Texas surpassed its number of hot car deaths from 2024 on July 14, according to the Texas Department of Health Services (DSHS). A sixth and seventh fatality was reported in August in North Texas.

The increase contributes to the more than 20 hot car deaths reported nationwide this year as of August 26. Vehicular heatstroke is the second-leading cause of vehicle-related deaths in children under 15, trailing only car crashes.

Experts from Cook Children's Health Care System, Viviana Esparza, program coordinator at the Center for Community Health, and Sharon Evans, trauma injury prevention manager, emphasize the preventable nature of these tragedies.

“It can happen to anyone but it is 100% preventable,” Esparza said.

She notes that 52% of hot car child deaths occur when a child is forgotten. According to kidsandcars.org, parents can suffer from exhaustion due to lack of sleep, stress, and changes in their normal routine. Any one of these can cause a parent or caregiver's memory to fail at a time when you least expect it.

“Parents need to realize this can happen to anyone,” Evans said. “They aren’t bad parents but they get distracted or there’s a change in their routine. Make it a habit to put something you need in the back seat with the child.”

Twenty-five percent of hot car child deaths are due to a child gaining access to an unlocked vehicle or a child getting the keys. Evans recommends teaching toddlers and preschool-aged children to honk the horn if they become trapped, enabling them to draw attention to the vehicle.

Esparza says the third most common is knowingly leaving a child in a vehicle for a quick errand. DSHS emphasizes that a cracked window does not protect a child or pet from heatstroke.

“A car heats up about 20 degrees in 10 minutes and the temperature just keeps growing after that, often reaching 130-140 degrees in 30 minutes to an hour,” Evans said.

Esparza encourages families to remember the acronym A.C.T. to prevent heatstroke:

• A: AVOID heatstroke and other heat-related injuries by never leaving your child alone in a car, not even for a minute. When the vehicle is at home, keep the doors locked and keys or key fobs out of a child's reach.
• C: CREATE reminders. Place an item you need, such as a bag, wallet, or cellphone, in the back of your car or next to your child. This is especially important if you're not following your normal routine. If your child is with a care provider, ensure vehicle-related procedures are in place, such as vehicle searches or locking vehicles when not in use. Use technology to your advantage and use apps or other communication methods to stay connected with your childcare provider.
• T: TAKE action. If you see a child alone in a car, call 9-1-1. Emergency personnel want you to call, and they are trained to respond swiftly to these situations. One call could save a life.

As of Tuesday, April 8, the Texas Department of State Health Services (DSHS) reports 505 cases and 57 patients hospitalized. Of the 505 confirmed cases, 495 are either unvaccinated or their vaccination status is unknown. No cases have been reported at Cook Children’s Medical Centers in Fort Worth or Prosper.

Cook Children’s Health Care System, through Marc Mazade, M.D., medical director of infection prevention and control, and Alice Philips, M.D., director of ambulatory quality and safety, explained what this means and what families should know.

The measles virus is highly contagious and can remain in the air for up to two hours.

“If the children at Great Wolf Lodge (during the exposure dates) were vaccinated then only observation is needed,” Dr. Phillips said. “Vaccination provides excellent protection and these kids have little risk to develop measles.”

Dr. Mazade explained that if a child visited either of these locations during the exposure period and was not vaccinated, they should watch for symptoms related to measles.

“Parents should watch for fever, congestion, cough, and red eyes and development of a rash,” Dr. Mazade said.

There is a 21-day incubation period, which means a child could develop the measles during that time. Children who develop any symptoms during that period should contact their doctor.

Dr. Mazade explained if symptoms develop, the family should keep the child at home and call their primary care physician.

Cook Children’s primary care clinics and neighborhood health centers can do testing on site for existing patients. 

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.

“Parents should not hesitate to call their primary care physician for any questions,” Dr. Phillips said. “We are here to answer them.” 

Cook Children’s Health Care System continues to work with county health departments where clinics, medical centers and urgent cares are located.

DSHS recommendations

DSHS released new guidelines Monday now recommending children living in Cochran, Dallam, Dawson, Gaines, Garza, Lynn, Lamar, Lubbock, Terry, and Yoakum.

Infants
Immediately administer an early dose of measles, mumps, and rubella (MMR) vaccine for infants aged 6-11 months.

