Ellie Ladd is buried wearing a light blue and white Princess Elsa costume made for her as a final gift from her aunt. “Frozen” was one of her favorite movies.

The mischievous 4-year-old, who loved getting dirty, dressing up and having dance parties with his older brothers and sisters, died on January 6th after a combination of influenza and adenovirus caused pneumonia and sepsis.

“She was probably the healthiest of all my children,” said her mother, Sarah Ladd.

“She had no medical problems. No eczema, no cavities in her teeth, nothing. She was completely healthy,” she said. “I don’t know why it hit her so hard.”

At least 17 children have died from the flu in the United States this season, and that number is likely to rise as more states report deaths to the Centers for Disease Control and Prevention. The last influenza season, which took place in the winter of 2024-2025, set a record for the most childhood deaths in a season, with 289.

This year’s flu season is proving to be even busier than last year, with the number of outpatient visits with “flu-like” symptoms reaching the highest level in nearly 30 years due to a new virus strain called subclade K. And infectious disease experts fear this year’s death rate will be even higher than last year.

“There were strains that emerged after we had a chance to make predictions about the current flu shot, so it was too late to change the vaccine,” said Dr. Buddy Creech, a pediatric infectious disease expert at Vanderbilt University. Although subclade K is not included in this year’s vaccinations, studies have shown that many people develop antibodies against it when they receive the current flu vaccine.

Still, “we’re seeing what happens when there’s a little bit of disparity and low enthusiasm for vaccination, and again, that one-two punch leads to a very important flu year,” Creech said.

The flu arrived at Ladds’ home in Ogden, Utah, on Christmas Day.

Sarah, a mother of four, was the first to fall ill. She kept it going for about a week, she says. “It was pretty tough, but everyone else seemed to be OK,” she recalls.

After that, 14-month-old Dani had a fever that came and went, but seemed to recover quickly. After that, her father, Michael, also started having intermittent fevers. By the time he started feeling better, his three older children, Mary Jane, 6, and Mary Jane, 2, were doing well. Ellie. And 3-year-old Kyler also had it. They started showing symptoms on New Year’s Day.

“Neither Michael nor I have ever had a flu shot and are not thinking about getting one,” she said.

“To be honest, I don’t even know if it would have helped in this situation, because it could have been something else,” she said. “We don’t know.”

Sarah said that for the most part, people were kind, but she and her husband were sometimes hurt by comments from strangers who took their medical judgment at heart.

“We feel like we made the best choice we could at that time,” she said.

Initially, Mary Jane seemed to be the weakest of the three older children. Her fever soared to 102 degrees, and Sarah began alternating doses of ibuprofen and Tylenol to keep it under control.

Sarah said Ellie and Kyler seemed to be back to their normal self right away after being given children’s ibuprofen on the morning of their first day, but the next day their fevers spiked and they needed multiple medications to stay comfortable.

On January 2nd, Ellie fell asleep on the couch, so Sarah woke her up and sent her to bed. A few minutes later, Kyler, who shares a bedroom with Ellie, came out with her sister and said, “Mommy, Ellie needs you.”

Ellie’s cough turned into a vicious bark, “and I was like, ‘Fuck, what?'” Sarah said, “I didn’t like the sound of that.”

Sarah picked Ellie up and took her to a local hospital, where Ellie tested positive for both influenza and adenovirus, which can cause respiratory illness.

Sarah learns that Ellie’s cough is called croup, which is caused by swelling around the vocal cords that can be caused by a viral infection. X-rays showed no signs of pneumonia, but her blood oxygen level was only 85%, so medical staff gave Sarah supplemental oxygen and the antiviral drug Tamiflu and told her they wanted to keep her overnight.

“I thought they were just going to give me something and send me home,” Sarah said.

Ellie woke up coughing all night. She cried a little and went back to sleep. Around 3 or 4 a.m., she started complaining of pain in her lower abdomen.

The next day, her doctor examined her and said everything was fine. As the hospital prepared to discharge her, her oxygen levels began to drop again, and Ellie began coughing up blood that afternoon.

She was bleeding internally, but doctors didn’t know where the blood was coming from.

