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 

“Because of the sensitive nature of the information, we can’t share any other details, other than to say that the child had underlying health conditions,” said Tarrant County Public Health Director Vinny Taneja. “The patient tested positive for Influenza B which is circulating early and predominately this season.”

Tarrant County Public Health stated there has been a “sharp rise in flu activity this season, trending nearly a month ahead of the previous two years.”

Taneja added, “We want to remind everyone to get their flu shot. It’s definitely not too late, and the vaccine offers you the best protection against the flu.”

Last week at Cook Children’s (Nov. 24 through Nov. 30), 964 children were tested for the flu at the medical center. Of those children, 231 tested positive for Influenza B and 24 more for Influenza A.

“The flu vaccine is still the best form of protection we have to fight off getting sick,” said Justin Smith, M.D., a pediatrician at Cook Children’s in Trophy Club. “The vaccine is especially important for children aged 6 months to 5 years. They are at the highest risk for serious flu-related complications, including death. Even if you do get the flu, people who are vaccinated generally get a milder and less dangerous form of the illness.”

You may remember the spray shot wasn’t previously available for children because it didn’t work as well. The newer versions appear to work as well as the shot. So the vaccine can be given this year either by a shot or nasal spray, depending on the child’s age and general health. Both protect against four types of influenza viruses: Influenza A (H1N1), Influenza A (H3N2) and two influenza B viruses.

The nasal spray is approved for use in people 2 years through 49 years of age. People who are pregnant or have certain medical conditions (such as asthma) should not receive the nasal spray influenza vaccine.

Based on guidelines from the CDC and the American Academy of Pediatrics, people with egg allergies no longer need to be observed for an allergic reaction for 30 minutes after receiving a flu vaccine. It is now recommended that people with a history of severe allergic reaction to egg (any symptom other than hives) can now be vaccinated in an inpatient or outpatient medical setting, under the supervision of a health care provider who is able to recognize and manage severe allergic conditions.

"All children with egg allergy of any severity can receive an influenza vaccine without any additional precautions beyond those recommended for all vaccines," the AAP wrote in the September 2018 edition of Pediatrics as part of its "Recommendations for Prevention and Control of Influenza in Children, 2018-2019."

Backing up the AAP and CDC, is recent research in the Annals of Allergy, Asthma and Immunology, which found the flu shot to be safe and recommended its use for people who are allergic to eggs.

Jason Terk, M.D., a Cook Children’s pediatrician in Keller, said previous recommendations on egg-allergic individuals not receiving a flu vaccine were based on the fact that most of the flu vaccine currently available is created from viral cultures in chicken embryos. Experts theorized there was a risk because of the concern that small amounts of the egg that the viral cultures come from could end up in the vaccine.

“After years of study and observation, it was found that no significant increased risk for reactions occured in egg-allergic people,” Dr. Terk said. “The recommendation to avoid flu vaccine for egg-allergic people has been removed. No medical intervention is without risk. But the risk of influenza and the complications arising from it far exceed the infinitesimal risk of influenza vaccination.”

If you have concerns, Dr. Terk said your pediatrician should be happy to answer questions about your child and why the flu vaccination should be given.

Influenza, commonly known as "the flu," is a highly contagious viral infection of the respiratory tract. It affects all age groups, though kids tend to get it more often than adults.

Flu A usually arrives prior to the B strain and is usually more severe than Flu B.

Of the 1,141 children tested last week, 484 tested positive for Flu A, 165 had RSV and none had Flu B.

The good news is that this flu season is currently lower than in previous years.

By this date in 2014-2015, more than 2,100 kids had tested positive at the medical center. By the end of last season, there were more than 3,000 kids who had tested positive.

To date this season, there have been a total of 1,395 positive tests.

Morgan Pence, Ph.D., a clinical microbiologist at Cook Children’s, says we are most likely to have a flu season similar to 2014-2015.

“It’s not clear if this flu season has peaked, but if it hasn’t yet, my guess is that it will peak in the next week or two,” Pence said.

Although the numbers are a bit lower than previously, Cook Children’s pediatricians are prepared to be busy over the next couple of weeks once the holiday break is over and kids return back to the classroom to share their germs with one another.

“We typically see an uptick in flu A a couple of weeks after kids go back to school following the winter break,” said Jason Terk, M.D., a pediatrician at Cook Children’s in Keller.

Dr. Terk stresses that the lower numbers right now may not mean an increase in flu cases in the near future.

"This isn't a guarantee that the total numbers will be lower," Dr. Terk said. "We could still have a later arriving season than we've had in the past and right now we don't know how long the season will last."

Flu Prevention Tips

Along with the vaccine and flu antiviral drugs if prescribed by a doctor, the CDC recommends these everyday preventive actions to stop the spread of germs:

• 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, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone for 24 hours without the use of a 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 often with soap and water. If soap and water are not 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.

“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 Disease. “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.”

Only time will tell for sure, but a new article published in The New England Journal of Medicine makes the case for a potentially severe influenza season.

The article explains that clinical experts have been watching the Southern Hemisphere, which recently went through its “flu season,” for signs of what might be in store for us in the north.

Australia saw record-high amounts of flu cases. The number of notifications reached 215,280 by mid-October, easily beating the mark of 59,022 cases during the 2009 H1N1 influenza pandemic.

Of special concern to the experts is the type of flu seen in Australia - Influenza A (H3N2). H3N2 is a more dominant strain of the flu and can cause more severe illness.

What makes this news worse is that the vaccine used in Australia, the same one used in the United States, was only 10 percent effective in preventing H3N2.

Last week, 33 kids tested positive for the flu at Cook Children’s and 28 of those cases were Flu A.

The article asks whether our current vaccines can be improved, but also stresses that immunization is still our best defense against the flu right now.

“However imperfect, though, current influenza vaccines remain a valuable public health tool, and it is always better to get vaccinated than not to get vaccinated,” the authors of the articles write.

The Centers for Disease Control and Prevention (CDC) estimates that influenza vaccination averted 40,000 deaths in the United States between the 2005–2006 and 2013–2014 seasons.

Still, the vaccine has a rate of between 50 to 70 percent effectiveness against other strains of the flu and people who are vaccinated generally get a milder and less dangerous form of the illness.

“The vaccine strains are chosen about nine months before flu season, based on circulating strains around the world by epidemiologists who are geniuses and do this for a living,” said Mary Suzanne Whitworth, M.D., medical director of Infectious Diseases . “They are not perfect, but they are very good.”

Even when the vaccine is a perfect match to the influenza virus that a person is exposed to, there are other factors in play. The child or adult who receives the vaccine has to be a “good host” and their immune system has to respond to the vaccine and develop protection.

“This does not always happen if the vaccine recipient has a weak immune system or is on medications that inhibit their ability to respond to the vaccine, or other things we don’t understand yet scientifically,” Dr. Whitworth said. “We do know that thousands of deaths nationally are prevented every year by vaccination against the flu. It is important to note that although the vaccine has known side effects that are similar to all vaccines given, side effects are mild and uncommon. Serious side effects are very rare.”

Even more importantly, Dr. Whitworth stresses a person cannot get the flu from the flu shot. They may feel achy for a day or two but that is very different from being in bed with high fever for a week with true influenza infection.

“The flu season has definitely arrived in the Fort Worth area and the time to get vaccinated is now,” Dr. Whitworth said. “I am vaccinated every year by choice and my adult children choose to be vaccinated yearly also.”