DALLAS -- In 2009, 11-year-old Cynthia Garcia of Garland became the first child in North Texas to die from the swine flu.
Sixty children statewide would succumb that season and more than 340 nationwide as doctors fought the novel strain of influenza.
"I'd like to say that we've learned things,” said pediatric infectious disease specialist Dr. Jeffrey Kahn of Children’s Medical Center Dallas.
Dr. Kahn was in Dallas during the initial swine flu outbreak and still practices at the hospital today during this season’s serious H1N1, or swine flu, outbreak.
“We’ve learned how to employ advanced technologies and when we should use them on kids, and at what point in their illness we should use them,” Dr. Kahn said. "So I think there's a certainly a learning curve there."
In Dallas County alone, more than 50 flu patients were on ventilators or other breathing equipment, according the latest report available from Dallas County Health and Human Services.
Five years ago, a bypass machine called an ECMO (extracorporeal membrane oxygenation), was considered a radical lung treatment. The technology removes every drop of blood from the body, providing both cardiac and respiratory support to patients with diseased lungs.
"It's going to oxygenate the blood and get rid of [carbon dioxide] also,” said ECMO specialist Don Potter. “So that way, we can breathe for the patient to allow the patient to get better with the lungs."
ECMO is now routinely used in severe influenza cases - even in the youngest of patients - because doctors know swine flu can turn deadly quickly. Bacterial infections that inflame the lungs as a result of influenza are a main cause of hospitalizations and deaths.
"It could be we're saving the sickest of children from influenza,” Kahn said.
What doctors say people haven't learned yet is the importance of a flu shot.
The vast majority of the most serious cases treated at Children's this year were not vaccinated. Most of the adults who have died from influenza in North Texas this year, according to county health authorities, have not been vaccinated against influenza.