I got a flu shot. My wife got a flu shot when she was pregnant. But at that time, our kids had not been vaccinated. Reflecting on this now, it shouldn’t have happened.”

The Lastingers and others families who lost their children to the flu became advocates for children and formed Families Fighting Flu. Joe and Jen are among the founders of the group and remain board members to this day. They fought for universal flu shot recommendations and advocated for CDC to expand the recommendations for all children to receive flu shots. The expansion of the recommendation was huge because now flu shots are covered by many insurance companies.

Much has been done over the past 10 years, but Joe knows more needs to be done because children still die every year due to the flu and usually because those kids didn’t receive a flu shot or a flu nasal spray. He knows parents and children are busy, but Joe says to learn from what happened to his own family – get the flu shot.

The Lastingers tell their story today in hopes that people will get immunized against influenza. They’ve appeared on national shows like Good Morning America and Anderson Cooper 360. They have received cards and letters from people all over the world thanking them for telling their story.

Although nothing can take away the pain of losing their daughter, the Lastingers do take comfort knowing that Emily’s story may save the lives of other children.

“We think about our daughter all the time,” Joe said. “She was here for such a brief time and didn’t have the impact on the world she probably would have had. Who knows what she might have done with her life. We try to make a difference and hope that it makes a positive impact on the world like we think Emily would have made if she was still with us. I do feel like we’ve made a difference. I would love to see 100 percent of kids in our country have the flu vaccine and have 0 children die of the flu. We aren’t there yet, but I think we can get there.”

Perhaps the biggest impact their older daughter’s death made was preparing the Lastingers to deal with Alea’s diagnosis of leukemia when she was almost the identical age of Emily.

“I remember one of the doctors saying you are so calm,” Joe said. “In retrospect, we were. We thought if Alea does have cancer, at least this time we know we can do something about it. It shaped our attitude in such a positive way. Yes, cancer was horrible and painful. But it wasn’t the worst thing that happened to our family. We knew we could survive this.”

Today, Alea is doing great. She’s in the gifted and talented program at her school and playing in multiple sports at a high level.

The Lastingers have battled two diseases in their lifetime and although flu took the life of one of their daughters, they aren’t giving up on the fight.

Fever, headaches, joint and muscle aches, weakness, fatigue, diarrhea, vomiting, stomach pain and lack of appetite.

Over the next few months, many children will have these symptoms and many parents will, and should, call their Cook Children’s pediatrician because of how their child’s feeling.

Unfortunately, many parents will assume the worst … Ebola. But the chances of that being a reality are extremely low. While knowing it’s not likely to be Ebola may be a relief, it’s important to remember that Ebola is not the only dangerous virus on the horizon for our children. The symptoms listed above are much more likely to be the flu.

Investigation of 25 outbreaks of Ebola over 38 years has shown that only direct contact with a person with Ebola would cause someone to become infected. Right now, there’s no approved vaccine to limit the epidemic in West Africa.

On the other hand, influenza can be deadly. The 2013-2014 flu season led to 108 pediatric deaths in this country. The flu is spread readily through the air by small droplets which can be infectious to someone near a person who is coughing and sneezing and is much more easily acquired and easily prevented through vaccination.

Please make sure to get your children the flu vaccine and parents should get them too! ASAP. Both injection and nasal mist vaccines are effective.

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.