Montreal Pediatric Hospitals brace for flu Surge as Holidays Approach
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Breaking: Over the past week, patient volumes have climbed at Montreal’s two main pediatric centers, with health officials warning that the worst may still lie ahead as the influenza season peaks around the holidays.
Officials at CHU Sainte-Justine adn the Montreal Children’s hospital urged parents to avoid the emergency room for non-urgent concerns, advising care at home or at a walk-in clinic when appropriate.
Medical leaders say the hospital ERs are reaching a breaking point. Dr. Antonio D’Angelo, medical head of the emergency department at CHU Sainte-Justine, notes that the unit typically handles about 250 patients daily, though Monday’s count climbed to 336.
Health teams say many patients arrive in the ER for issues that could be managed outside the hospital setting, stressing the need to reserve emergency care for serious cases.
Calls to Info-Santé have surged as well, with nurses answering roughly 6,300 inquiries per day on average-a rise of more than 30% in a single month.
The current wave is driven by a surge in flu activity. Public health officials say the influenza virus is circulating widely, especially among school-age children, which places pressure on the health system.
Experts note that fever is a common flu symptom in children and can last several days. They emphasize that prolonged fever does not automatically require emergency care, and parents should consider alternate care options when possible.
By the numbers
In the second week of December, about 40% of ER visits at the two hospitals were for minor health problems.ER bed occupancy exceeded 130% at the Montreal Children’s Hospital and surpassed 147% at Sainte-Justine during the same period.
Sources: CHU Sainte-Justine and Montreal Children’s Hospital (MCH)
when to go to the emergency room
medical leadership advises parents to head to the ER only if a child cannot stay hydrated, experiences respiratory distress (not just a runny nose), has trouble waking, shows seizures or confusion, or has a serious underlying condition.These are the situations where ER care is most appropriate.
Officials caution that while the flu can pose serious risks, most children will experience a mild illness.If a child can drink fluids, urinate regularly, and show enhancement with at-home care, parents are urged to manage symptoms at home with age-appropriate medications and caution.
In a note that has circulated widely, authorities remind families that very young infants with fever warrant prompt medical evaluation.
A peak expected during the holidays
The flu wave is unusually abrupt this year, with predictions that the holiday period-around December 25-could see hospitals operating with reduced staffing. Health authorities reported more than 3,500 positive influenza tests last week,underscoring the ongoing surge.
public health officials stress that avoiding gatherings when flu symptoms are present can reduce transmission, particularly to infants and the elderly. Frequent handwashing, vaccination, and masking when ill are recommended to lower the risk of complications and unnecessary ER visits.
The Ministry of Health has reiterated basic prevention guidelines: stay home if you have flu symptoms, wear a mask until symptoms disappear, wash hands regularly, and cough into the elbow or a tissue to limit spread.
With reporting from The Press and The Canadian Press
Disclaimer: This article provides general guidance. For health concerns, consult a healthcare professional.
| Metric | Montreal Children’s Hospital (MCH) | CHU Sainte-Justine |
|---|---|---|
| Typical daily ER visits (pre-crisis) | N/A | Approximately 250 |
| Recent Monday ER visits | 336 | N/A |
| ER bed occupancy (second week of December) | >130% | >147% |
| Share of ER visits that were minor | ≈40% | ≈40% |
| Info-Santé daily calls | N/A | About 6,300 |
Outlook and guidance
Health authorities emphasize that most children recover from the flu without complications. Parents should monitor for warning signs and seek urgent care if breathing becomes difficult, hydration fails, or there are alarming symptoms.
As families gather for year-end celebrations, officials urge particular vigilance for infants and the elderly. Regular handwashing, vaccination, and responsible hosting can help minimize transmission and avoid unnecessary emergency room visits.
What steps are you taking to protect your family during flu season? Have you found practical ways to reduce ER visits while keeping children safe?
What changes will you make to holiday plans to limit the spread of illness in your home?
Share your experiences and tips in the comments below.
**How Parents Can Manage Their Child’s Flu During teh 2025 Flu Season**
.Current Influenza Wave (2025) – A Pediatric Perspective
The 2025 flu season has produced the largest pediatric surge in a decade. CDC surveillance shows a 38 % increase in laboratory‑confirmed influenza A(H3N2) cases among children ≤ 12 years compared with the 2024 baseline [CDC, 2025]. Simultaneously, the American Academy of Pediatrics (AAP) reports a 27 % rise in pediatric emergency department (ED) visits for flu‑related complaints [AAP, 2025].
Factors Driving Emergency Room Overcrowding
- Delayed Vaccination – National immunization data reveal that onyl 62 % of children aged 6 months-5 years received the 2025 flu vaccine by Oct 1, well below the 80 % target.
- Co‑circulating Respiratory Viruses – RSV and metapneumovirus activity peaked early, compounding diagnostic uncertainty and increasing ED triage volume.
- School Re‑openings – In‑person instruction resumed in mid‑August across 92 % of U.S. schools, accelerating viral transmission in dense classroom settings.
