The first outbreak-related cases were reported on May 13 in Collin and Rockwall counties. Alice Phillips, M.D., director of ambulatory quality and safety, advises parents to be aware but not alarmed.

“These cases remain small in our region. If your children are vaccinated, nothing about activities needs to change,” Dr. Phillips said.

Cook Children’s Health Care System continues to work with local public health departments on any report of measles cases. The Texas Department of State Health Services in April recommended that children between 6 months to 11 months traveling to or living in an area with an active measles outbreak receive a vaccination.

Dr. Phillips explained that the best way to protect a child from measles is the MMR vaccine. One dose offers 93% protection, and two doses provide 97% protection against the virus.

DSHS has designated these counties as outbreak areas: Cochran, Dawson, Gaines, Lamar, Lubbock, Terry, and Yoakum.

Currently, the Tarrant and Denton County health departments, where Cook Children’s Medical Center – Fort Worth and Prosper are located, have not issued this recommendation.

“If that changes due to a rise in cases, we will update,” said Dr. Phillips.

However, Dr. Phillips noted that families planning to travel outside of the United States, should be aware of regions where the MMR and/or Hepatitis A, vaccine is recommended for infants between 6 and 12 months.  She encourages parents to check with their pediatrician.

“If your kids are vaccinated, they are safe and protected,” said Dr. Phillips.

Measles is highly contagious; one infected person can potentially infect 12 to 18 unvaccinated individuals. The virus spreads through infectious respiratory droplets and airborne transmission (from coughing or sneezing), where tiny droplets can remain suspended in the air.

 Measles symptoms typically appear seven to 14 days after infection. 

They can include:

• Rash
• Fever, sometimes over 104º Fahrenheit or 40 º Celsius
• Runny nose
• Cough
• Red, watery eyes
• Sore throat
• Tiredness

How do we stay safe?

The most effective prevention against measles is vaccination. The size of the virus makes it more contagious. Measles can live in the air in a room where an infected patient has been for two hours after that patient leaves.

This means that if ten unvaccinated children are in a room and one of them has measles, nine out of ten of them will likely catch the virus. 

In addition to getting vaccinated, the spread of measles can be mitigated by proper hygiene. This includes:

• Handwashing
• Covering your mouth and nose when you cough or sneeze
• Avoid sharing drinks or eating utensils
•  Disinfect frequently touched surfaces

What about other illnesses?

While Cook Children’s Medical Centers in Fort Worth and Prosper are not seeing an abnormal number of cases for RSV, COVID, and Flu, these illnesses can be prevented with proper hygiene as well.

It is important to speak to your primary care physician if you have any questions or concerns about vaccines. There are now vaccines to help prevent the severity of RSV, COVID, and Flu.

Where can you get immunized?
Here are a few resources and tips for finding a place to take your child for immunizations. 

• Check with your child’s doctor. Ask which vaccines are due and make an appointment. If your child needs a doctor, see our locations or call 211 for help. 
• Visit a public health vaccine clinic. Anyone from any county can call Tarrant County Public Health at 817-248-6299 to make an appointment or to find a walk-in clinic. 
• Check with your local school district for vaccine events. 
• Enter your zip code at Vaccines.gov to find other options. 
   

If a parent suspects their child may have measles, they should call the primary care doctor before arriving at the office so arrangements can be made for safety and to minimize potential exposure in the waiting room.

One of the best parts of the holiday season is spending time with the ones we love most. But amidst all the excitement and travel, it can be easy to overlook some crucial practices to keep your little ones safe and healthy. Whether you’re traveling down the road or across the country to visit loved ones, these tips will help keep you and your kiddos comfortable in transit. 

Things to Consider Before Getting Behind the Wheel 

What to know when it comes to navigating car seats, entertainment, and safety on the road.

1. Babies and young children should sit in an appropriate car seat in the backseat of the vehicle and always wear a seat belt. Infants and toddlers should ride in a rear-facing car seat until they reach the highest weight or height allowed by the car seat manufacturer. At that point, your child should ride in a forward-facing car seat. Find updated recommendations on safe travel here. If your child has outgrown their car seat with a harness, they should ride in a belt-positioning booster seat until the vehicle's seat belt fits properly—at a height of about 4' 9", or between 8-12 years of age. All children should ride in the backseat until they reach the age of 13.  
    
