Seasonal Influences on Children’s Hospital Colorado and the Challenge of RSV: A Dr. Kevin Messacar, MD, M.D., COVID-19 Adjunct Adviser
Children’s Hospital Colorado has seen an early uptick in RSV hospitalizations and is starting to see the first few flu cases of the season, said Dr. Kevin Messacar, an infectious disease specialist and associate professor at the University of Colorado School of Medicine.
Researchers don’t understand a lot of seasonal viruses. rhinoviruses, which are the most popular cause of colds, seem to have little impact on COVID-19 restrictions because of reasons that are not fully understood. Miller says it could be because of their hardy nature. They can persist in the environment for a long time.
If your child is preemies, newborns, kids with weakened immune systems, kids with chronic lung and heart conditions, or children under 2 years old, then you should be careful with RSV.
Hospitals are functioning at the edge of how they can function, because we’ve been strapped. Staffing needs are largely to blame for the fact that we’re seeing more people requiring help and fewer beds available. “This combination is going to create more and more problems.”
In the advisory, hospitals were guided to keep heightened awareness for these more severe infections when treating pediatric patients, and parents were instructed to keep an eye out for specific symptoms, like difficulty breathing and the sudden onset of limb weakness.
If you see that a child’s chest is moving up and down when they breathe, if their cough won’t let them sleep or if it’s getting worse, “that might be a sign that they need to seek help from their pediatrician or take them to the emergency department, because then they might need a supplemental oxygen, or they may need a nebulization treatment.”
Children’s Hospitals in Connecticut are Slammed with RSV and Undergone Diagnosis after a Girl’s Day Out of State
After the Sizemore family went out of state to celebrate their daughter’s birthday last week, they hoped Raegan would try swimming. But the 15-month-old, normally energetic and adventurous, wasn’t herself on Saturday.
RSV, or respiratory syncytial virus, is a common respiratory infection that typically causes mild, cold-like symptoms, but it can cause serious illness, particularly in older adults and infants.
The staff at UHRainbow Babies & Children’s Hospital in Cleveland knew they needed to admit Raegan as soon as they saw her vitals. She needed help with her breathing.
For some kids it can be a serious and life threatening disease. The CDC says that children with chronic lung and heart conditions, as well as preemies with weakened immune systems or Muscular disorders, are particularly vulnerable to being affected by RSV.
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.
UH Rainbow Babies went on diversion for two days in October due to it not being able to take external emergency admissions. It’s taking patients again now, but it’s still slammed with RSV cases.
Connecticut Children’s Hospital, with the help of the governor and public health commissioner, is trying to decide whether to use the National Guard to open up more beds for young patients in Connecticut.
The case of RSV in the United Hospital for Children’s Oncology, an analogy with a pediatric nurse at an ambulatory hospital
“I don’t know how but she slept with those ice packs on top of her,” Zoey Green said, holding an exhausted Lindy at the hospital. She said they are hydrating her to make sure she doesn’t have to go back to an IV.
She said that their census numbers were pretty high as they figure out how to accommodate all the sick in the community.
staff at UH Rainbow Babies are hoping the situation wont 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.
When everyone stayed home in 2020 and 2021 to prevent the spread of the coronavirus, it seemed to change the typical RSV season. Themunity gap was created due to low case counts.
It’s generally such a mild illness that adults often don’t realize they have it, or they think it’s nothing more than a cold or allergies and go on to interact with others.
You do feel fine even though it is a fatiguing virus, since it is not the same as Covid. “And then what happens is, your neighbor has that beautiful baby, and you bring over a casserole, and you kiss that little baby because you feel fine. You do not feel sick. And unfortunately, you pass it on to them, and sometimes they end up at the hospital.”
What to Look For when You’re Sick: What to Do When You Are Sick, and How to Take Care Of Your Hands
“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 wants people to wash their hands before touching their faces.
When kids or grownups are sick, they need to do one thing and one thing only, she said: “Stay home when you are sick so you won’t spread whatever respiratory illness you have.”
“I would like other parents to know they shouldn’t watch their child’s cough lightly and take symptoms seriously,” she said. This could have been a lot worse 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.
The importance of knowing what to watch for with the respiratory syncytial virus is stated by Mora, who is a volunteer medical representative for the American Lung Association. That way, they know whether a sick child can be treated at home or needs to go to a hospital.
On average, an infection lasts five days to a couple of weeks, and it will often go away on its own, the CDC says. The cough can last for several weeks, according to doctors.
Parents should watch for any changes in behavior, she said, including taking longer to eat or not being interested in food at all. A child can have a severe cough.
It may be a good idea to seek more intensive care if an infant or young child is working too hard. The skin between the ribs or collarbone pulls into and out when they breathe and exhale, that includes a flaring of the nostrils.
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Cold medicines can sometimes contain ingredients that are bad for kids, so talk to your doctor before giving them to your child.
This respiratory difficulty that includes a bobbing head is one of the two major trouble signs that you should avoid if you have a respiratory illness. The other is dehydration. “That particularly applies to babies with stuffy noses. They might not be feeding.
There is a thin tube that can be inserted into the lungs to remove mucus. A child can be helped with extra oxygen through a mask or tube. Some children may need to use an oxygen tent. Those who are struggling a lot may need a ventilator.
Parents should be concerned about the Children’s COVID-19 Epidemic — A Brief History and Some Frequently-Fried Questions from Health Experts
How concerned should parents be? The answers to some of the most frequently asked questions about the outbreak are here.
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.
