In January, four children from New York State died from the flu, with pediatric flu death considered a key marker of a harsh flu season. This has prompted warnings for parents to stay alert.

Influenza activity keeps increasing in the United States in general, and the U.S. Centers for Disease Control and Prevention put states like New Jersey and Pennsylvania in the red zone for the condition. Other places with high flu activity — based on the percentage of outpatient medical visits due to flu-like symptoms — include Kansas, New York, Missouri, Oklahoma, and South Carolina.

As of Jan. 21, the flu outbreak has affected 37 U.S. states versus the previous 29 states, and in this time period three pediatric deaths also occurred due to flu infection.

Pediatric Flu Cases

Kids bear the brunt of a strong flu season, with 15 children dying from flu in this season so far. There were 148 pediatric deaths in the 2014 to 2015 season and 89 last year.

In Nassau University Medical Center, the pediatric nursing department is catering 24/7 to Long Island children with flu symptoms such as fever, chills, nausea, and muscle pains.

“The cases of flu are continuing to increase week by week,” Dr. Rachel Robbins said in a CBS report. “We are right in the middle of flu season.”

Public health officials recommend that everyone over the age of 6 months should be vaccinated. The nasal spray shot, however, is not used this year due to its lack of effectiveness in children.

Child deaths are used as a parameter for how severe a flu season is. In mild ones, there are no pediatric deaths recorded, prompting epidemiologists to call the current outbreak “significant” so far.

The CDC noted that while flu activity has been prevalent this year with many areas across the nation reporting illnesses, this has been an average year. The season is expected to peak in February until springtime.

How The Flu Season Will Proceed

The reported cases, though, tell only half the story since it remains unknown how many flu cases the vaccine actually prevented. The CDC asserts that having more people vaccinated will reduce the chances of infection, and sometimes translate to lighter symptoms even when the recipient gets sick.

For most, the flu will feel a lot worse than a typical cold, coming on suddenly and often accompanied by chills and fever. The flu usually comes with respiratory symptoms, headaches, and fatigue, with the occasional diarrhea and vomiting in children.

At a higher risk for complications are kids under age 5 as well as adults 65 years old and above. They are advised to visit the doctor once they experience a fever exceeding 100.4 degrees Fahrenheit, severe body aches, and excessive fatigue.

But it’s not yet too late to get a shot as well as prevent the disease through frequent hand washing, advised Susan Coffin of Children’s Hospital of Philadelphia.

"You shouldn't send your kids to school while sick," she said, adding that patients are most contagious for around a half-day before they suffer symptoms and at the start of their actual illness.

Read the CDC's Big Three ways to prevent the flu.

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