2. In cold weather, dress your baby in thin layers with a blanket over the top of the car seat harness straps if needed. Bulky clothing, including thick coats and snowsuits, should never be worn underneath the harness of a car seat.
    
3. Adults, remember to buckle up, too. Never drive under the influence of alcohol or drugs.
    
4. Point out interesting sights to keep your children from getting restless on a long road trip. You can also bring soft, lightweight toys, play your child’s favorite music, and stop for a break every two hours. There are many family fun games you can play while on the road. 
    
5. In addition to a travelers' health kit, pack some other essentials for the trip: safe water and snacks, child-safe hand wipes, diaper rash ointment, and a water- and insect-proof ground sheet for safe play outside.

Things to Consider Before Taking Flight 

From the security checkpoint to your seat on the plane, ensure you and your family have a smooth ride.

1. If you can, wait until your baby is 2-3 months old to fly. Crowded planes and airports can increase a newborn’s risk of infectious disease.
    
2. Allow your family extra time to get through security at the airport, especially when traveling with younger children. Have your kids wear shoes and outer layers of clothing that are easy to take off for security screening. Talk to them about the security process before getting to the airport, letting them know their belongings must be put through the X-ray machine and will be returned to them afterward. 
    
3. Remember that strollers can be brought through airport security and gate-checked to make travel with small children easier.
    
4. Arrange to have a car seat at your destination or bring your own along. Airlines will typically allow families to bring a car safety seat with no additional luggage expense but check your airline's policy ahead of time, so you know before you arrive at the airport. 
    
5. Ask if your airline’s “lap baby” policy will allow you to use an empty seat to install a car seat for your baby. Avoiding the busiest travel days and times will increase your odds of finding an empty seat next to you. Ideally, avoid seating your baby on your lap, as turbulence may make it physically impossible for you to protect them from injury. 
    
6. Place your baby or toddler in a child safety restraint (an FAA-approved car seat or airplane harness device) that is approved for your child's age and size and installed with the airplane's seat belt. Booster seats are not allowed on flights, and not all car seats are FAA-approved. Make sure your car seat says “this restraint is certified for use in motor vehicles and aircraft.”
    
7. Tuck infants under 20 pounds into a rear-facing car seat and children 20-40 pounds in a regular car seat. Children cannot use the airplane’s lap belt until they are at least 40 pounds. 
    
8. Look for rows with more space, like the bulkhead, and choose a seat close to the window, if possible. You want to make sure your little one is out of the way of hot beverages and carts coming through the aisle. To find an airline that ensures your child can sit next to you at no extra cost, visit the U.S. Department of Transportation Airline Family Seating Dashboard. 
    
9. Even on planes, practice safe sleep. If you have an infant sleeping on your lap, stay alert and check their breathing often. Make sure their face is uncovered so they can breathe easily. If your baby sleeps in a car seat or other device, make sure it is firm and flat, with no soft bedding. 
    
10. Wash your hands frequently and consider bringing hand-washing gel and disinfectant wipes to prevent illnesses during travel.
     
11. Consult your pediatrician before flying with a newborn or infant who has chronic heart or lung problems or upper or lower respiratory symptoms. 

Keeping Your Child Comfortable in Transit 

Prevent common stressors that often arise mid-air. 

1. Dress your little one in layers. This will help ensure your child is comfortable in the wide range of temperatures we often encounter on planes. Choose outfits that make changing diapers in a small space easy, and be sure to pack an extra change of clothes in case turbulence hits during changing or feeding.
    
2. Anticipate ear pain during takeoff and landing, when changes in pressure can cause pain and discomfort. If your child has had an ear infection in the last two weeks, ask their doctor if they are cleared to fly. Having your baby drink from the breast or a bottle, or suck on a pacifier, can help. If your child has a cold or ear infection, check with your doctor before administering a dose of acetaminophen or ibuprofen. 
    
