The Rise of Respiratory Syncytial Viruses in Connecticut Children’s Hospitals After the 2019 H1N1 Influence
The rates of all viruses plummeted when the United States was hit with the H1N1 flu in March of 2020. She said that’s mostly due to people staying indoors wearing masks and washing their hands frequently.
Temperatures are dropping and the risk of COVID-19 and influenza are up. And for the last few months, patients with a different malady — respiratory syncytial virus, known as RSV — have been overwhelming hospitals. Public health officials say it could be a “Tripledemic” in winter.
I have been doing this for a long time. I’ve been at Connecticut Children’s for 25 years, and I’ve never seen this level of surge specifically for RSV coming into our hospital,” Dr. Juan Salazar, the hospital’s executive vice president and physician in chief, told CNN.
Hospitals have been functioning at the edge of how they can function, because we’ve been strapped. We’re seeing more people requiring help and fewer beds available, largely due to staffing needs,” explained Kalu. “There will be more and more problems as a result of this combination.”
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Kalu said that if parents notice these symptoms of infection, in addition to a runny nose, a cough or a fever, they usually can be managed at home with attentive care.
To pay particular attention to respiratory distress, parents should be very astute to any changes in their activity and appetite.
When Amber Sizemore and her family went out of state to celebrate her birthday last week, she had hoped her toddler daughter, Raegan, would try swimming. The 15-month-old wasn’t herself on Saturday.
Sizemore took her to urgent care and told them what Sizemore also knows: that Raegan’s day care was suffering from the common cold-like virus, called respiratory syncytial Viruses orRSV.
As soon as they saw her vitals, the staff at UH Rainbow Babies & Children’s Hospital in Cleveland knew they had to admit Raegan, her mom said. She needed oxygen.
The US Centers for Disease Control and Prevention says most kids catch the disease when they’re 2 years old. Most adults who catch it will only have a mild illness, but for people with weakened immune systems or chronic heart or lung disease, it can be dangerous. But RSV can be especially tricky for infants and kids.
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The US Department of Health and Human Services does not specify the reason for hospitalization, but about three-quarters of pediatric hospital beds available nationwide are being used now. By comparison, pediatric hospital beds were about two-thirds full on an average day over the past two years.
The UH Rainbow Babies had so many patients that they went on diversion for a couple of days, which meant they couldn’t get emergency admissions. It’s taking patients again now, but it’s still slammed with RSV cases.
Connecticut Children’s Hospital and the governor and public health commissioner have been working on a plan to deal with a rise in cases where the National Guard is needed.
Zoey Green said she didn’t know how she slept with ice packs on top of her. They are trying to hydration her so she doesn’t have to take an IV again.
“We are very full, and our census numbers are pretty high as we work through kind of figuring out how to accommodate all of the sick kiddos in the community,” she said.
At UH Rainbow Babies, staff are hoping things don’t get much worse. “I mean, I hope we’re peaking right now, because if we’re not, then holy hell,” said Dr. Amy Edwards, associate medical director for pediatric infection control.
Source: https://www.cnn.com/2022/10/21/health/rsv-hospitals-what-to-know-wellness/index.html
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When everyone stayed home in 2020 and 2021 to prevent the spread of the coronavirus, it seemed to change the typical RSV season. Case counts were low, and that created an “immunity gap.”
Adults usually don’t realize they have a mild illness, or that they think it’s just a cold or allergy, and go on to interact with others.
“It’s not a fatiguing virus the way influenza or Covid is, so you really do feel fine,” Edwards said. Then your neighbor has a baby and you kiss that baby because you feel fine, then you bring over a casserole. You don’t feel sick. Sometimes, you pass it on to them, and they end up in the hospital.
“Hand hygiene is the single most important thing that we can do to keep ourselves and others safe,” said Davis, of the children’s hospital in Grand Rapids. She tells people to never touch their faces unless they recently washed their hands.
She told the children to stay home when they are sick so that they don’t spread any respiratory illnesses.
She wanted other parents to know that they shouldn’t watch their childs cough lightly and take their symptoms very seriously. “This could have been a much worse situation if we didn’t get Raegan help.”
Like her peers across the country, the allergist and immunologist has been treating little ones with this cold-like virus well before the season usually starts.
It is important to take a sick child to a doctor since it is hard for parents to distinguish respiratory illnesses, like flu, from other illnesses.
The average time for an infection to last is five days to a couple of weeks, according to the CDC. Doctors say the cough can linger for up to four weeks.
She said that parents should watch out for any changes in behavior, like taking longer to eat or not being interested in food. The child can also have a bad cough and wheeze.
