There's a spike in respiratory illness among children — and it's not just COVID

The United States is seeing a significant spike in respiratory illness among children.

Sick kids are crowding emergency rooms in various parts of the country, and some pediatric hospitals say they are running out of beds. But this uptick in illness has largely been due to viruses other than the coronavirus, like RSV, enteroviruses and rhinovirus.

While respiratory infections typically surge in the winter months, experts say that this year the season has started much sooner, and that numbers are unusually high.

"Rates are as high as 25% of those [who have] tested positive for RSV. That is quite unusual for October, we would typically start to see higher rates in November, December and January," said Dr. Ibukun Kalu, a specialist in pediatric infectious diseases at Duke Children's Hospital in Durham, North Carolina.

Kalu said that while respiratory viruses like RSV can be severe in young infants, older children were also beginning to experience severe symptoms that required hospitalization to help with breathing.

When combined with the fact that some children may already have underlying illnesses that require them to receive oxygen at home when they get a viral infection, a hospital system already feeling the strain from the COVID pandemic is once again being slammed with demand for care.

"We've been strapped, and hospitals have sort of been functioning at the edge of how they can function. We're seeing more people requiring help and fewer beds available, largely due to staffing needs," explained Kalu. "This combination is going to create more and more problems."

For now, the issue is concentrated among younger patients. But Kalu said that with the colder months coming up, it could begin to impact more people.

"As we see more viral infections in kids, we will see a similar pattern in adults," she said. "The reason for more severe illnesses with some of these viruses is the smaller airways in kids. Because the viruses get in there and cause such a high amount of inflammation, they are unable to clear out a lot of these secretions or get air in."

The CDC issued a health advisory in September saying that health care providers and hospitals had alerted the authority in August "about increases in pediatric hospitalizations in patients with severe respiratory illness who also tested positive for rhinovirus (RV) and/or enterovirus (EV)."

In the advisory, hospitals were guided to keep heightened awareness for these more severe infections when treating pediatric patients, and parents were instructed to keep an eye out for specific symptoms, like difficulty breathing and the sudden onset of limb weakness.

Kalu said that if parents notice these symptoms of infection, in addition to a runny nose, a cough or a fever, they usually can be managed at home with attentive care.

"It is good for you to contact your provider and talk through symptoms," she said. "And be aware that if you see any of those symptoms worsening — specifically, if a child is having issues breathing, or is constantly throwing up, or unable to drink or eat — it would be important to ensure they get seen, to assess if they need oxygen support or if they need help with maintaining their hydration."

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