3. Bring cotton balls, small earplugs, or noise-canceling headphones to reduce the level of loud jet engine noise your child is exposed to. 
    
4. If possible, travel at a time when your little one naturally sleeps. You might also try to put off naptime until it’s time to fly. Keep in mind that sleeping babies are easier for everyone!
    
5. Do not use Benadryl to help your child sleep without talking to your doctor. This medication can have serious side effects, especially if repeated doses are given on long flights. Once you get the go-ahead and correct dose from your doctor, try it at home first. Instead of getting sleepy, some children react to the medicine by becoming more awake. 
    
6. Pack toys and books to distract your kiddo. Be ready to play the entire flight, and if toys and books stop working, a tablet with videos can be a good backup.

When You Get Where You’re Going: Reminders from the American Academy of Pediatrics

1. Remember that the homes you visit may not be childproofed. Keep an eye out for cleaning products, medicines, unattended bags, small objects, and other dangerous items or areas that could be within reach for your kids.
    
2. Keep a list of important phone numbers you or your babysitter might need in case of an emergency. This list should always include the police and fire department, your pediatrician, and the National Poison Helpline, 1-800-222-1222. Laminate the list to prevent it from tearing or getting damaged.
    
3. Stick to your child's usual routines, including sleep schedules and nap times, to help both you and your little one enjoy stress-free celebrations. 

No matter where your travels take you, we hope you and your family enjoy a safe, healthy, and fun holiday!

As families start their summer traveling, water safety vigilance is key at all ages and no matter where your family might be. Swimming pools, lakes and beaches all pose risks but with the right preparation, you can avoid tragic outcomes.

“Many families stay on rental properties with pools and they may not have a pool at home,” said Sharon Evans, trauma injury prevention coordinator. “Knowing ahead of time what questions to ask and the kind of barriers to put in place lowers the risk of a drowning event.”

Cook Children’s has already treated 10 drownings so far this year, one of which was fatal. Parents need to remember that 70%  of toddler drownings happen during unplanned swim time. This is when parents didn’t expect their child to be in or around the water. 

Ensuring the pool is completely secure after swimming for the day is extremely important. Remove all toys and floats from the pool area so children are not tempted to get close to the water. For above-ground pools, make sure the ladder is removed and not accessible when it’s not swimming time.

Staying Afloat with the Right Life Jacket

Evans says it is not always a matter of strong swimming. Especially with murky water, your child could hit his head on an object underneath and quickly become disoriented. That is why life jackets are a must at lakes and beaches. Texas state law requires all children under 13 years old to wear a U.S. Coast Guard-approved life jacket on boats under 26 feet in length. With so many life jacket options, be sure you choose one that fits properly and is Coast Guard-approved.

A life jacket that is too big will cause the flotation device to push up around your child’s face but too small means it will not be able to keep your child’s body afloat. If there is excess room above the openings and the life jacket rides up over your child’s chin or face, it does NOT fit properly.

A snug fit in these areas signals a properly fitting life jacket. Do not buy a life jacket for your child to grow into – it must fit your child just right. Check the weight limits on the label – and try it on before getting in the water.

A Safe Day at the Beach

At beaches, pay close attention to the warning flags as they can change throughout the day. A red flag is a high hazard meaning high surf and/or strong currents. A yellow flag is a medium hazard meaning moderate surf and/or currents. A green flag is a low hazard meaning calm conditions, exercise caution. A purple flag means dangerous marine life spotted.

“The safest way to play at the beach is with a life jacket,” Sharon said. “Strong waves can come out of nowhere and pull a child down to the bottom causing you to quickly lose sight of them.”

Preparations to make before landing at your vacation spot:

• Check to see if the pool has barriers such as fencing.
• Ask if there are locks high up on doors leading to the outdoors and door alarms.
• Ask if there are dog/pet doors that have direct access to the pool area. Young children can fit through these doors without triggering the door alarm.
• Bring bright swimsuits for your children – choose swimsuit colors that do not blend into the body of water in which your child will be swimming. Light colors, like white or light blue, tend to blend into the swimming pool, making the child harder to see. Neon colors are more noticeable and contrast against the water at pools, lakes and beaches.
• When there are children around water, always designate a Water Watcher, an adult who is in charge of watching all children without any distractions.
• Pack water watcher tags for adults to wear at the pool.
• Refresh CPR and first aid skills.
• Bring portable door alarms and body alarms for additional layers of protection.
• Bring doorknob covers.