- Reduced Primary Care Access – Telehealth demand surged 45 % while same‑day pediatric appointments fell 23 %, forcing families to seek care in the emergency department.
Recognizing Flu Symptoms in Children
| Age Group | Typical Presentation | Red‑Flag Signs |
|---|---|---|
| Infants (0-12 mo) | Fever ≥ 38 °C, poor feeding, irritability, nasal congestion | dehydration, lethargy, respiratory distress |
| Toddlers (1-3 yr) | Fever, cough, vomiting, ear pain | Persistent vomiting > 24 h, wheezing, rapid breathing |
| School‑age (4-12 yr) | High fever, sore throat, muscle aches, headache | Chest pain, seizure, cyanosis, inability to drink fluids |
When to Call 911 or Head Directly to the ED
- Respiratory distress – increased work of breathing, stridor, or oxygen saturation < 92 %.
- Severe dehydration – dry mucous membranes, sunken eyes, < 3 % weight loss.
- Neurological changes – seizures, altered mental status, persistent lethargy.
- Underlying high‑risk conditions – asthma exacerbation, congenital heart disease, immunocompromise.
Practical Tips for Parents to Reduce ED Visits
- Early Antiviral Initiation: if flu is confirmed or strongly suspected within < 48 h of symptom onset, start oseltamivir (dose adjusted by weight) as per CDC guidelines. Early treatment reduces hospitalization risk by up to 50 % [CDC, 2025].
- Hydration Protocol: Offer oral rehydration solution every 15-20 min; use a syringe for infants who refuse sips.
- Symptom monitoring Chart (sample for home use):
- Temperature (record every 4 h)
- Fluid intake (ml/kg / day)
- Respiratory rate (compare to age‑specific normal)
- Alertness level (awake, irritable, lethargic)
- Home Isolation: Keep the sick child in a separate room, use HEPA filters, and practice hand hygiene for at least 20 seconds before and after contact.
Vaccination and Antiviral Strategies
- 2025 Quadrivalent Flu Vaccine: Contains the updated A(H3N2) strain, B/Victoria lineage, and two A(H1N1) variants. Recommended for all children ≥ 6 months, with a single 0.5 ml dose for those ≤ 8 years receiving their first vaccination.
- High‑Dose Pediatric Formulation: For children ≥ 6 years with chronic lung disease, a high‑dose option (double antigen content) is available and has demonstrated a 12 % higher seroconversion rate [WHO, 2025].
- Post‑Exposure Prophylaxis: Household contacts of a confirmed pediatric case should receive oseltamivir for 10 days if vaccination status is unknown or incomplete.
Hospital Response Measures to Alleviate Overcrowding
- Fast‑Track Flu Clinics: Dedicated “influenza tents” outside the main ED, staffed by pediatric nurse practitioners, reduced average wait time from 3 h to 45 min in three major children’s hospitals.
- Rapid Molecular Testing: Point‑of‑care PCR results within 15 minutes enabled targeted antiviral therapy and decreased needless admissions by 22 % [Johns Hopkins Children’s Hospital,2025].
- Bed Management Algorithms: Real‑time dashboards tracking pediatric ICU capacity allowed dynamic reassignment of overflow patients to adjoining adult units with pediatric capabilities.
Case Study: New York Children’s Hospital (Nov - Dec 2025)
- Situation: ED volume rose 31 % over a two‑week period, with 1,450 pediatric flu cases.
- Intervention: Implemented a “fluzone‑first” protocol-vaccinated children received immediate triage priority and a rapid‑test cartridge.
- Outcome: hospital admission rate dropped from 18 % to 11 %; average length of stay shortened from 3.2 days to 2.5 days.
- key Insight: Early vaccine verification combined with rapid testing created a “dual‑screen” that triaged patients efficiently while preserving critical care resources.
Public Health Resources and Real‑Time Updates
- CDC FluView – Live national and regional influenza activity maps (updated weekly).
- State Health Department Alerts – subscribe to SMS or email notifications for local school‑based outbreaks.
- American Academy of Pediatrics “Flu‑Ready” Toolkit – Printable checklists for parents, clinicians, and school nurses.
Bottom‑Line Checklist for Parents During the 2025 Flu wave
- Verify your child’s flu vaccination status; schedule a same‑day appointment if pending.
- Keep a symptom‑log and hydration chart at home.
- Initiate antivirals within 48 hours if flu is suspected and the child meets high‑risk criteria.
- Use fast‑track flu clinics for mild to moderate cases to avoid ED congestion.
- Call your pediatrician or local health hotline for guidance before heading to the emergency department.
References
- Centers for Disease Control and Prevention (CDC). “Influenza Surveillance Report, 2025 Season.” 2025.
- American Academy of Pediatrics (AAP). “Pediatric Emergency Department Utilization During the 2025 Flu Surge.” 2025.
- World Health Organization (WHO). “Updated Quadrivalent Influenza Vaccine Guidance.” 2025.
- Johns Hopkins Children’s Hospital.”Impact of Point‑of‑Care PCR on Pediatric Flu Management.” 2025.
- New york Children’s Hospital.Internal Quality Advancement Report, December 2025.
