Rising children's virus emerges in Ventura County hospitals without an RSVP

Flu arrived early. COVID hasn't left yet. And now Ventura County hospitals and pediatricians are reporting another unwanted visitor as holidays approach: RSV.

Respiratory syncytial virus is a very common condition that causes cold-like symptoms. It goes away on its own for most people but can bring severe illness to infants, seniors and people with compromised immunities.

An early-arriving surge of the illness has strained resources at children's hospitals nationwide and caused Orange County officials to declare a health emergency on Monday, sounding alarms about available beds in hospital pediatric units and emergency rooms.

Locally, hospital RSV cases are rising in a wave that usually begins in January or later. About half the children hospitalized last week at Ventura County Medical Center were diagnosed with RSV, said Dr. Todd Flosi, a pediatrician and the hospital's associate chief medical officer.

The children who have needed hospital care in past years for the virus were almost all infants and toddlers. This year, some are older.

"Now we're seeing kids 4 years of age," Flosi said, adding it's possible the rising RSV incidence is pushed by the reduced use of masking that helped reduce viruses during the heart of the COVID-19 pandemic. "I do think they're linked."

Officials at the Community Memorial Health System network of hospitals and clinics in Ventura County said the positivity rate for RSV has tripled in recent weeks with 1 of 4 patients tested for the virus coming up positive. Cases have risen at Los Robles Regional Medical Center in Thousand Oaks and a spokeswoman at St. John's Regional Medical Center in Oxnard reported a small uptick over the last week.

"We encourage anyone with acute respiratory symptoms to stay home while ill even if they have tested negative for COVID-19," Community Memorial spokeswoman Jamie Maites said in an email. "Another way to protect yourself and the community from circulating respiratory illness is to wear a mask when in public."

The rise sparks concern about hospital capacity heading into a holiday season when respiratory illnesses often fill up hospitals. Local officials say they still have available beds. Dr. Robert Levin, the county's health officer, said problems could emerge if COVID, flu and RSV hospitalizations rise simultaneously but also said there is no need yet to follow Orange County's lead and declare an emergency.

"We haven't seen a significant stress on our hospitals at this point," he said in an email.

The RSV surge has stretched emergency room capacity at Children's Hospital Los Angeles. Some requests for patient transfers from other hospitals have been turned down, said Chief Medical Officer Dr. James Stein.

Nearly 40% of the kids tested for RSV are coming up positive at Children's Hospital Los Angeles, Stein said in a statement.

What parents should know: RSV in infants and kids is threatening to overwhelm hospitals

Who's at higher risk?

The virus is so common that most children have been infected by their second birthday. RSV spreads through coughing, sneezing, direct contact and contaminated objects like door knobs. It can cause infections of the lungs and respiratory tract and is the most common source of bronchitis and pneumonia in kids ages 1 and younger.

Adults and children with compromised immunities can be at higher risk. People 65 and older, especially those with heart or lung conditions, can also be more vulnerable to severe infection.

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There is no vaccine for RSV though one is being developed by Pfizer. Doctors encourage people to get vaccinated for COVID-19 and flu to increase their defenses for other respiratory illness, said Dr. Davey Smith, infectious disease specialist and virologist at UC San Diego.

"It will put some water on the timber," Smith said.

RSV symptoms include runny nose, decrease in appetite, coughing, sneezing, fever and wheezing. Flosi said parents should reach out for care if they see signs of labored breathing from their children like flared nostrils when inhaling or grunts of effort when exhaling.

Parents shouldn't be scared of RSV but they should be careful about exposing newborns or children with severe asthma, said Dr. Ken Saul, a pediatrician in Thousand Oaks.

"They need to be away from crowds," he said, adding that risks are lower with toddlers who don't have pre-existing health conditions. His two grandchildren, ages 14 months and 2 years, are still both attending preschool.

Saul has admitted six patients diagnosed with RSV in three weeks and contended the virus can be far more harmful to infants than COVID. He thinks the early arrival and increased illnesses is related to the pandemic.

"It does seem that for whatever reason kids' immune systems are not as good now," he said. "They are not fighting things off as well as they did before the pandemic."

Smith offered his own theory. Masking and other COVID restrictions helped protect people against RSV, flu, COVID and other respiratory illnesses. But the protection also prevented people from developing natural immunities, he said.

"That decreases the amount of immune responses to both flu and RSV," Smith said. "You have a large susceptible population right now. You can get these huge outbreaks."

Fears of a 'triple threat'

RSV isn't the only viral intruder making an early appearance. Ventura County doctors started reporting flu cases in October, months before the season usually emerges. The county has already reported two flu deaths.

The county's COVID activity and hospitalizations continue to fall but officials worry another rise could emerge.

"We have a triple threat coming this fall with flu, COVID and RSV," Levin said. He worries people could get two illnesses at once and increase their chances of severe illness.

"If you have two of them, that increases the possibility that you’ll be even sicker," he said.

RSV's symptoms aren't identical to flu or COVID but are close enough that people shouldn't try to diagnose themselves. Smith worries people with symptoms will decide it's OK to attend holiday gatherings as long as they test negative for COVID and end up spreading RSV or flu.

He thinks all three viruses could rise at the same time.

"We're due for a bad flu year. We’re due for a bad RSV year and then you throw in a new COVID variant and (doctors will be) busy. I’d like to be proven wrong," he said.

Tom Kisken covers health care and other news for the Ventura County Star. Reach him at tom.kisken@vcstar.com or 805-437-0255.

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This article originally appeared on Ventura County Star: RSV emerges in Ventura County, bringing rise in hospital cases