This respiratory virus is filling hospitals with kids. What you should know

Childhood illnesses are part of life, but parents do not expect their children to need a hospital admission due to seasonal sickness. Yet the spike in cases of RSV, flu and cold is causing exactly that.

Eastern Shore hospitals have not been immune to the fall bringing its usual bevy of illnesses when temperatures get cooler, but some local hospitals have already started surge planning for the rise in the number of hospital admissions. Dr. Lauren McGovern, a pediatrician at TidalHealth Peninsula Regional hospital, estimates only 5-10% of childhood RSV cases require a transfer to Washington, D.C.'s Children's National Hospital, but notes all parents should stay vigilant about possible severity.

Respiratory Syncytial Virus, or RSV, is a common respiratory virus that usually causes mild, cold-like symptoms. According to McGovern, most children will start to improve after 3-5 days.

For others like Brooke Day, a Salisbury mother of three, an RSV diagnosis for one of her then-eight-month-old twin sons was the beginning of a steep decline in his breathing and being airlifted to Children's National. It was there she saw the reality of an outright pandemic, with areas of the hospital being converted into makeshift RSV units.

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'A medical center overrun'

"It started at eight months and the twins were in day care, so they were sick all the time but with nothing serious," said Day. "When they got RSV, it started mildly with a cough and got worse. The big issue was my son's breathing along with a severe cough and it was hard for them to eat. The doctor had told us about retraction when their lungs pull in when they try to breathe."

Dangerously fluctuating oxygen levels in her son made a hospital admission inevitable.

As doctors monitored the infant on oxygen, he failed to improve. The tough decision to have him airlifted to the Washington, D.C. hospital for more intensive treatment meant making another medical center home while relying on her husband and extended family to take care of two children staying behind.

"It was terrifying and to this day, it gives me bad anxiety every time he gets sick. It was something we didn't plan on doing, but it was difficult," said Day.

While the care was exceptional, the reality of a medical center being overrun with both cases of RSV and COVID had her son waiting in the emergency room for 24 hours before finally being moved to a room. A surgery recovery wing was converted to a temporary pediatric intensive care unit. With 10 to 15 patients in a section of the hospital separated by only a curtain, the cold comfort of a crib and a non-reclining chair is what Day could expect for the next four days.

Sleep, or close proximity to it, meant her sitting down while holding her son, who was now starting to improve.

"After we got home, we saw that there was a great deal more people going through the same thing. I heard stories from other people, and even into this year, I heard from those going through it with their (children). You don't realize how prevalent and how severe it can be until it happens to you," said Day.

The two-week ordeal from the start of the symptoms to his return to day care would have been the end of the story for most. Yet it was a common cold that would have the child return to the hospital. His compromised immune system made such a common illness that much more dangerous.

Cursory data points in brochures about children with severe RSV having 30% higher risk of decreased lung capacity and asthma were as close as Day recalls she got to a specific conversation about long-term effects of the illness.

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Molly Comly, a mother of two who lives in Eden, knows all too well that RSV could begin only with mild to moderate symptoms. Her 3-year-old son was like many children who entered day care and returned with an illness that passed to his sister, only five weeks old at the time.

Efforts to be mindful about protecting the infant from illnesses like RSV, flu and colds were difficult enough when Comly noticed her daughter begin to suffer from congestion and breathing issues. Even laying on her back was troublesome and would be met with crying.

Three visits to the doctor over weeks of worsening symptoms precipitated a COVID, flu and RSV test, with all of them coming back negative. But added blood tests and an x-ray revealed the baby suffering from pneumonia, with a hospital admission to follow.

"In the hospital, they redid most of the tests and the X-ray," said Comly, who also had several hours of waiting before being placed in a room. "The pediatrician on call told us she didn't have pneumonia based on the first image, but she did have RSV. It was confusing and they kept her overnight for observation, but I think she was on the back end of the illness."

Congestion, sinus drainage and the increasingly difficult breathing were testament to the worst of the RSV symptoms.

"It was very hard for me, because I was relying on these medical professionals, but I wasn't getting accurate information. Looking back, she had been stuck with a needle more times than she needed to be. She had got blood work done three separate times and a spinal puncture to make sure an infection hadn't spread to her spine," Comly said.

Like Day, her spouse and in-laws stepped in to help the family amid their bout with RSV.

Comly, in her own right a certified doula and midwife assistant, has taken this experience and applied it to her clients. Through empathy and advice, Comly still believes simple prevention methods go a long way to not only mental health for parents, but practical approaches to peak times for RSV, flu and colds.

Cyclical surges and hospitals

"We're seeing what's going on nationally and an increase in cases of admissions for RSV and flu. This typically occurs in the fall seasons and isn't something we're not prepared to handle. This year, there was an overlap with a summer virus and another of influenza. That's probably why you're seeing surges nationwide," said McGovern.

Respiratory therapy, emergency, critical care and education departments have all started working together to better serve the growing public need.

According to McGovern, the illness causes an inflammation of the airpipes and also presents as a viral pneumonia.

"There is a subset of patients that are at higher risk, such as premature babies, babies with neuromuscular weaknesses, chronic lung disease and heart conditions. Even a moderate case of RSV can overwhelm their capacity to recover quickly. We try to keep them feeding and their energy level high enough to not get too tired to breathe," said McGovern.

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Supportive care is still the best option for many suffering from RSV through suctioning and scheduling oral feeds. Placing a line into the patients for them to get nutrition in some capacity is also an option.

"Supportive measures at home include Tylenol and Motrin. You have to keep them hydrated and parents have a sense about their children. They should speak to their pediatricians, and they shouldn't think they necessarily need to come to the hospital, because RSV is so prevalent," said McGovern.

The children who need to be seen in a hospital are those not feeding well or having breathing issues.

This article originally appeared on Salisbury Daily Times: Eastern Shore sees hospitalization spike with RSV, flu and cold cases