Children’s hospitals across the country are dealing with a rise in respiratory syncytial virus (RSV) cases, stressing healthcare and millions of parents with sick children.
RSV is a common and generally mild disease, but millions of children are exposed to the effects of the coronavirus pandemic later in life. Babies who were walled in during the pandemic did not get RSV, and now children born just before or during the pandemic are getting it in large numbers.
“Last year we had RSV, but this year it wasn’t at the level, in part because we were still doing some of the mitigation efforts around masking and people were still staying away,” said Jason Newland, a pediatric infectious disease specialist in Washington. University in St. Louis.
“We’re seeing older patients being admitted with RSV because they’ve just never seen it before,” he said. “And your first illness is usually the worst and it leads to even more people being hospitalized.”
The overcrowded hospitals are also a concern as the country expects a difficult flu season and increasing cases of COVID-19 as temperatures get colder and people spend more time indoors.
Newland said St. Louis Children’s Hospital has seen “super-high” RSV recordings in the past two to three weeks, levels he hasn’t seen in the six years he’s been at that location.
Providers in other states have reported similarly high take-ups. Caroline Njau, senior vice president of patient care and chief of nursing at Children’s Minnesota, said the rise in RSVs this year is much greater than what she’s seen in the past six years.
“Cases continue to rise and we haven’t seen a spike yet,” Njau said. “And RSV itself makes up about two-thirds of the respiratory viral diseases we see.”
Publicly available data from the Centers for Disease Control and Prevention (CDC) indicates a strong presence of RSV in the Midwest, with states such as Minnesota, Nebraska, Missouri and Wisconsin in the top ten states in terms of positivity rates. However, this data is incomplete, with about a quarter of states reporting no case data.
The CDC said in a briefing Friday that RSV cases are increasing in 8 of the 10 regions in which states are divided under the Department of Health and Human Services. The southeast and south-central regions of the US are seeing a drop in cases, including states like Alabama, Arkansas, Florida, Georgia, and Texas.
Andrew Pavia, chief of the Division of Pediatric Infectious Diseases at the University of Utah, noted that RSV cases have moved in a southeast to northwesterly wave this year, a reversal for the virus that usually spreads west to east around the world. is being observed. U.S
While RSV is a common pathogen, Pavia said it’s “significantly more complicated” in terms of how it’s transmitted.
“We don’t really understand why. It does not follow strict weather patterns. It doesn’t follow a strict movement of people,” Pavia said. “But what you can say with some certainty is that once it starts to accelerate rapidly in a region, it will rise for eight to 12 weeks, or it will have an eight to 12 week breakout.”
Pavia noted that it could be a good thing that the virus is not equally severe across the US
“There are regions where child health care is really overloaded and there are no ICU beds for children in the whole region. And that’s happening right now in the Midwest, where people in two or three states are looking for an ICU bed,” he said.
The health care providers who spoke to The Hill agreed that this recent spike in RSV has exposed problems within the U.S. pediatric health care system, both old and new.
Newland said there are concerns that staffing at children’s hospitals may not be enough, which could lead to situations where some services, such as non-emergency surgeries, are delayed, similar to what happened during the toughest parts of the COVID-19 crisis. pandemic.
Pavia noted that pediatric health systems have lost many staff members in the past three years and that the remaining employees are dealing with burnout.
Another problem that providers cite is the lack of capacity in children’s hospitals. Stephen Dolter, chief of the pediatrics division at the Children’s Hospital & Medical Center in Nebraska, said his main concern during this viral wave was almost lack of space.
“We will do our very best to get them into the hospital, whether it’s repurposing hospital play areas into treatment rooms, or repurposing our emergency department into a clinical ward,” Dolter said.
There are no vaccines for RSV, although Pfizer announced promising results from a maternal vaccine earlier this week. Monoclonal antibodies are sometimes used as a primarily preventive measure for children at high risk of developing serious disease. The providers who spoke to The Hill said they have had no problem obtaining and maintaining an adequate supply of monoclonal antibodies so far.
Health experts and caregivers say it’s critical for parents to recognize the signs that a child should go to hospital for care if they develop a respiratory infection. RSV symptoms usually manifest about two to eight days after exposure to the virus, and symptoms usually last about a week on average.
Njau of Minnesota Children’s advised parents to watch for signs that their child is having trouble breathing easily. If breathing has become difficult, a baby will begin to breathe short and fast and may growl as he breathes. A child’s ribcage going in when they inhale is also an indicator that they are working too hard to breathe.
A child’s skin can also take on a blue or purple hue if they don’t get enough oxygen. In darker-skinned children, a lack of oxygen can manifest as a similar change in color in their lips, gums, and around their eyes. Njau said parents should also watch for signs that their child is dehydrated or has lost an appetite.
“Fortunately, almost all children recover from the infection on their own, but especially those who may have been born prematurely [and] have other comorbidities [it] can have a significant impact on the respiratory system. And that’s why it’s very important for them to seek care,” Njau said.