These viruses are sweeping through young children who have no prior exposure to them and no immunity. Older people are at higher risk of having an immunity-related problem. Experts aren’t recommending dropping all guards to build immunity. But they do note that social distancing and masking measures played a role in throwing other viruses off their historical patterns. Mary Krauland, a research assistant professor in the school of public health at the University of Pittsburgh says that by doing that you prevent other things that are less infectious. People are more vulnerable over time.
“My hope is that this is not the new normal,” Madhavan said on Friday. “For this year, it is concerning because we don’t know what we will see as we head deeper into fall and especially this winter.”
What can families do to prevent the spread of RSV in children’s infants and toddlers? A pedagogical note on the role of the immune system
The problem is that their small lungs and muscles can’t muster up the power to cough up or sneeze out the increased secretions and mucus caused in their airways.
“They have a hard time getting out the excess fluid, that causes them to have problems eating and drinking, that’s why they have trouble breathing, that’s the reason,” he said.
Health officials say that hand washing, staying hydrated, and keeping your hands away from your face are some of the things you can do to prevent the spread of the RSV disease.
She suggested not being shy about grilling others about how they’ve been feeling. “A lot of the time when people ask that question, the person on the other end really only thinks to mention anything if they’ve been really sick, so they don’t think to mention if they’ve had a minor cold.” That could become a more serious case for an infant or toddler.
Updating COVID booster and flu vaccine is the best way for children and adult to stay healthy throughout the remainder of the fall and winter season, said Madhavan.
Anyone under the age of six months can get the vaccine. It takes about two weeks for the shot’s full protection to take effect. If a kid is under eight years old, and they have never received a vaccine before, they will not get protection until two weeks after the second dose.
The COVID bivalent boosters for people 5 and older became available in September. And children over six months can get any of the three available COVID-19 vaccines. Don’t wait until the middle of a new wave to get your booster, warns Madhavan.
There is, however, a treatment called palivizumab that is available to high-risk infants. It is an injection that can be given to premies and other babies born with certain lung or heart conditions who are at high risk for severe RSV disease. During the season, it is administered once a month.
The immune system doesn’t work long term, but it can still give additional protection during high-risk periods for those children by giving them a vaccine that is anti-RSV.
Pediatric Health Care: An Emerging Emergency Room for Mental Health in the Era of the Pandemic and Growing Populations, a Commentary by Ms. Madhavan
palivizumab is not given to everyone, according to Madhavan. There is a possibility of more serious side effects from the drug, which include swelling of the throat, difficulty breathing, and unresponsiveness.
If you think you have it, you need to call your doctor or nurse instead of going to a hospital that might be long waits or exposure to other viruses that your child and family don’t have.
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 the child is older than one, they can suggest ways to treat a cough or bring down a high temperature.
Editor’s Note: Moira Szilagyi, MD, PhD, FAAP, is the president of the American Academy of Pediatrics. The views expressed in this commentary belong to the author. View more opinion at CNN.
First, we must invest in resources to care for children with mental health conditions. The AAP and more than 130 organizations recently urged the Biden administration to declare a national emergency in children’s mental health, which would galvanize funding and support access to care.
Respiratory therapists and nurses are understaffed, and the additional shortages that came about when clinicians left their jobs during the Pandemic have to be addressed. Chronically overburdened and understaffed systems can put children in need of care at risk, as clinicians are often too busy to take good care of them. We need to expand the pediatric health care workforce and improve our support of them.
There are videos on Healthy Children’s website that can show a child in need of medical care for a respiratory disease.
A parent concerned enough about their child’s symptoms to seek care in an emergency room should not have to worry they’ll be turned away. Let’s use this moment to make sure we can care for all children in the same places.
The number of flu illnesses, hospitalizations and deaths in the US has nearly doubled in the past week. The CDC now estimates that there have been at least 1.6 million illnesses, 13,000 hospitalizations and 730 deaths from influenza, including two reported deaths among children so far this season. A number of flu tests were positive last week.
Since the H1N1 swine flu epidemic, flu hospitalization rates have been very high this early in the season. The data goes through October 29, the latest CDC update.
Less than one in five beds are available in seventeen states. Rhode Island,Arizona, Maine, Minnesota and Delaware are all full along with Washington, DC.
The Granddaddy of the Viruses, Flu: Where do we stand? How do we fight it? Why do we go? What can we do about it?
COVID-19 limits make us more susceptible to these viruses. The current surge in the Northern Hemisphere will be followed by a new normal.
The University of Pennsylvania professor says that theviruses are coming back with a vengeance. “It is possible that this year will be sort of the granddaddy of them all in terms of flu.”
For older children and adults who have been previously infected, the problem is waning immunity. Antitrypsin levels decline when there is no exposure to a virus. In a typical year, “we might get exposed to a small bit of virus and your body fights it off”, says John Tregoning, an immunologist at Imperial College London. That kind of boosting has not happened in the last few years.
There is one open question about how theviruses compete and interfere with one another. Infection with one virus can raise a strong innate immune response that might prevent infection with another virus. Hensley states that last year the first wave of flu declined soon after the Omicron surge began. It might be possible that Omicron provided some protection against flu. Or maybe the Omicron surge simply convinced people to mask up and keep their distance.
What is the worst winter, and what is the least unusual winter? – J. Pitzer, C.S. Brown, and M. L. Macaulay, Ph.D. Anderson
Pitzer thinks the peaks and valleys will look similar to those thatcurred before the Pandemic. She isn’t placing any bets. But she says: “I do expect that this winter is probably going to be the last unusual winter.”