‘Unprecedented’ spike in RSV cases filling pediatric ICU beds

Initially, Logan Bentley had a mild fever and no other signs of illness.

However, after a few days, the Geneva infant began to have trouble breathing. His mom noticed that his nostrils were on fire.

“His symptoms did not appear immediately,” Christie Bentley said. “And when they attacked, they attacked and it escalated pretty quickly.”

Logan, now 15 months old, was rushed to the emergency room in September with respiratory syncytial virus known as RSV.

RSV cases are surging faster than usual, and children’s hospitals are overflowing with sick children.

Dr. Melissa Manrique, a pediatric hospitalist at Northwestern Medicine Central Dupage Hospital in Winfield, said she had never seen such a surge in her 14-year career.

The RSV season usually runs from October or November through March. But this year’s cases began to rise around mid-September, Manrique said.

“We have certainly experienced RSV and influenza surges in the past.” I have.”

The hospital’s pediatric inpatient and intensive care units were operating at full capacity last week. Doctors say they see cases of enteroviruses, rhinoviruses and influenza, but the dominant virus is RSV, causing him 75% of respiratory-related pediatric hospitalizations at Central DuPage .

The Illinois Department of Public Health reported that as of October 25, only 6 percent of pediatric intensive care unit beds were available statewide.

“We have been operating at maximum capacity for the past five weeks, and our emergency rooms continue to register record numbers of patients,” Manrique said.

Hospitals are prepared for three threats. An influx of RSV cases collides with the start of the flu season, and a possible winter spike in COVID-19 cases.

“Given the limited number of beds in pediatric hospitals and pediatric wards, I really think we need to have a high level of concern at this time,” Manrique said.

Why RSV is on the rise

Most children have been infected with RSV at least once by the time they are 2 years old. The virus often presents like a cold in older children and some adults.

However, some pediatricians say this year’s RSV season has led to severe respiratory symptoms and lengthy hospital stays.

Most people with Central DuPage are under the age of 1, and infants are more severely affected. Doctors say there is also an increase in infants and preschool children requiring hospitalization for RSV-related dyspnea.

When the children remained in the home environment, Manrique said, “they lacked other natural immune builds against the virus.

The youngest patient “has not had many infections in the last two years,” said Dr. Michael Capello, vice chair of pediatrics at Advocate Children’s Hospital in Park Ridge.

“They were segregated behind masks,” he said. “And now we’re uncovering a lot, and the same children who may have been gradually exposed over time — everyone understands it all at once.”

At the Park Ridge campus, nearly 40 patients were infected with RSV last Wednesday, including five in the pediatric intensive care unit, Cappello said.

“We are trying to find creative ways to find more space for adult partners to see if they can help some of our older patients.

Illinois Department of Public Health officials advise medical facilities to consider cross-training non-pediatric staff members who may be able to provide patient care in the pediatric area in response to surge in respiratory infections Did.

“Increased visits and hospitalizations have created a health system crisis in access to pediatric emergency care with a severe shortage of pediatric intensive care unit (PICU) beds, directly impacting health system capacity heading into the fall/winter. We are giving,” said an IDPH official. Oct 20 An alert has been sent to the hospital.

According to the Centers for Disease Control and Prevention, more than 5,000 laboratory tests were reported to be positive for RSV nationwide during the week of October 22nd.

Capello praised emergency room and inpatient doctors, nurses and respiratory therapists for “really going above and beyond” to manage patient numbers.

“It just comes at us in fast waves,” Capello said. “There was really no break.”

Get vaccinated against influenza

There is no vaccine to prevent RSV infection. Dr. Nicholas Tapas, a pediatrician at Central DuPage Hospital, said monthly injections of Synagis, an antibody drug, are currently available on a limited basis to boost immunity in certain high-risk and severely premature infants. .

With all these respiratory viruses circulating at once, experts are calling on parents to vaccinate their children against flu and COVID-19.

“This takes two out of three issues off the agenda,” Dr. Ashish Jha, the White House COVID-19 response coordinator, said at a briefing last week. “It also creates more capacity for the health care system.”

The CDC recommends that everyone over the age of 6 months should get the flu vaccine every year.

Tips for parents

Parents should seek emergency medical attention if their child has trouble breathing.

“The child may be breathing faster than normal and may be using his ribs and abdominal muscles to exhale and inhale,” Manrique said.

About 58,000 children under the age of five are hospitalized for RSV each year, according to the CDC. It can cause pneumonia, bronchiolitis, and inflammation of the small airways in the lungs.

“It is spread by droplets, contact with actively infected people. Minimizing it will reduce transmission to others,” Arlington Heights.

Hospitalized patients primarily receive supportive care, including oxygen, intravenous fluids, and nasal aspiration to remove secretions.

Frequent hand washing helps prevent the spread of RSV.

“Unlike COVID, which is purely airborne, RSV is mostly surface-borne,” Jha said. “So it turns out that washing hands is actually very good for RSV.”

Christie Bentley, mother of three, urges parents to stay vigilant as the infection progresses. Logan was first diagnosed with RSV at the pediatrician’s office.

“Very scary,” Bentley said after seeing his son experiencing breathing problems.

After a trip to the emergency room, he came home with a nebulizer.

“When he played with his brothers and wanted to keep up with them,” said Bentley.

Last week, his parents took Logan to the nearest emergency room when he contracted another virus and an ear infection.