Health
RSV infection spreads rapidly in South Dakota
In South Dakota, an earlier and more virulent strain of RSV infection caused severe illness in young children, putting pediatric intensive care units on edge, especially when flu and COVID-19 cases surged in the winter. There are concerns that it may become
RSV (Respiratory Syncytial Virus) is a highly contagious infection that is common in children under the age of 2 and usually peaks in January and February. Representatives of Avera and Sanford’s health system said that visits and hospitalizations for RSV began to increase in late October and her early November, with the most severely ill patients receiving ventilators to assist breathing. said to be wearing
According to the US Centers for Disease Control and Prevention, nearly 20% of RSV tests were positive in the week ending October 29, nearly double the number in early October. South Dakota’s positive test rate in the week ending Oct. 29 rose to 12% from 5% in early October, according to the CDC. But that reported rate “seems to be low” compared to what doctors are seeing in the state, according to Kara Bruening, head of pediatrics at Abella McKennan in Sioux Falls.
“I can say clinically that it feels much higher than that,” Bruening said. And when COVID comes and the hospitalization rate goes up, there will be problems in pediatrics.”
Bruning said Abella’s pediatric intensive care unit has been at or near capacity for several weeks and staff are preparing to maintain that level “for the foreseeable future.” Sanford’s pediatric ICU is about 75 percent full, and another unit may handle patient overflow if needed, said Joe Segereon, deputy director and medical officer at Sanford Children’s Hospital.
“By talking to our pediatrician [specialists], they seem to think this year’s virus is more virulent,” Segereon said. “Children’s hospitals are experiencing surges in RSV each year, but according to their observations, children are significantly sicker this year.”
more:Health experts predict South Dakota’s flu season to be worse than usual, peaking early
RSV is spread through droplets released into the air when an infected person coughs, sneezes, or touches a contaminated surface. RSV can also be spread through direct contact with an infected person, according to the CDC.
An estimated 60,000 to 80,000 children under the age of 5 years are hospitalized each year nationwide due to RSV infection, usually due to inflammation of the airways due to mucus accumulation or pneumonia-associated infection of the lungs. Adults over the age of 65 and people with chronic heart or lung disease or weakened immune systems are also at risk of severe RSV infection.
The CDC recently said, “Surveillance indicates that RSV detections and RSV-related emergency department visits and hospitalizations are increasing in several regions of the United States, with some regions approaching seasonal peak levels. I issued a warning that it is being done.
Although there is currently no vaccine against RSV, the U.S. Food and Drug Administration granted Fast Track designation to an intranasal RSV vaccine candidate developed by Codagenix on November 2, with a Phase 1 dose-escalation trial scheduled for early 2023. increase.
The South Dakota Department of Health and state epidemiologist Josh Clayton did not respond to multiple requests for information from News Watch about the state’s response to the rising number of RSV cases. Meanwhile, medical professionals on the ground are closely monitoring the number of hospitalized patients and her ICU visits and responding with extreme caution.
“Most cases of RSV are fine, with a cough and a runny nose,” Bruning said. That being said, this year we are seeing very sick children who need hospitalization, but it is happening at a strange time and we are seeing a lot of children. where we are.
“He was really struggling”
Kim Stone noticed her 1-year-old son, Junior, was coughing more than usual over the weekend of October 8-9, but she wasn’t too concerned. But he seemed even more wheezing when she woke him up for a nap that Monday, with Mr. Stone, along with his 4-year-old daughter, Haven, taking him to bed. I took him to a local clinic. Both children were positive for her RSV.
Haven never had a bad cough, but Junior’s symptoms got worse. He was put on steroids on his October 11th and was breathing faster and by the next morning he was clearly out of breath with many contractions in his neck and ribcage.
“He was really struggling at that point,” said Stone, 27, who lives in Madison and works at Little Explorers Childcare in Sioux Falls. taken, where he was put on an IV for dehydration and given full oxygen as his levels were low.
“Thirty minutes after he was admitted to Madison Hospital, he had to be airlifted to Sanford Children’s Hospital in Sioux Falls,” Stone said. “He hadn’t improved at all.”
She took a drive with her husband, Josh, hearing the words “difficulty breathing” and “viral pneumonia” in her head. “It was really scary,” she said of her diagnosis, which she heard from her doctor.
Jr. received full oxygen via a ventilator at Sioux Falls, plus an IV for not eating or drinking. By the third day, doctors had taken him off oxygen a bit, he was playing with toys on the floor, and he was starting to look more like himself. By the end of the day, he was released from Children’s Hospital and returned to Madison with his family.
Stone estimates that as many as five children (including Junior) at Little Explorers Childcare, where she works, were hospitalized with RSV this fall. Many others have tested positive and are staying home. This is not an uncommon trend during community surge.
“Respiratory diseases tend to pass through daycare centers,” says Segeleon. “In very young children, less than 4 weeks old, it can manifest as apnea, which stops breathing. “It’s the buildup of inflammation and mucus plugging in the very small airways. In older children, it’s often the common cold, but it can be more serious if there’s an underlying medical condition.”
The American Academy of Pediatrics recommends removing children from day care or school if their temperature is over 101 degrees Celsius or if they have signs or symptoms of illness such as sore throat, rash, vomiting or diarrhea. The association and the CDC also emphasize proper hand hygiene and urge parents to keep their children up to date on recommended immunizations.
Stone said Little Explorers staff sanitize surfaces and toys throughout the day and try to keep children “as close to each other as possible.” A child with a temperature above her 101 degrees will be sent home for at least 24 hours.
Junior is happy to be home, but he has to take two inhalers twice a day to help him breathe.
“He doesn’t really like it,” Stone said. “But we’re glad he’s back.”
Pandemic-affected immunity
Last year, South Dakota experienced a summer spike in RSV, with cases peaking in July. Segeleon said most experts believe this is due to the disruption of “frequency of exposure to infectious diseases and viruses” due to social changes that took place at the height of the COVID-19 pandemic. .
“We experienced a period of dramatic decline in pediatric visits,” said Segeleon, an expert in pediatric critical care. “They have decreased because schools have closed [in the spring of 2020] Reduced amount of socializing, including after-school activities and social programs. “
Other COVID-19 precautions are also factors in keeping overall transmission low, he said.
“We were also much more aware of things like hand hygiene and wearing masks to some extent. I don’t know how long it will take me to get back.”
Positive rates of RSV tests were higher during the 2021 summer spike than this fall, but Avera’s Bruning said the spike “hit quickly, was fairly mild, and then went away.” Health experts are investigating the possibility that pandemic-related disruptions may have affected immune profiles, making some children more susceptible to, and in some cases more severe, respiratory viruses.
more:How seriously does South Dakota take the multi-million dollar zebra mussel threat?
“There are whole cohorts of young children in daycares, preschools, or in the community who are not constantly exposed to the virus as they normally would,” said Vandana Madhavan, senior pediatrics director at Mass General Brigham in Boston. told NPR. “And now they’re exposed and they’re being hit very hard.”
Regarding the current wave of RSV, Bruning said that before health systems could assess the potential for simultaneous outbreaks of RSV, influenza, and possibly COVID-19, and what that would mean for pediatric resources, , said it depends on how long it lasts and whether it remains highly virulent.
“I hope it doesn’t,” she said.
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