Follow-up X-rays revealed that Ellie had developed pneumonia in one lung overnight. She also had sepsis, which causes excessive inflammation in the body in response to an infection. This can lead to a dangerous condition that causes both uncontrolled bleeding and clotting at the same time.

Paramedics airlifted Ellie to Primary Children’s Hospital in Salt Lake City, but struggled to maintain oxygen in her blood. At the hospital, Ellie was fitted with extracorporeal membrane oxygenation (ECMO), a device that takes over the work of her heart and lungs, giving her body time to recover.

On January 5, doctors told Ellie that a blood clot had formed in her heart, but that she was too fragile to remove it surgically. They discussed trying blood-thinning drugs, but that was risky because she was already suffering from internal bleeding.

While the Lads were talking to doctors about Ellie’s dire situation, Sarah’s phone rang. It was the mother who looked after her two older children, Kyler and Mary Jane, both of whom were still ill. Mary Jane had developed pneumonia as well as bronchitis.

“I’d like to say it was a complete…shit show, but that’s such a vulgar way of saying it,” Sarah said. “There’s no other way to really say it.

“It was shocking,” she said. “It was total chaos and awful.

“Everything just got worse and worse with Ellie and there was nothing good about the situation we were in,” Sarah said. “I couldn’t stop crying for a while. I felt like I had lost all hope at that point. I tried to hold onto some hope, but there was very little left.

“It hit her so fast and so hard.”

Blood thinners didn’t help. Twelve hours later, Ellie suffered a severe stroke.

“There was no brain activity on the left side of her brain,” Sarah said. “At that point, it was just time to let her go.”

Creech, a Vanderbilt resident, said the details of Ellie’s story are tragic but familiar. He has seen several children come down with the flu and rapidly deteriorate.

“We talk about this a lot in pediatrics. We don’t mean that, but young children often lie to us. They’re okay until it looks like they’re actually okay,” he says. “The younger the child, the faster things can change.”

When he evaluates children, he looks for three types of physical signs: Do you have any neurological symptoms? Are you hydrated?

First, parents should pay attention to how fast their child is breathing and how hard they are trying to breathe.

“Are they having trouble breathing, are they having trouble breathing and are they having to really push themselves?” Creech said. “Do they have to use extra muscles around their neck and ribs to breathe? That’s a red flag.”

In cases of neurological symptoms, it’s important to check to see if the child is lethargic, even if they don’t have a fever, she said. Have they lost interest in eating, drinking, or interacting with you?

“I think that’s a really important characteristic. They take all their energy away from watching the show and interacting with you as a parent and focus on just breathing and trying to stay in a place where they’re okay,” Creech said.

Finally, he says children who breathe too quickly can quickly become dehydrated.

“And, unfortunately, when children become dehydrated, they don’t want to drink any more. They vomit, which can delay them further,” he says.

Another good test is whether children feel better after taking the medication. Will I feel better if Tylenol or Ibuprofen brings down my fever?

“Most of us would give them Tylenol or Motrin and reassess after about an hour. And if the child seems fine and is drinking and watching a show, OK, that makes us feel better,” he said. “But if you’re still feeling unwell, even if your fever has gone down, that’s another red flag that you need a little more thorough evaluation.”

The Rudd family said goodbye to Ellie at the hospital on January 6th.

Family and friends have rallied around the girls as they struggle to survive each day without their daughter. family has We have started a GoFundMe page To cover medical expenses and funeral expenses.

Sarah said the other children were coping well.

“The other day, when we went to drop off Ellie’s burial dress, Kyler asked if Ellie had wings now and was an angel in heaven, and I said, ‘Yes,’ because we’re religious, so I think he understands on some level, but I don’t know how much,” Sarah said.

Mary Jane is older and more settled. She is recovering well from her illness and is “finally starting to feel like herself again.”

Asked if she had a message for other parents, Sarah said Ellie’s death had made her family reconsider the importance of getting the flu shot.

“Honestly, just get your flu shot,” she said. “Even if things didn’t go well this year, maybe it helped her a little bit, I don’t really know.

“Maybe next season we’ll look into getting flu shots for the kids and for us,” Sarah said. “And that gives you even more peace of mind.”

She said this would be the first time anyone in her family has received a flu shot.

“I’ve never been afraid of getting sick before, but now I’m a little scared.”