Pediatric units at hospitals in the Lehigh Valley and across the United States have seen an outbreak of respiratory syncytial virus in children this month.
Although RSV, a common respiratory infection, virtually disappeared in the early stages of the COVID-19 pandemic, it is back with a vengeance in the summer of 2021. The number of cases declined in early 2022 and rose slightly before reaching a stable plateau this summer. But Dr. Nathan Hagstrom, chairman of pediatrics at Lehigh Valley Health Network’s Reilly Children’s Hospital, said hospitals are seeing a much sharper and sharper spike in cases than last year.
He said the network is seeing an all-time high of RSV cases, both inpatient and outpatient, with a significant number requiring more intensive care, such as ventilators. During the week ending Oct. 22, there were 286 cases of RSV confirmed by Health Network Laboratories, LVHN’s laboratory service, more than double the number confirmed two weeks earlier.
With staffing already at suboptimal levels, the influx of children with RSV puts a significant strain on the network and its resources, Hagstrom said.
“It hit our emergency room the hardest, it was really hard for them,” Hagstrom said. “But everyone is really stepping [up] and does an incredible job.”
During a news conference this month, Dr. Ron Keren, chief medical officer at Children’s Hospital of Philadelphia, also said that there are a large number of very sick children with RSV.
“The volumes are now extremely high in primary care pediatricians’ offices, in urgent care centers, in our emergency departments, and also in our inpatient units,” Keren said. “It puts a lot of strain on the system. And this is a phenomenon that happens all over the country.”
RSV causes symptoms similar to the common cold, such as a runny nose and cough. But in young children and infants, RSV can cause bronchiolitis, inflammation and swelling of the smallest airways in the body. Because the airways of young babies are small, the condition can lead to difficulty breathing and make it difficult for them to drink and eat.
Hagstrom said children usually start experiencing less severe symptoms by age 3 to 4, although LVHN sees some 3-year-olds who are quite sick with RSV. People with asthma or other respiratory conditions are also prone to more severe disease.
Warning signs of bronchiolitis are wheezing, difficulty breathing, and deep chest tightness. Children may also take very frequent and shallow breaths, refuse to drink or eat, and their skin may start to turn blue, especially around the lips and nails.
“If you see these signs, you should definitely see your child’s primary care doctor,” Hagstrom said.
Experts believe that a major factor in the increase in RSV is that children’s immune systems have been suppressed by measures to combat COVID-19, such as masks and social distancing, which have helped reduce the spread of many respiratory infections. With far fewer people engaging in these behaviors and their immune systems weakening at the same time, there will likely be more cases of respiratory infections like RSV and the flu, Hagstrom said.
During the CHOP press conference, Keren said that children were exposed to viruses all the time before the pandemic, and in a typical year they may have eight to 10 colds. Many children are now being exposed to RSV for the first time.
“You don’t build up your defenses against these viruses, and then when you’re exposed to them, you see them for the first time, you don’t have immunity to them, and you’re likely to have a more severe form of that infection,” Keren said.
Keren said the industry-wide health care problem is also contributing to overcrowding in children’s health care facilities: Some hospitals are closing pediatric departmentswhich has led to large regional pediatric hospitals like CHOP picking up the slack.
There are several things parents or caregivers can do to protect children from RSV.
First, make sure children know about proper hand hygiene. Dr. Kathy Lockwood, CHOP’s primary care physician, said that means teaching children how they should wash their hands.
“I know as pediatricians we think about this all the time and it seems like common sense, but I’m a parent,” Lockwood said. “I don’t know if you’ve ever watched your child wash their hands, but they often don’t do what we recommend, which is the full 20 seconds and get in all the nooks and crannies between their fingers and on their wrists. .”
Parents should also keep their children home when they are sick and away from other children and people who are sick.
Hagstrom said for children who are sick but well enough to recover at home, there are several things parents can do to help children get through the illness. He said making sure children’s nasal passages are clear goes a long way in helping them breathe easier.
Also, parents should keep an eye on their children’s hydration, Lockwood said.
“I always say this is the time to bribe them with things that pediatricians don’t normally like, including sugary drinks like juice or ice — any way you can tempt them to take small sips of liquid,” Lockwood said. “If your baby is over 1 year old, you can also give him some honey, and sometimes honey and warm apple juice or decaffeinated tea can soothe a sore throat from a cough.”
Morning Call reporter Leif Grice can be reached at 610-679-4028 or firstname.lastname@example.org.