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Pediatricians warn of surge in respiratory infections, flu and COVID-19 in children

Pediatricians warn of surge in respiratory infections, flu and COVID-19 in children

 


BUFFALO, NY – Oscar G. Gomez-Duarte, M.D., has called for the federal government to declare a formal emergency this month for pediatrics across the country as cases of respiratory syncytial virus (RSV) and influenza surge. The request from the hospital was not surprising.

As director of the Department of Pediatrics, Infectious Diseases at the University of Buffalo Jacobs School of Medicine and Biomedical Sciences, and director of the Pediatric Infectious Diseases Service at John R. Oishay Children’s Hospital, Gomez has seen the surge in cases first-hand. Both RSV and influenza are transmitted, resulting in increased hospitalization of children.

By September, Daisei Children’s Hospital reported more RSV hospitalizations than seen for the entire 2019-20 respiratory season, with higher influenza infection rates and some requiring hospitalization. did.

Gomez said the surge early in the season was unusual and particularly concerning because COVID-19 and childhood flu vaccination rates are so low. In addition to an increase in RSV cases this winter, there may be an increase in cases, especially among unvaccinated children.

How would you characterize this season so far for RSV and influenza in children?

“What we are concerned about is not just the number of infections, but the severity of these infections, which is driving up the number of emergency room visits and hospitalizations. It’s a more dramatic increase than usual, especially at this point in the season, and we’ve seen a significant increase in cases this year, and this is even before the winter season begins. RSV cases peaked in the summer and another peak was reported in October.This RSV transmission pattern is quite different from what was typically seen before the COVID-19 pandemic.”

How do you think COVID-19 has affected the rise of other respiratory viruses?

“The surge in respiratory viruses we are seeing now is very likely related to the dramatic changes in community behavior over the past two years due to the COVID-19 pandemic.

“These behaviors greatly restricted the normal exchange of viruses that normally occurs by people interacting with each other. This is especially true. Its exposure allows children to develop natural immunity to common respiratory viruses at an early age.

“During much of the pandemic, there was no viral exchange and there were gaps in natural protective immunity. Exposure to these viruses that were not present resulted in higher peaks of infection and by far the highest number of ER visits and hospitalizations.There was an increase in RSV in particular, and some of these cases were It’s serious.”

What factors make children particularly susceptible to developing respiratory syncytial virus?

“RSV tends to affect very young people, under the age of two. Those at greatest risk are premature or immunocompromised infants.”

Are most children with underlying medical conditions hospitalized with RSV and influenza?

“We see hospitalizations for RSV and/or influenza among previously healthy RSV-infected children with no comorbidities. You can see it in the children who have it.”

Are there cases of children being infected with two viruses at once?

“Yes, some children get caught with multiple viruses at once, a condition we call co-infection. These co-infections tend to be more serious than if a child had just one infection. Different viruses can attack different receptors and use different mechanisms to damage respiratory cells, which can exacerbate the disease and, in some cases, prevent it from being used for management. Your child may need to be admitted to the intensive care unit at

What treatments are available for children hospitalized with RSV or influenza?

“There are specific treatments for influenza and COVID-19, but there are no specific treatments for RSV and other respiratory viruses. If the child’s breathing is severely impaired, we will give the child oxygen and, depending on the severity of the respiratory failure, a more powerful machine such as a ventilator. We may even need to take action.”

Can children be vaccinated against RSV?

“Passive immunization in the form of monoclonal antibodies is available for premature babies during the RSV season. This FDA-approved monoclonal antibody, named Palivizumab, has the ability to block RSV and reduce the severity of RSV infection. I have.

“There is no effective vaccine against RSV licensed for children or adults in the United States. However, there is evidence that pregnant mothers pass antibodies against RSV to their babies. Pregnant mothers pass those antibodies on to their babies, and it was recently reported that these infants have a lower risk of developing RSV infection.These developments are very good news for the future, and vaccination is recommended. Pregnant women who receive it may be able to pass this protection on to their babies.”

How worried are you that your children could start contracting COVID-19 this winter, in addition to RSV and flu?

“COVID-19 stays with us just like RSV, influenza and other respiratory viruses. Current subspecies of the COVID-19 virus are becoming resistant to preventative measures such as monoclonal antibodies, but vaccines are still protective.

“The low vaccination coverage of COVID-19 and influenza vaccines among children in our community is a concern. Nationwide, only 4% of children under the age of 5 and less than one-third of children aged 5-11 have received the COVID vaccine series. There is strong evidence that vaccines prevent infections, prevent hospitalizations, and prevent deaths from COVID-19.

What should parents do?

“The first and most important way to protect children is to ensure they are vaccinated against diseases for which vaccines are available, such as influenza and COVID-19.

“If a child has a respiratory infection, they may experience upper respiratory symptoms such as fever, sore throat, cough and nasal congestion.

“Parents should be aware of more concerning symptoms such as shortness of breath. You need to take immediate action, such as taking him to a police station or calling 911.

“However, most respiratory infections in children are self-healing and are not related to shortness of breath.

Sources

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2/ https://www.buffalo.edu/news/tipsheets/2022/018.html

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