San Antonio pediatricians say the old idea of a neatly defined "sick season" is fading fast. Childhood viruses are popping up at odd times of the year and, in many cases, seem to be hitting kids harder than parents remember. Doctors at University Health and UT Health San Antonio report that fewer early-life exposures during the pandemic, combined with more aggressive circulating strains, are leaving the youngest patients especially vulnerable. Parents are being urged to watch breathing, hydration and energy levels closely and to seek medical advice quickly when those start to slide.
As reported by KSAT, Dr. Mandie Tibble-Svatek, a pediatric hospitalist with University Health and UT Health San Antonio, said "viruses such as like rhinovirus, enterovirus, even adenovirus, parainfluenza, and the flu have popped up during different times of the year." In the same report, Tibble-Svatek warned that Group A strep infections in the post-COVID period are showing up more aggressively and that orbital cellulitis has emerged as a serious complication. Local clinics say those trends have kept staff on high alert through the holidays.
What's driving the change
Researchers and public-health experts point to an "immunity gap" created when masking, distancing and other pandemic measures interrupted the usual circulation of common bugs, leaving more children susceptible once regular exposures returned, according to a study in Open Forum Infectious Diseases. Modeling and surveillance work since 2022 has documented out-of-season rebounds for influenza, RSV and other respiratory viruses, helping explain why illnesses are now appearing year-round instead of clustering neatly in winter.
Group A strep and complications doctors are watching
On top of routine colds, clinicians are keeping a close eye on invasive Group A streptococcal (iGAS) disease, since some outbreaks have produced more severe cases than were typical before the pandemic. An analysis of a pediatric iGAS outbreak in Colorado found higher hospitalization and critical-care rates, and a global genomics review has identified expanding virulent GAS lineages, according to findings in the Journal of the Pediatric Infectious Diseases Society and FEMS Microbiology Reviews. That mix of more virulent strains and reduced prior exposure may be helping some infections escalate more quickly from a sore throat to serious disease.
How doctors say families can protect kids
Pediatricians continue to recommend staying current on vaccinations, practicing good hand hygiene and talking with your provider about options that reduce the risk of severe disease. The CDC's recent MMWR on RSV immunization notes that maternal RSV vaccination and infant monoclonal antibodies (nirsevimab and the newly recommended clesrovimab) are available tools to prevent severe RSV in infants, while the seasonal flu vaccine remains the best protection against serious influenza outcomes. Parents are advised to discuss timing and eligibility with their pediatrician. For newborns and very young infants, providers can help families decide which RSV prevention strategy, maternal vaccine or infant antibody, makes the most sense based on timing and local availability.
When to head to the emergency room
Doctors stress that some symptoms are non-negotiable red flags. Fast or labored breathing, a bluish color around the lips or face, poor fluid intake or very few wet diapers, severe lethargy or seizures are all reasons to seek emergency care, according to Children's Mercy. If an infant under 3 months has a fever, or if any child becomes difficult to wake or stops eating and drinking, families are urged to call their pediatrician or head to the nearest ER without delay.
What San Antonio families should expect in 2026
Locally, Tibble-Svatek told KSAT that hospitals are preparing for a likely winter spike and that it may take more than one season for viruses to settle back into predictable patterns. Families should be ready for intermittent waves of respiratory illness throughout the year and keep an ongoing conversation with their pediatrician about vaccines and infant RSV protection.
Bottom line: keep routine immunizations up to date, stick with basic infection-control habits and do not hesitate to seek care if your child's breathing, hydration or alertness worsens. Talk with your pediatrician about specific protections for babies and get help early if symptoms start to escalate.
