Respiratory diseases have increased among children. Here’s what parents need to know.

Over the past few weeks, many children have returned to in-person learning and resumed after-school and sports activities. Certain public health measures used to mitigate the spread of COVID-19, such as masks and social distancing, which are also effective against other respiratory viruses, have been lifted in many schools across the United States. While all of this has brought back a much-needed sense of normalcy for children and their families, it has also come with some challenges, including a significant increase in respiratory illnesses among children.

Children’s hospitals in major US cities have reported unusually high numbers of patients with respiratory illnesses caused by viruses other than the coronavirus. These include respiratory syncytial virus (RSV), enteroviruses (VE) and rhinoviruses (RV), which mainly cause cold symptoms such as runny nose, cough, sneezing and fever.

Normally, these viruses appear during the winter months. During this period, also known as the viral respiratory season, pediatricians and hospitals are prepared to deal with an influx of patients with these viruses. However, this year the season started earlier than expected and the number of children requiring hospitalization was so high that in some areas, hospital systems are already overwhelmed.

“In general, pediatric hospitals are operating relatively close to capacity,” Dr. Michael Chang, a pediatric infectious disease specialist at UTHealth Houston and Children’s Memorial Hermann Hospital, told Yahoo News. “So when you see patients requiring hospitalization for respiratory viruses at unusual times of the year, then it’s easy to reach capacity in hospitals.”

In September, the Centers for Disease Control and Prevention alerted public health departments and physicians treating pediatric patients to some of these respiratory viruses. The agency published a health notice warning of an increase in the number of pediatric hospitalizations for severe respiratory illness where patients tested positive for rhinovirus and/or enterovirus, including enterovirus D68 (EV-D68) – which has been linked to a rare but serious condition called acute flaccid myelitis, or AFM. The primary purpose of the advisory, the CDC said, was for physicians to keep this information in mind when diagnosing and treating respiratory illnesses in children, as some of these viruses “may have clinically similar presentations.” and be “indistinguishable from each other”. ”

Chang said his home state of Texas is currently in the midst of a “big RSV surge,” which began a few weeks ago and wasn’t expected until at least the end of October. “We have something like 20% of our tests for RSV coming back positive, which is well above the 10% threshold that we consider some sort of epidemic level for RSV,” he said.

Enterovirus D68 cases have also increased and are “at a higher rate than baseline,” according to Chang. He noted that enterovirus numbers are not as high as seen in previous outbreaks. However, he said doctors aren’t sure exactly how deep in the flare they are because it’s coming at an unusual time.

Additionally, doctors in the state have started seeing a number of flu cases – again, sooner than expected. COVID-19 cases, however, are on the decline, Chang said.

Why are these respiratory viruses increasing right now?

The COVID-19 pandemic has not only disrupted people’s lives, but also the historical seasonal trends of other common respiratory viruses. Chang said these patterns have completely changed, and while it’s unclear why, it likely has a lot to do with human behavior.

“We were really focused on these infection prevention techniques, which again, not only do they work for SARS-CoV-2, but they really work for most respiratory viruses,” he said. “We knew these infection prevention techniques could work for influenza and RSV. It’s just that we’ve never performed them on such a global scale, have we? Like we’ve never done it in such a widespread way where so many people were wearing masks, so many people were isolating, so many people were physically distancing. So we never got to see the impact that these kinds of preventions on such a large scale could have for RSV and influenza, but they were obviously very effective.

Chang said the past two winters have been among the mildest flu seasons on record. Similarly, doctors didn’t see much RSV in the winter of 2020-21, when the country was dealing with a surge of COVID-19 and strict public health restrictions were in place. However, as some of these pandemic restrictions were relaxed last summer, there has been a sharp increase in RSV. He said two things were unusual about it: how quickly it happened – well before winter – and the severity of some of the cases.

This year, RSV is again increasing earlier than usual, and flu case have also begun to increase in parts of the country, particularly in the southeastern and south-central United States. According to health experts, we could face a serious flu season that coincides with a winter surge of COVID-19.

Another explanation for why these winter respiratory viruses are affecting us more now, experts say, isn’t necessarily because they’ve changed, but because we have less immunity to them.

“Basically for two years, two winters where children and adults would have been infected with RSV or the flu, they didn’t have it, and so some of that immunity that we would have had against infection before , we don’t have now,” Chang explained.

What symptoms should parents watch out for?

For most parents, “all of these viruses are going to be pretty much indistinguishable,” Chang told Yahoo News. Common symptoms are runny nose, sore throat and cough. These, the pediatrician said, can last three to five days, sometimes peaking on the fifth day, just before they begin to subside.

Most children, he said, recover fully from these viruses without long-term complications. However, parents of children with asthma or reactive airway disease (when asthma is suspected but not confirmed) should be more cautious about these viruses, especially enterovirus D68, which can cause more serious illnesses.

“Definitely anytime you notice they’re having difficulty, like shortness of breath at rest, or if they’re having trouble finishing sentences, if they’re wheezing a lot, the cough is more severe, any type of ‘shortness of breath and then any type of chest pain, you’re going to want to… see a doctor,’ Chang said.

Infants and young children, especially if they were born prematurely or have a history of underlying congenital heart disease, are at increased risk of serious disease from RSV, he explained.

“The main things you need to watch out for are difficulty feeding, difficulty catching his breath if he takes a bottle or breastfeeds. Definitely a decrease in eating, a decrease in appetite,” he said.

How can parents best protect their children at this time?

There is currently no vaccine available against RSV, enterovirus D68 or rhinovirus. But Chang said the best way to protect children this winter is to ensure parents and children are vaccinated against viruses for which we have vaccines, such as influenza and COVID-19.

“Anyone who qualifies for [a] flu shot, which is pretty much everyone from 6 months to adulthood, should go get the seasonal flu shot as soon as possible,” Chang said.

He also urged those who have not been vaccinated against COVID-19 to get vaccinated.

“The best way to minimize the risk of serious illness and hospitalization, regardless of your age, regardless of your underlying conditions, is to get vaccinated and be up to date on your SARS-CoV vaccinations. -2, including new bivalent boosters.”

Cover thumbnail photo: Peter Cade via Getty Images

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