Children
Administer a second dose of MMR vaccine for preschool-aged children aged 1 to 4 years who received one prior dose.

Children at least one year of age with no documentation of vaccination history should receive two doses at least 28 days apart.

Adults
Administer a second dose of MMR vaccine for adults who received one prior dose.

Adults with no documentation of vaccination history should receive two doses at least 28 days apart.

Dr. Phillips advised parents that while this does not include Tarrant County, families should watch for any updates to this recommendation and discuss any questions or concerns with their doctor.

Where can you get immunized?

Vaccinations and immunizations 
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. 
   

What are symptoms of measles?

Measles symptoms typically appear seven to 14 days after infection. They can include:

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

Following the initial symptoms, a rash will develop that starts on the forehead and spreads down the body and out to the hands and feet.

Related Stories

What Parents Need to Know About the Measles Vaccine
Proactive Protection: Cook Children's Measles Response Plan
Cook Children's Addresses Rising Measles Concerns
Measles FAQs: What Parents Need to Know
Measles and Community Health 

We thank all doctors worldwide and the incredible physicians at Cook Children's Health Care System for their dedication and contributions. At Cook Children’s, our doctors do more than just fix boo-boos. They give hope and high-fives to little ones and their families. The work they do every day makes a difference in the lives of children.

Slime-A-Doc 2025

Ahead of National Doctors' Day on Sunday, March 30, we celebrate our doctors with some slime! 

On Thursday, Cook Children's employees, patients, and patient families helped us celebrate with some slime at our annual Slime-A-Doc. We had six categories of participants: doctors, nurses, child life specialists, advanced practice providers, volunteers, and members of our administrative team. Watch the Facebook Live here. 

Thank you to everyone who participated! A big shout-out to the Facility Appearances team, and our incredible host, Kimberly Johnson, for making this event possible!

Congratulations to each of our winners:

Administrative Staff: Orlando Chapa, Vice President of Nursing and Patient Care

Child Life Specialists: Erin Reid, CCLS

Volunteers: Steve Stelter

Nurses: Courtney Campbell, RN

APPs: Jay Pearson, PA-C, NP/PA

Physicians: Hector Grajeda, M.D., F.A.A.P.

Five years later, we reflect on all that has occurred and changed since March 4, 2020. We asked Cook Children’s employees to reflect on their experiences during the COVID-19 lockdown and how they experienced growth, loss, and change.

El martes, Cook Children's Medical Center en Fort Worth atendió 572 pacientes en el departamento de emergencia. En los siete Centros de Cuidado de Urgencia hubo 842 pacientes. Entre el 10 de noviembre y 16 de noviembre Cook Children's Medical Center en Prosper evaluaron a 113 pacientes por Virus Respiratorio Sincitial (RSV, por sus siglas en ingles) y 29 resultaron positivos.

Cook Children's Medical Center en Prosper también ha notado un gran volumen de pacientes en la sala de emergencia. La mayoría de los pacientes admitidos ha sido debido a VRS, influenza o neumonía.

El aumento de las visitas al hospital se debe a una fuerte propagación del VRS y neumonía ambulante (mycoplasma pneumoniae) en Dallas-Fort Worth.

Cada año por estas fechas, los casos de VRS aumentan más rápidamente de lo habitual este año, dijo El Director Médico de Servicios de Emergencia, Dr. Taylor Louden.

"Hemos visto a más de 1,100 pacientes en los últimos dos días a través de la sala de emergencias, y ha sido es muy difícil para nosotros manejar este volumen de una sola vez", dijo Louden.

De los 972 pacientes examinados en Cook Children's Medical Center entre el 10 y el 16 de noviembre, el 39% de los niños tenían VRS o neumonía ambulante. De ellos, 224 dieron positivo para el VRS y 99 resultaron positivos para neumonía.

¿Qué es el VRS y cuando debo de ir a la sala de emergencia?

El VSR generalmente afecta más a niños menores de dos años y puede causar una acumulación de moco y congestión que dificulta la respiración de los niños. Los padres deben tomar precauciones para limitar la propagación del virus. Quédese en casa si están enfermos. La vacuna contra el VRS está disponible para mujeres embarazadas, bebes, y personas mayores.

