WAUWATOSA – Like pediatric hospitals throughout the country, Children’s Wisconsin here is currently experiencing a spike in the hospitalization of children with RSV (respiratory syncytial virus). Experts at Children’s and at the federal Centers for Disease Control and Prevention (CDC) are urging the public to help prevent the disease from spreading.
Children’s Wisconsin has an average of about 45 to 60 young patients hospitalized for treatment of RSV. That’s up dramatically from 11 back in early October, Dr. Rainer Gedeit, the hospital’s acting chief medical officer, told an online press briefing on Monday.
“We started seeing the illness in October and it really kind of doubled about every week,” he said.
RSV is a contagious virus that can spread from viral respiratory droplets. For most children and adults, RSV brings minor cold-like symptoms.
However, premature infants and young children with weakened immune systems or congenital heart or chronic lung disease are the most vulnerable to complications from the virus.
Health experts expect RSV to spread each year, particularly during the fall and winter months when people spend more time indoors. But in 2022, RSV arrived somewhat early and hit much harder. The CDC last week issued an official health advisory in response to the rise in respiratory infections among children.
According to the CDC, death from RSV is rare. There are between 100 to 500 pediatric deaths and 14,000 adult deaths each year related to RSV. The federal agency cautions that the actual figure may likely be higher due to undercounting.
Strain on services
With 298 beds, Children’s Wisconsin is the state’s largest pediatric hospital.
“We really want to ensure that we have the right amount of beds capacity to take care of the sickest kids,” said Gedelt.
In response to the statewide uptick in RSV cases, he said that Children’s Wisconsin has juggled staffing and services to accommodate patients most in need of inpatient care.
“We’ve had to evaluate our surgical cases as well as our elective admissions and our requests for transfer from other organizations,” he said.
In the past week, Children’s Wisconsin saw 114 requests for transfer from other hospitals for treatment of children who were seriously ill with RSV. Gedeit said that about 90 were accepted. The remainder remained at local hospitals where Children’s Wisconsin staff are consulting with local physicians regarding care.
In addition to hospitalizations, Children’s Wisconsin staff are seeing RSV cases in the emergency department, urgent care and physician visits “in the hundreds every day,” Gedeit said.
The highest level of intervention for hospitalized RSV patients has involved ventilators. Gedeit said that a typical hospital stay for pediatric RSV patients is three to five days but can be considerably longer if they’re also being treated for other complications.
COVID ‘skewed’ viral season
Gedeit said that physicians don’t really know what to expect from the 2022-23 viral season when colds, influenza (the flu) and other respiratory diseases are expected. The diseases are usually seen starting in the fall and peak around February.
The last big viral season – a combination of RSV and the flu – occurred in late 2019, he said. A few months later – in early 2020 – the COVID-19 pandemic swept the country. Widespread isolation prevented an RSV spike until the summer of 2021.
“Exactly what will happen with our normal viral season is unpredictable at this point,” said Gedeit. “We’re hoping we can get back to our normal cycle within the next few years.”
But for the near term, Gedeit and other experts are concerned about current levels of RSV and upcoming increases in flu cases.
Reducing the RSV spread
“Prevention is always what we want in pediatrics,” Gedeit said.
Here are a few simple steps that families can take that will help reduce the spread of RSV:
- Get vaccinated. Although there are no vaccines against RSV at this time, eligible adults and children should get vaccinated against the flu and COVID-19.
- If you’re sick, stay away from young children – particularly infants.
- Keep infants away from people who may be sick.
- Practice hand-washing and wipe down surfaces that might have the RSV virus on them, like tables, door knobs and crib rails.
- Wear face masks in a household when someone is ill.
Gedeit added that RSV symptoms in children are similar to colds and the flu but with greater severity. He suggests that parents and caregivers should seek medical care immediately if a child has “significant trouble breathing” and when an infant who is bottle or breastfeeding is unable to suck or swallow.
“We’re hoping right now that is our peak,” Gedeit said. “The numbers have been pretty stable over the last few days. We’re hoping it peaks and then starts to decline.”