Pediatricians warn of spike in child virus

A sudden increase in the number of children hospitalized with a common respiratory virus is sparking concern among pediatricians, who are urging parents to be vigilant.

“It’s incredible,” said Dr. Scott Schroeder, chief of the division of pediatric pulmonology and allergy at Floating Hospital for Children at Tufts Medical Center. Respiratory syncytial (pronounced sin-SISH-uhl) virus, or RSV, is “so prevalent and it seems the kids are much, much sicker.”

In a typical year, Schroeder said, 1 out of 100 kids with RSV might need to be hospitalized.

“This year it’s much higher with a large number of children needing to be hospitalized and increased numbers of those children admitted to intensive care units,” Schroeder said. His hospital is currently treating six RSV patients in the pediatric intensive care unit.

The spike in cases was unexpected, Schroeder said.

“Last year was a bad year” for RSV he said. “Traditionally, that would mean we could expect fewer cases this year, but this year is even worse.”

Schroeder also said he started seeing cases as early as October. RSV is most often diagnosed from November to March. Fortunately, he said, there have been no deaths due to the virus at his hospital.

Boston Medical Center reports a similar increase in sick kids. From September to December, BMC diagnosed 40 cases of RSV, nearly double the number of cases diagnosed over the same period in 2018. The hospital has not yet tallied the number of RSV cases it has seen so far this month.

A common virus

“If you have what you think is a cold, said Dr Jamie Colbert, senior medical director for Blue Cross Blue Shield of Massachusetts, “it could well be RSV.”

Anyone can contract RSV and in fact, according to the Centers for Disease Control, most people will catch the virus by their second birthday for the first time. Like a cold or the flu, you can get RSV multiple times. In most cases, the virus resembles the common cold – stuffy nose and congestion, a cough, sneezing, and a fever. However, for the very young and for the elderly, it can pose particular dangers.

“The problem is that in infants and children under 1 year old, RSV can lead to more serious respiratory illnesses such as bronchiolitis and pneumonia,” conditions that lower the amount of oxygen that lungs can take in from air, warned Colbert.

RSV is the most common cause of bronchiolitis and pneumonia in children younger than 1 year of age in the United States, according to the Centers for Disease Control. Each year in the United States, an estimated 57,000 children younger than 5 years old are hospitalized due to RSV infection.

Children born prematurely and with congenital heart and lung defects are especially at risk of developing a severe illness.

Other red flags include a loss of appetite or signs of dehydration such as a dry diaper.

“Of course, if your baby’s finger nails or skin take on a blue tinge, you should consider going to the emergency room right away,” Colbert said.

Adults -- especially those over 65, or who have chronic heart and or lung diseases, such as asthma and those with weakened immune systems – also are at risk of developing severe RSV infection. Each year, it is estimated that more than 177,000 older adults are hospitalized and 14,000 die in the United States due to RSV infection, according to the CDC.

Keeping baby healthy

There is no vaccine that prevents RSV, though researchers are working to develop one, according to the CDC. The drug palivizumab can prevent severe RSV illness in infants and children who are at high risk for severe forms of the disease, but it cannot help cure or treat children already suffering from the virus and it can’t prevent infection. Doctors also recommend flu vaccination, so young patients do not have to battle two viruses at once.

If your child is at high risk for severe RSV disease - infants born prematurely or with congenital heart disease or chronic lung disease - talk to your pediatrician to see if palivizumab can be given to your child to prevent severe illness caused by the virus.

The best way to protect your child is to prevent the spread of the virus, said Blue Cross’ Colbert. “Given how these viruses are so common, especially in the winter, your best approach is to practice good hygiene – wash your hands often and cover your cough with a tissue or the crook of your arm, not your hands.”

Parents should also try to limit contact with people who appear sick, and avoid spreading illness themselves. If you or your child are not feeling well, stay home from work or school.

As for the children that Floating Hospital’s Schroeder is treating, “there’s not much we can do, except keep them comfortable, ensure their oxygen levels are right and make sure they don’t get dehydrated – and watch them get better.”

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