Si su hijo está enfermo, los padres y cuidadores pueden ayudar a reducir el estrés en el sistema de servicios de emergencia sabiendo cuándo llevar a su hija a la sala de emergencia y cuándo programar una cita. Limitar el tráfico de la sala de emergencias a verdaderas emergencias ayuda a evitar que el sistema se sobrecargué.

Si su hijo está enfermo, pero no tiene problemas agudos, consulte con su pediatra. Si es posible, programe una cita con unos de los Centros de Cuidado de Urgencia en lugar de visitar la sala de emergencias.

El tratamiento para el VSR es monitoreando y tratando los síntomas. No hay cura para el virus. Muchas enfermedades respiratorias virales se pueden tratar en casa con descanso, hidratación y electrolitos. Para la congestión, los padres y cuidadores pueden usar solución salina nasal para diluir la mucosidad y succionarla con una pera.

¿Qué es neumonía ambulante?

Desde el verano casos de neumonía ambulante han estado alto, dijo Louden. Entre el 10 y el 16 de noviembre, 99 niños resultaron positivos para la enfermedad. A comparación del año pasado, durante la misma temporada, Cook Children's reportó menos de 10 de casos de neumonía ambulante entre agosto y diciembre.

La neumonía ambulante suele afectar a los niños en edad escolar. Algunos de los síntomas incluyen: fiebre leve, fatiga y tos. La mayoría de los casos de neumonía atípica se pueden tratar con antibióticos, pero si su hijo tiene neumonía y ha tenido fiebre durante más de cinco días y/o dificultad para respirar, busque atención de emergencia.

La neumonía, el VRS, la gripe y el COVID-19 pueden tener síntomas similares. La gripe y el COVID-19 también pueden incluir dolor de garganta, dolores de cabeza, dolores corporales, escalofríos y cambios/pérdida del gusto y el olfato. Los padres no deben acudir a atención de urgencia ni al departamento de emergencias para hacerse una prueba de RSV, gripe o COVID. Su pediatra puede realizar pruebas para todos estos.

En muchos casos, los médicos pueden evaluar y tratar a un paciente mediante una cita de salud virtual. Descargue la aplicación MyCookChildrens para programar una cita virtual de salud/telemedicina aquí.

¿Cuándo acudir la sala de emergencia?

•  La temperatura mayor de 100.4F o 38°C en bebes menores de dos meses, es una emergencia médica.
•  Si su hijo tiene fiebre por más de tres días, comuníquese con su pediatra o el centro de cuidado de urgencia.
• Preocupación por deshidratación.  En bebes deshidratados habrá menos pañales mojados o falta de lágrimas. La fontanela hundida puede ser un signo de deshidratación.   
• Su hijo está respirando inusualmente rápido y se puede ver la piel entre las costillas.
• Su hijo requiere más su inhalador de rescate o los síntomas de asma empeoran

Síntomas

Síntomas de Virus Respiratorio Sincitial (RSV, por sus siglas en ingles) en bebes menores de 6 meses:

• Irritabilidad
• Letargo
• Apetito reducido
•  Episodios en donde dejan de respirar
•  Fiebre

Síntomas en bebes y niños mayores de 6 meses:

• Mocos
• Congestión
• Apetito reducido
• Tos
• Estornudos
• Fiebre
• A veces sibilancias

¿Cómo prevenir?

•  Nunca es tarde para vacunarse. Llame a su pediatra para obtener la vacuna contra el COVID-19 y la influenza.
• Adopte buenas prácticas de higiene como cubrirse al toser y estornudar.
•  Lavarse o desinfectarse las manos a menudo.
•  Limpiar las superficies que se tocan con frecuencia.
•  Si usted o su hijo se sienten mal, quédense en casa para prevenir la propagación de enfermedad. Tome tiempo para descansar y manténganse hidratado.

2. Fifteen-20 percent of kids WITH NO SYMPTOMS AT ALL will be POSITIVE FOR STREP if tested. This means 15-20 perecent of kids are strep “carriers.” A tiny amount of strep lives in their throat all the time, and it doesn’t make them sick. Let that sink in a moment. Think about all the unnecessary antibiotics kids are getting!

3. The most common symptoms of strep throat are a sore throat, fever and swollen glands in the neck. I also see kids get nauseous, have stomach aches and headaches. It’s odd – sometimes their only signs are fever and vomiting or nausea and a headache.

