Children’s hospitals across the country are experiencing a surge in cases of respiratory syncytial virus (RSV), straining health care services and millions of parents with sick children.
RSV is a common and generally mild illness, but due to the coronavirus pandemic, millions of children are being exposed during their lifetime. Infants who had mumps during the outbreak did not get RSV, and now babies born before or during the outbreak are becoming infected.
“We had RSV last year, but it hasn’t reached the level this year, in part because we’re still doing some mitigation in terms of masking and people are still avoiding it,” said Jason Newland, a pediatric infectious disease specialist in Washington. at St. Louis University.
“We’re seeing older patients getting infected with RSV because they’ve never seen it before,” he said. “And your first illness is usually much worse and it’s causing some more people to go to the hospital.”
Overcrowded hospitals are also a concern as the country faces a difficult flu season and rising cases of COVID-19 as temperatures cool and people spend more time at home.
Newland’s St. Louis Children’s Hospital has seen “extremely high” RSV admissions in the past two to three weeks, a level it hasn’t seen in the six years he’s been there.
Providers in other states have reported similarly high intakes. Caroline Njaw, senior vice president of patient care services and chief nursing officer at Children’s Minnesota, said this year’s increase in RSV is the highest she’s seen in at least the last six years.
“Cases continue to rise and we haven’t seen a peak yet,” Njaw said. “And RSV itself accounts for two-thirds of the respiratory viral illnesses we see.”
Publicly available data from the Centers for Disease Control and Prevention (CDC) shows the prevalence of RSV in the Midwest, with states such as Minnesota, Nebraska, Missouri and Wisconsin among the top ten states in positivity rates. This data is incomplete, however, with nearly a quarter of states not reporting any case data.
The CDC said in a briefing on Friday that RSV cases are increasing in 8 of the 10 states under the Department of Health and Human Services. The southeastern and south-central regions of the United States are experiencing declines in cases, including states such as Alabama, Arkansas, Florida, Georgia, and Texas.
Andrew Pavia, head of the Division of Pediatric Infectious Diseases at the University of Utah, said this year RSV cases have moved in waves from the Southeast to the Northwest, which is the opposite of the virus observed across the West to East. US
Although RSV is a very common pathogen, Pavia said how it is transmitted is “very complicated.”
“We don’t really understand why. Does not follow strict weather conditions. It doesn’t follow a strict human movement,” Pavia said. But what you can say with certainty is that if it starts to accelerate in a region, it will take eight to 12 weeks to grow or have an epidemic that will last eight to 12 weeks.
Pavia said it might be a good thing the virus hasn’t reached an even level of severity across the US.
“There are regions where the children’s health care system is overcrowded and there are no ICU beds for children in the entire region. And that right now in the Midwest, people are reaching two or three states to get an ICU bed,” he said.
Health care providers who spoke to The Hill agreed that this latest RSV operation has highlighted old and new issues in the US pediatric health care system.
Newland said there are concerns that staffing at children’s hospitals may be insufficient, which could lead to delays in some services, such as non-emergency surgical procedures, similar to what has happened in the hardest-hit parts of the COVID-19 pandemic.
Pavia said Children’s Health Systems has lost many employees in the past three years and the rest of the staff are dealing with fires.
Another issue providers raise is the lack of capacity at children’s hospitals. Stephen Doller, chief of pediatrics at Nebraska Children’s Hospital and Medical Center, said the main concern during this virus surgery is running out of space.
“Whether it’s moving hospital playrooms back into medical inpatient rooms or moving our emergency department into inpatient rooms, we’re going to expand as much as we can to get them into the hospital,” Doller said.
There are no vaccines for RSV though Pfizer announced promising results At the beginning of this week, the mother’s vaccine. Monoclonal antibodies are sometimes used as a preventative measure in children who are at high risk for severe disease. Suppliers who spoke to The Hill said they have had no problems procuring and maintaining sufficient supplies of monoclonal antibodies.
Health professionals and providers are critical that parents recognize the signs that a child should go to the hospital for treatment if a child has a respiratory infection. RSV symptoms appear two to eight days after exposure to the virus, and symptoms last about a week on average.
Njaw advises parents of Minnesota children to watch for signs that their child is having difficulty breathing. If breathing is difficult, the baby starts to take short, rapid breaths and grunts when breathing. When a child breathes in, the rib cage is an indication that they are working very hard to breathe.
If they don’t get enough oxygen, the baby’s skin may turn blue or purple. In children with darker skin tones, a lack of oxygen can be seen in the same discoloration around their lips, gums and eyes. Njaw said parents should watch for signs that their child is dehydrated or has lost appetite.
Fortunately, almost everyone can recover from the disease, but especially for those born prematurely [and] They have other co-morbidities [it] It can have a significant effect on the respiratory system. And that is why it is so important to seek care for them,” said Njaw.