They are children’s hospitals in Louisiana. Resistance to increased penetration and ER visits due to fewer respiratory viruses. While it’s not unusual to see an increase in viruses as the weather cools, it’s rare to encounter many at once, leading to hospitals hoarding sick children.
“We’ve got a full house,” said Dr. Mark Klein, chief physician at Children’s Hospital in New Orleans. “We stay strong.”
Hospitals are seeing an unusual constellation of these viruses. Rhinoviruses and enteroviruses, which cause the symptoms commonly associated with the flu, are responsible for most cases. The two viruses cannot be distinguished from each other on the tests used by most hospitals. Tests for these viruses in children are coming back positive about 40% of the time — “very exceptional,” Klein said.
In Baton Rouge, it’s even higher, around 50%, said Dr. Michael Bolton, a pediatric infectious disease specialist at Our Lady of the Lake. The Acadiana area has yet to see a similar upheaval, but there is a sense that it is inevitable.
“I would expect kids at school not wearing masks and viruses in the environment very soon,” said Scott Hamilton, MD, Ochsner Lafayette General’s pediatric emergency department medical director.
The Centers for Disease Control and Infection issued a health advisory about the increase earlier this month. Further testing revealed a significant increase in a particular type of enterovirus called D-68, which causes polio-like paralysis. Most hospitals don’t have testing for that strain, and Klein said Children’s in New Orleans has yet to see a case.
Influenza A is also showing up earlier and in higher numbers than usual, with 19% of tests coming back positive in children. Flu season typically doesn’t start gearing up until October. Adenovirus, another common cold or flu-like illness, affects about one in ten children in children.
Respiratory syncytial virus, or RSV, is worrying kids and parents alike. While enterovirus and rhinovirus are the most commonly diagnosed, children with RSV are more likely to be admitted to the ICU, Bolton said. The number of tests that come back positive for RSV in OLOL is recently 1 in 5.
The only silver lining, doctors say, is that cases of COVID among children currently remain low, although it’s unclear if that will hold throughout the winter. In the pediatric unit, about 2% of tests come back positive for Covid. At its peak last summer, it was about 30%.
‘I don’t think we’ll get any more than that.’
The recent spike in cases has outstripped past spikes in Covid-19. In July 2021 Children’s hospitals have seen a rapid increase in admissions due to Covid.. They are more full now than they were then.
“When we reached a patient count of 160 last summer, we felt like we were full. The count this afternoon is at 182,” Klein said Thursday.
And not only in Louisiana. Children’s hospitals in Birmingham, Atlanta and Texas are also full, according to colleagues there, Klein said.
The number of viruses flooding the pediatric healthcare system at once comes as hospitals prepare staff to care for patients, especially during the winter months.
“Kids are always going to be exposed and contaminated by some of these things over time,” Klein said. “When four or five move together, it’s a strain on the health system.”
As many hospital workers have experienced over the past few years, the influx of patients can lead to burnout among staff. Hospitals count on a slow summer to prepare for and coincide with the respiratory virus season, which runs from October to spring.
If you’re always on the go, if you’re on your feet, if you’re at the patient’s bedside, you don’t get that relief of, ‘This is what I did well today, this is what I can do,’ tomorrow will be better,”’ Bolton said. Instead, the workers are just trying to get through the day, knowing they have to come back for a busy day tomorrow.
The cause of the problem is unclear, but it may be due to a return to pre-pandemic habits of not wearing masks when school starts. Decreased exposure to viruses over the past few years may also contribute to a weakened immune system.
“There’s a small group of kids out there right now that haven’t been infected with these viruses in the last couple of years,” Klein said. “Now that masks have been released, these viruses are finding more vulnerable hosts.”
Pediatricians recommend that children stay Up to date on their vaccinationsincluding the covid-19 and flu vaccine.