Fall 2022: RSV, Flu, Strep, and more!

by |  November 21st, 2022

There has been an extraordinary amount of illness in our community so we want to let you know what is going around and provide some office updates. Our staff is working hard to handle the significantly large volume of patients needing appointments and advice by phone/portal. We appreciate your patience and understanding!

  1. RSV is here. RSV infection is in the news because it is filling up pediatric hospitals across the country. But most kids with RSV infection do not need hospitalization. RSV, or Respiratory Syncytial Virus, is not a new virus. As pediatricians, it’s a virus we are very familiar with (and dread every year). What’s new is how early in the winter respiratory illness season we are seeing it and how many children and adults are getting it. Here’s a link to learn more about it (it’s free!) and a helpful video link to see what labored breathing looks like in a young child.

     2. Flu is here. And, it’s ugly. The “A” strain is circulating now. Here are some things to know:

Flu symptoms start with high fever (often 102 F or above), fatigue, and bodyaches. This particular A strain often starts with a sore throat. The runny nose and coughing begins much later in the course of the illness. Think about flu when the early signs appear, as treatment is more effective when started within 48 hours of symptoms.

The rapid flu test is not 100% accurate. If your flu test is positive, you have the flu. A negative test does not rule out flu. Healthcare providers rely on their clinical judgment and decide whether or not to treat for flu when testing is negative.

Tamiflu and Xofluza* (anti-virals) do not provide immediate relief.Antiviral medications work differently than antibiotics. Antibiotics kill illness-causing bacteria (like taking Penicillin for Strep throat)–so after taking just a dose or two, you start to feel better. Antivirals prevent the influenza virus from replicating–it shortens the duration of the flu and may reduce the severity of it. *Xofluza is brand-name only so many insurance companies do not cover the cost of it.

Tamiflu can be unpleasantAbout 10-15% of people who take Tamiflu feel nauseated and some actually vomit. If you weren’t feeling bad enough already…and the liquid version of the medication tastes pretty awful (which is why we prefer to use the capsule version–you can pour the powder into a spoonful of food to give to your child).

The Flu vaccine is still helpful and we still have it. Even if you get Flu A infection, the vaccine covers for 2 A strains and 2 B strains–and B strain shows up later in the season. So, yes, the vaccine is still recommended. We offer flu vaccine by appointment only and have both the shot and the Flumist nasal spray.

  1. Strep is here. How do you know when it’s Strep throat? Here’s some useful info in our new online parenting library. It’s free to download! Also, there is a nationwide shortage on Amoxicillin, leading to back orders on alternative antibiotics. We are staying abreast of which pharmacies have medications in stock, so you can get what your child needs without too many phone calls or trips to pharmacies. It is a problem, though, so thank you for your understanding!
  2. Saturday hours and sick visits. We are back with in-person office visits on Saturdays from 9am-1pm. Please call the office to schedule an appointment. We are doing our best to offer same-day sick visit appointments, but given the extreme rise in patient volume, we may have to schedule your child for the next day. We are adding as many appointments as possible during our office hours to care for your children.
  3. We encourage and offer the Pfizer COVID bivalent vaccine for children age 5-11 years in our office. Shot visits are available by appointment only. Children ages 12 and up can obtain a bivalent booster at area pharmacies.

The details:

  • Bivalent vaccine contains two components: one covers the original strain of COVID and the other protects against the omicron 4/5 spike protein variant. About 80% of the circulating strains in the US are BA.5. The additional 20% are other omicron variants.
  • Children ages 5 and up are now eligible for a bivalent COVID-19 Pfizer-BioNTech bivalent boostervaccine booster.
  • The Moderna bivalent booster authorizationis approved for children ages 6 and up.
  • Bivalent is not authorized for the primary series vaccination.
  • Children as young as 5 years who have completed a primary series can receive a single bivalent booster 2 months after primary vaccine series.
  • Anyone can receive the bivalent booster at least 2 months after their most recent booster dose.
  • The bivalent booster can be a different brand than the primary series.

411 Pediatrics


Dr. Ari Brown is a pediatrician and a mom. Dr. Brown is Board Certified and a Fellow of the American Academy of Pediatrics. She has been in private practice for over 20 years. Her passion to advocate for children and educate families extends beyond the office setting. She is the co-author the bestselling "411" parenting book series including Expecting 411: Clear Answers and Smart Advice for your Pregnancy, Baby 411, and Toddler 411. Dr. Brown has received several professional awards including the Ralph Feigin, MD Award for Professional Excellence, the prestigious Profiles in Power Award by the Austin Business Journal for her service to the community, Austin's Favorite Pediatrician by Austin Family Magazine, and Texas Monthly Magazine's Super Doctor.

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