Dallas doctor shares tragic story as reminder to prepare for flu season

With Thanksgiving just two weeks away, health experts say now is the best time to get protected from potentially dangerous fall viruses.

A Dallas doctor is sharing his story of heartbreaking loss – and a warning for others.

Dr. Caesar Termulo, an associate medical director at Parkland Health, lost his 16-year-old daughter, Teresa – who also went by the nickname “Reese”— in January 2020. He said she was a healthy and active teenager, but she was not immune to the unpredictable danger of the flu.

"With the flu, you can catastrophically become apneic and stop breathing and with no heart rate,” he said. "The instance of it is about like 1.5 in a million. But it happens and it happened to my daughter."

STARTED WITH A FEVER

Dr. Termulo said on the morning of January 9, 2020, Reese came down with a fever.

Flu cases were exploding across North Texas at the time.

“I was probably seeing and diagnosing about five cases of flu every single day,” he recalls. “So I immediately thought that she could have the flu.”

After a trip to the clinic, it was confirmed to be flu. Reese was started on medication and bed rest right away. She was also forced to skip her drill team practice, which she was excited to audition as an officer for.

Dr. Termulo said he checked on her constantly throughout the day and the next morning. Her lungs were clear and her heart sounded fine.

“She took her medicines, she was still doing her homework, she was doing the things that teenager usually does. She was still texting her friends and checking her Snapchat and doing all that,” he said. “I checked all the things that I would normally check with a patient and she basically was fine. I checked her lungs for like breathing problems and her lungs were clear. Her heart was fine and I told her you're going to get better. That was the last words I said to her.”

That night, she took a bath but struggled. She continued to try to work on her homework in bed.

“My wife went to the kitchen to make her some soup. And then when my wife returned, it was probably about 11 o'clock – she found she stopped breathing. She had no heart rate,” Dr. Termulo said. “The ambulance came and they tried to revive her. They did an extraordinary job trying to do everything they could to revive her.”

But her heart wouldn't restart. She was pronounced dead at the hospital, less than two days after first being diagnosed with the flu.

The medical examiner determined she had a rare and deadly combination of flu and bacterial pneumonia.

"What I can tell you is that for whatever reason for her, you get the flu and then that makes you susceptible to pneumonia,” said Dr. Termulo. “And she got a really bad pneumonia that spread. It's a bacteria that spreads all over her body. And that's actually kind of how it happened. But basically, it starts with the flu."

The loss was earth-shattering for the family. Reese was in the top 10 percent of her 11th-grade class at Bishop Lynch High School and had a bright future ahead of her. She was also the 10^th person to die from the flu in Dallas County during the 2019-2020 flu season, according to Dallas County Health and Human Services.

IMPORTANTANCE OF FLU VACCINES

Dr. Termulo says about 50 percent of flu patients who die have pre-existing medical conditions like asthma or heart issues. But the rest, like Reese, were healthy.

According to the family, Reese received her annual flu vaccine over the Christmas break from school in late December of 2019. However, the subtype of influenza B that infected Reese was not included in that year’s vaccine.

Dr. Termulo said flu vaccines are updated every year to reflect the strains of flu that are most likely to spread, but the vaccine does not always match the strains that make people sick because the virus evolves quickly.

“In terms of the pediatric population, over 100 children died last year from the flu nationwide and 90% of them, either didn't get their flu shot or they didn't get the correct doses or correct the number of flu shots that they were supposed to,” he said.

He added that although flu vaccines are not perfect, they can be compared to seatbelts in cars. While people may still die from a car crash when wearing a seatbelt, it’s still the best protection available. Although flu vaccines are not always a perfect match, flu vaccines save lives and reduce flu-related hospitalizations.

FLU CASES NOW

Right now, Parkland Health is seeing an uptick in flu cases. The hospital system’s clinics started seeing cases in September and began offering flu shots to prepare for the season.

He said that in Australia – which just wrapped up its winter and fall season in the Southern Hemisphere – already experienced a bad flu season this year, which can be indicative of the type of season North America could see.

“We don't really see a whole uptick in the flu until December or January – that’s when we see the full brunt of flu. But we do expect that with what's going on, with people not masking anymore and less people getting the flu shot – we do think that the flu season this year will be significant,” Dr. Termulo said.

The Centers for Disease Control and Prevention tracks flu cases every year. According to this map updated weekly online, flu cases are trending up in the southeastern United States.

One thing Dr. Termulo wants people to take seriously is a fever. As soon as you come down with it, get tested and start the medications – he said it's most effective within the first two days of symptoms. Shortness of breath or any changes in breathing should be addressed immediately by a doctor.

Dr. Termulo said it takes a couple of weeks to develop those antibodies following a flu shot – something to keep in mind ahead of the holidays.

Patients of all ages can visit Parkland’s Community Oriented Primary Care Centers for a flu shot at no cost and with no appointment necessary. To avoid a wait, Wednesdays are recommended. During Walk-In Wednesdays, a staff dedicated only to providing flu shots is available from 9 a.m. to noon and from 1 to 4 p.m.

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