4. Sometimes, strep comes with a rash. We then call it “Scarlet Fever” and it is no more dangerous than just plain strep throat. Someone just gave it a cool name and then we get to feel like we are living in that computer game “Oregon Trail.”

5. Most people look at the back of the throat to see if their kiddo has strep. I don’t look there – that’s typically where drainage from the nose causes bumps and other changes. When I look for strep, I look at the tonsils and the ROOF of the mouth – the arch over that dangly thing (the uvula) to see if there are dark red spots.

6. If your child has congestion, coughing, a runny nose, watery eyes and/or diarrhea, she most likely doesn’t have strep. Chances are it’s just a cold or some allergies – and postnasal snot drip is the most common cause of sore throats in my office.

7. Strep is passed from kids to kid through “large respiratory droplets.” Yum. This means kissing, sharing drinks or food, or a sneeze or a cough either lands directly on another kid’s hand which then they put that hand in their mouth, nose, or eyes. Or, the drops land on a surface and another child touches it and touches their face somehow.

8. If you are a strep carrier, you don’t have much strep in your throat. It’s enough to catch on a strep swab, but not enough to fly out of your kid’s mouth and onto things and people (ew). Also, these bacteria aren’t as “mean” as typical strep bacteria are. So you aren’t really very contagious at all. And with 15-20 percent of kids being carriers, many of us live with them on a daily basis and are just fine.

9. I always talk with incredulous parents in the office about how “the strep came right back” after finishing antibiotics. They finished treatment and then the fever and sore throat hit again, and the test is positive again. I call these kids “strep bounce-backs” and it’s more common than you think. It doesn’t mean anything went wrong, and there are lots of explanations. Sometimes there are a lot of kids in the class passing it back and forth, and getting treated at different times. Sometimes, it is because the bacteria is hiding deep inside the tonsil folds and the antibiotic had a hard time reaching it. Changing up the antibiotic, or just repeating a course, can help it go away.

10. You can get over strep on your own, without antibiotics. Isn’t that amazing? Our immune systems are awesome. BUT, we like to treat strep with antibiotics anyway. Why? Because it makes you feel better sooner. It makes you less contagious to others (you are no longer contagious 12 hours after the first dose of Amoxicillin). And it can prevent the VERY rare complications we see with strep – when strep attacks the heart (acute rheumatic fever).

Hope this helps you to better understand strep!

❤️Dr. Diane

It’s not about being rude or even shy, it’s just he wants to make darn sure the love is spread around for the people that make up the Neuro-Oncology Program at Cook Children’s.

“That’s probably the reason why I don’t like to do these interviews! I don’t want the attention on me,” Dr. Murray said. “The bottom line is the kids and the team that takes care of them. It’s not me. There has to be a leader. I understand the hierarchy that has to be there. I accept that, but begrudgingly. I am proud of our Neuro-Oncology team. We are truly interchangeable in so many ways.”

This is not just humble speak on Dr. Murray’s part. A large part of the reason he became Medical Director of Neuro-Oncology is because one of his gifts is to build a solid, capable team that he empowers to do their work to the best of their ability.

When asked to talk about Dr. Murray, Mandy Mansell, the nurse practitioner for the Neuro-Oncology Program, says she’s “surprised he is letting you do a story on him.” Mansell praises Dr. Murray as a teacher and says he’s “constantly looking to work his way out of a job by training his staff to function so well.”

Dr. Murray is fond of saying if he gets hit by a bus, his team of Mansell, Neuro-Oncology Nurse Ashleigh Hines and Kelly Rand, the team’s social worker, could step right in and do his job.

“No other team of medical providers can say that they have educational support like we do,” Mansell said. “He does trust us implicitly and values our gut instinct/experiences, because he has taught us those things. He doesn’t view himself as the leader, but more as just another member of the team. Our structure flows naturally out of this. Communication is fluid and immediate because we all contribute to the turning of the wheel in Neuro-Onc. He is constantly telling us that we don’t need him or that we ‘run the program.’ This is validating and continues to make us want to work hard.”

Communication is key for Dr. Murray. Watch him throughout the day and you’ll find him on his phone or on his computer. He’s either e-mailing his co-workers on patient care or checking with colleagues across the nation on the best way to handle a case. He’s also there for those same colleagues when they need help from him.

Dr. Murray jokes that he texts with the neurosurgeons throughout the day like they are teenagers, but adds they are in constant contact for the very serious reasons of making sure they are providing the best care possible for their patients.

