Why Pediatricians Are Wary of Childhood Respiratory Infections, Flu, and COVID Surges – UBNow: News and Views for UB Educators

Children’s hospitals across the country this month have urged the federal government to declare a formal state of emergency in light of a surge in cases of respiratory syncytial virus (RSV) and influenza, according to UB faculty member Oscar G. Gómez- It was no surprise to Duarte.

As head of the infectious diseases division at Jacobs College of Medicine’s Department of Pediatrics and director of Pediatric Infectious Diseases Services at John R. Oishay Children’s Hospital, Gomez has seen first-hand the surge in both RSV and influenza cases. As a result, hospitalizations for children are increasing.

By September, Daisei Children’s Hospital reported that more RSV patients had been hospitalized than in the entire 2019-20 respiratory season, leading to higher influenza infection rates and some requiring hospitalization.

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.

In this Q&A, Gómez tells UBNow why doctors are so worried and what parents can do to keep their kids healthy.

What worries us is not just the number of infections, but the severity of these infections, which has led to numerous emergency room visits and hospitalizations. I’m applying pressure. This is a more dramatic increase than usual, especially at this point in the season. There has been a significant increase in cases this year, and this is even before the start of the winter season.This summer he saw a peak in RSV cases, with another peak reported in October. This pattern of RSV transmission in him is quite different from the pattern normally seen before the COVID-19 pandemic.

The surge in respiratory viruses we are seeing now is most 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 people normally do by interacting with each other. Yes. That exposure allows children to develop natural immunity to common respiratory viruses at an early age.

During much of the pandemic, there was no virus exchange and gaps in natural protective immunity. Now that children are attending daycares, schools, and other gatherings again, exposure to these viruses, which had not been exposed in the past two years, has resulted in higher peaks of infection, leading to ER visits and hospitalizations. The number has increased dramatically. Some of these cases are severe, especially as we see an increase in her RSV.

RSV tends to affect very young people under the age of two. Infants who were born prematurely or who have a weakened immune system are most at risk.

Hospitalizations with RSV and/or influenza are seen among previously healthy children with RSV without comorbidities. However, it can also be seen in children with underlying medical conditions such as asthma, heart disease, neurological disorders, and other chronic conditions.

Yes, some children are infected with what we call co-infection, being infected with more than one virus at once. You can get infected with rhinovirus (common cold virus), RSV, or other respiratory viruses. These co-infections tend to be more severe than if the child had her only one infection. Different viruses can attack different receptors and use different mechanisms to damage respiratory cells. This can exacerbate the disease and in some cases require the child to be admitted to an intensive care unit for management.

Flu and COVID-19 have specific treatments, but RSV and other respiratory viruses do not. The primary management of respiratory infections is supportive care, including hydration, fever control, and supplemental oxygen if needed. If a child’s breathing is severely compromised, we may even provide oxygen to the child and, depending on the severity of the respiratory failure, stronger measures such as a ventilator.

Passive immunization in the form of monoclonal antibodies is available to 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.

There are no licensed and effective vaccines against RSV for children or adults in the United States. However, there is evidence that an expectant mother passes antibodies to her RSV to her baby. It was recently reported that pregnant mothers who received an vaccine against RSV passed those antibodies on to their babies, and these infants had a lower risk of developing her RSV infection. These developments are very good news for the future, and vaccinated pregnant women may be able to pass this protection on to their babies.

COVID-19 stays with us just like RSV, influenza and other respiratory viruses. Therefore, it is expected that children will continue to be infected with COVID-19, along with respiratory syncytial virus and influenza. Current variants of the COVID-19 virus are becoming resistant to preventive measures such as monoclonal antibodies, but vaccines are still protective.

The low vaccination coverage for COVID-19 and influenza vaccines among children in our community is a concern. Less than a quarter have received the COVID vaccine series. There is strong evidence that vaccines prevent infections, prevent hospitalizations, and prevent deaths from COVID-19.

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.

Children with respiratory infections can develop 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. If a parent notices that their child is breathing hard and is having difficulty, this is an emergency and should be addressed immediately, such as taking the child to the nearest emergency room or calling 911 .

However, most respiratory infections in children resolve on their own and are not related to shortness of breath. In most cases, calling your pediatrician for advice is the best thing to do.