DES MOINES, Iowa (AP) — Some Iowa hospitals have tightened visitation rules in the wake of a widespread flu outbreak that has claimed the lives of three children in recent months, including that of a 3-year-old Elk Horn girl. The Des Moines Register reports that 3-year-old Ayzlee McCarthy died on Monday from complications from the flu. Her mother says that only three days earlier, Ayzlee appeared healthy and active.

Iowa Department of Public Health reports show that for the week ending Dec. 27, 161 Iowans were hospitalized with the flu at a set of hospitals the department monitors. That has prompted Des Moines medical centers to ban any would-be visitors who show any flu symptoms, and anyone visiting flu-infected patients must wear a surgical mask over his or her nose and mouth.