“Dr. Murray has been an invaluable addition to our Neurosciences team,” said John Honeycutt, M.D., medical director of Neurosurgery at Cook Children’s. “He has spearheaded our Neuro-Oncology program. Jeff works very closely with us about each individual patient. We have continuous back-and-forth conversations, with emails and texts at the time of diagnosis and initial treatments (surgery) and after care. He readily assumes responsibility for each patient and immediately has his Neuro-Onc team start working on appointments, follow-up, treatment plans, etc. This easy communication with his colleagues allows seamless transition of care and provides personalized care for each patient and their family. Families love the thoroughness and honesty that Jeff brings.”

Linda Margraf, M.D., a pathologist at Cook Children’s, says no one goes as far as Dr. Murray to make sure everyone is kept in the loop of patient care. He doesn’t just send a piece of tissue or wait for the scan to come back. He sends as much background as possible to the pathologists to help them before they even look at the microscope.

He sends emails to Pathology to inform staff of details about an upcoming tumor surgery including the radiology findings and any significant clinical concerns. He visits the team with any special issues and when time allows, he will present patient cases at the Neuro-Oncology tumor board prior to tumor surgery so the pathologists can review the images and hear about plans and concerns of the neurosurgeons regarding the case.

“For some types of tumors (and many other conditions), knowing what the imaging studies show is quite important in rendering an accurate pathology diagnosis,” Dr. Margraf said. “His approach also improves communication between the various specialties, both during the tumor board conference and after. He always emphasizes how much Neuro-Oncology is a team effort and all caregivers, not just the pathologist, benefit from this approach. I think this truly optimizes care for the patient and family.”

Dr. Murray’s team approach and emphasis on communication includes more than physicians. On every email, he copies Rand, the social worker, and Peggy Johnson in Pastoral Care. He consistently invites team members (nurse practitioners, nurses, social workers and chaplain) to attend every formal diagnosis conference and every progression on treatment or relapse conference, as well as every end-of therapy conference.

“He trusts that everyone will bring their professional best to the table for our patients and their families,” Rand said. “He values every team member and their professional expertise, and he actively seeks out the knowledge and thoughts we each have to offer. Dr. Murray is as brilliant as he is humble. He’ll often say that our RN, Ashleigh, and nurse practitioner, Mandy, are the brains behind the whole operation. I think that shows how highly he values his team members and their hard work and commitment to our patients.”

The Neuro-Oncology team faces tough challenges every day. They treat patients for tumors in the brain, brainstem, optic tract and spine, as well as neurofibromatosis and more.

Dr. Murray admits that these day-to-day battles of life and death wear on him. He places the heartache after the death of a patient away somewhere and says he may walk around with a permanent case of post-traumatic stress disorder.

But Dr. Murray moves on and says he tries his best to put his job behind him while he’s at home with his wife and son.

“Obviously you feel for these families and certainly after I had my own child it's become more difficult as it would for anybody because you start feeling … putting yourself in the shoes of those parents,” Dr. Murray said. “Of course it's most difficult when I'm dealing with a child who is exactly the age of my child and happens to be boy like my own son. It's very difficult. I have to catch my emotions and be relatively emotion free when I'm talking to families like that. So it's gotten more difficult since I've had a child, but not impossible.

“And also except for a couple of exceptions most of these kids will be cured. They will be fixed. They may have some damage and some side effects that last a long time but most of these kids are going to be OK. I've learned a lot about the human spirit from a parent’s point of view. It is stronger than you can imagine. It's just witnessing it over and over again. Parents and families in spite of hearing horrible news are almost always able to rally and create something special for their child. Whether it's a child who is going to live or a child who is going to die, it's remarkable how families can create an environment around them to create something really good.”

Just like the Neuro-Oncology family he’s created at Cook Children’s … something really good.

#erasekidcancer

If we had one wish it would be that no child would ever experience cancer. That's why we're asking you to join forces with Cook Children's oncologists, researchers, patients and families to help make that wish come true. Click here to help.

The funds we raise together during September, Childhood Cancer Awareness Month, will support life-saving research, treatments, technology and programs for patients and families at Cook Children's in Fort Worth, Texas. Please help us create hope for kids, families and caregivers who are fighting every day to #erasekidcancer.