RELATED STORIES:

• What Color Is Your Child's Swimsuit? Experts Say Choose Safety Over Fashion (checkupnewsroom.com)
• Tips for Best Fit, Safe Practices for Wearing Life Jackets (checkupnewsroom.com)
• Pediatrician Shares Top Beach Vacation Tips (checkupnewsroom.com)
• Water Watcher Tag: 1 Item Can Help Prevent Drownings (checkupnewsroom.com)

With so many people out on the road, it means more opportunity for danger.

From Dec. 20 to Dec. 31, 2018, the Trauma Department at Cook Children's reports 17 children were admitted at the Medical Center for injuries related to motor vehicle crashes and an additional 29 children were treated and released after a visit to the Cook Children's Emergency Department. One wreck during that time frame included a fatality and a total of three children died during the entire month of December.

“Unfortunately, we've seen children die around the holidays," said Debbie Wheeler, a Child Life specialist for the Emergency Department at Cook Children's. "With other traumas, we’ve seen young kids live by the grace of being properly restrained in the correct car seat. I really want to encourage parents to travel safely this holiday season, especially for everyone in the vehicle to be buckled up appropriately. It is really sad to see a patient hurt and have injuries that could possibly have been prevented if they were in a car seat, a proper car seat, or a seat belt.”

Motor vehicle injuries are the leading cause of death among children in the United States. Many of those deaths could have been avoided if parents took the extra time to make sure their children were properly restrained.

Sharon Evans, Trauma/Injury Prevention outreach coordinator at Cook Children’s, says it’s extremely frustrating because she has seen wrecks where one child who was properly restrained lived and the other child not buckled died.

“Honestly, it’s just so infuriating,” Evans said. “These crashes are preventable. It’s because the adults in the car aren’t doing something that could save their child’s life. I don’t think people think it can happen to them. But it can happen to anyone. It breaks my heart because these are deaths that shouldn’t occur if people would just place their kid in the proper car seat and buckle them up with a seat belt."

Holiday Injuries Treated at Cook Children's (Dec. 20-31, 2018)

The Centers for Disease Control and Prevention (CDC) found that in one year more than 618,000 children ages 0-12 rode in vehicles without the use of a child safety seat or booster seat or a seat belt at least some of the time. Statistics show this is especially a problem for Hispanics in the community. Ninety percent of the ejections that have occurred since April 2015 were Hispanic.

“I think a lot of it has to do with our culture,” said Magdalena Santillan, Trauma Injury Prevention Specialist at Cook Children’s. “These are people who love their kids, and they want to hold their baby. A lot don’t want to hear their baby cry, and so it’s easier to hold their baby in the car. They are showing love, but the consequences are too high and can be a deadly mistake.”

Texas law states that “all children younger than 8 years old, unless taller than 4’9”, are required to be in the appropriate child safety seat system wherever they ride in a passenger vehicle. The safety seat MUST be installed according to the manufacturer’s instructions.”

That means that when a child reaches his or her eighth birthday – no matter their height, it is legal for the child to use only the adult safety belt in the passenger vehicle.

However, the Texas Department of Public Safety states on its website that best safety practice is: “if the child is not yet 4’9”, they are better protected if they continue to use the appropriate child safety seat system until they can fit properly in the adult safety belt.”

“From a safety standpoint, I encourage parents to follow the best safety practice guidelines,” Evans said. “Graduating to a seat belt too early does keep children in the car if they crash, but when the seat belt doesn’t fit properly, it can cause serious injuries. That is something else we are seeing right now at Cook Children’s – children in a halo brace for severe neck injuries because they were in seat belts too young and too early.”

Call 682-885-2634 to set up a FREE car seat checkup to ensure your seat is properly installed.