But, Madhavan warns, it may be time to seek more intensive care when an infant or young child is working extra-hard to breath. That includes grunting and a flaring of the nostrils, as they exhale and inhale, or the skin between the ribs or collarbone pulling out.
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CNN medical analyst Dr. Leana Wen says this respiratory difficulty – including a bobbing head, a flaring nose or grunting – is one of two major trouble signs with any respiratory infection. Dehydration is the other. “That particularly applies to babies with stuffy noses. They may not be feeding.”
They may need a thin tube inserted into their lungs. A child can get oxygen through a tube attached to their nose. Some kids might need to use an oxygen tent. Those who are struggling are more likely to need a ventilator.
How concerned should parents be? Answers to common questions about the RSV outbreak and why it’s causing more deaths than we thought they would be
How concerned should parents be? Here are answers to some of the most common questions about the RSV infection, who is most at risk and what might be causing this year’s outbreak.
While it may be too early to know for sure, health experts agree that the earlier-than-usual surges are a consequence of the broad lifting of COVID-19 precautions, which served to protect the public from a variety of viruses.
After restrictions were loosened, health experts started to notice strange patterns of circulation of the respiratory viruses. This year, the return to pre-COVID social activities and interactions, travel and in-class teaching has led to another dangerous spike, Madhavan explained.
“My hope is that this is not the new normal,” Madhavan said on Friday. This year it’s concerning because we don’t know what to expect when we head into fall and winter, especially since it is only late October.
The small lungs of the people who live there can’t cough up or sneeze out the increased mucus that accumulates in their airways.
“They have a hard time getting out that excess fluid and that’s why they have trouble breathing which then that leads to problems eating and drinking,” Madhavan said.
Health officials say handwashing, staying hydrated, keeping hands away from the face and disinfecting surfaces help to stave off RSV or keep it from becoming a serious illness.
She suggested not being shy about grilling others about how they’ve been feeling. “It’s not uncommon for the person on the other side to only think about if they’ve had a really bad cold, so they don’t mention if they’ve had a minor cold.” It could be a serious case for an infant or a toddler if that is the case.
Madhavan said the effective way for children and adults to try to stay healthy throughout the remaining fall and winter months, is to get updated COVID booster and influenza vaccines.
Anyone under the age of six months can get the vaccine. Madhavan noted that it takes a couple of weeks for the shot’s full protection to take effect. “If a child is under eight and has never gotten influenza vaccine before, they need two doses one month apart before getting full protection two weeks after that second dose,” she added.
The COVID bivalent boosters are for people over the age of 5. And children over six months can get any of the three available COVID-19 vaccines. Don’t wait until we’re in the middle of another wave to get the booster, warns Madhavan.
There is, however, a treatment called palivizumab that is available to high-risk infants. Babies who are at risk for severe rsV disease because of certain lung or heart conditions can be given the injection. It happens once a month during the season.
“It is not a vaccine in that it doesn’t help the immune system make longer term immune protection, but it keeps giving antibody against RSV every month during those high-risk periods for those high-risk children to give them additional protection,” Madhavan explained.
Source: https://www.npr.org/2022/11/02/1133040571/rsv-questions-answers-treatment-options
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palivizumab isn’t given to all children, said Madhavan. Part of that is due to the possible, more serious side effects associated with the drug, which include swelling of the throat, difficult or rapid breathing, muscle weakness, and unresponsiveness.
“If you think you or your child has it, it’s best to pick up the phone and call your doctor or nurse rather than coming into a setting that might mean a long wait or might mean exposure to other viruses that your child and family don’t have and can have risks on their own,” she said.
Madhavan said that in most cases, health care professionals can go through a checklist of warning signs and make suggestions for potential at-home treatments.
“Based on that information they can recommend that you start doing nasal saline drops, use a humidifier or shower, or do other things to help loosen up mucus and decrease congestion,” she said. If it’s a child older than one, they may say to try honey to help with a cough or give some advice on how to reduce the severity of their illness.
The South has highest flu activity followed by the Mid-Atlantic and the West Coast. Data from Walgreens that tracks prescriptions for antiviral treatments – such as Tamiflu – suggest there are hotspots in Mississippi and Alabama, as well as the Gulf Coast area, including Houston and New Orleans.
It has been more than a decade – since the H1N1 swine flu pandemic – since flu hospitalization rates have been this high at this point in the season. The updated CDC tracks data through October 29.
As of Friday, seventeen states have less than one in five beds available. Five of them are more than 90% full: Rhode Island, Arizona, Maine, Minnesota and Delaware, along with Washington, DC.