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Triad hospitals cope with barrage of child respiratory cases

News & Record - 10/27/2022

Oct. 25—GREENSBORO — Increasing numbers of young patients with a respiratory illness called RSV have filled many of the pediatric beds at Moses Cone Hospital, according to the unit's medical director, Dr. Suresh Nagappan.

The 22-bed unit has needed to divert pediatric patients to other hospitals when capacity peaks. Nagappan estimated that between 80 to 90% of the unit's patients are there for treatment of RSV.

Some young patients continue to be cared for in the emergency room until a bed opens up in the children's unit, he said. It's an issue other hospitals across North Carolina and the nation are frequently facing.

"It's the worst RSV season I've seen in my career," Nagappan said by phone Monday. "It's been an incredible challenge."

RSV stands for respiratory syncytial (sin-SISH-uhl) virus, which is a common illness that usually causes mild, cold-like symptoms, according to the Centers for Disease Control and Prevention. Although many easily recover, the illness can be severe for infants and the elderly.

The state Department of Health and Human Services said in an emailed statement Monday that "some North Carolina hospitals have been unable to accept transfers from other hospitals that are not part of their normal referral networks due to the high number of children with RSV and the limited number of pediatric intensive care unit beds."

Most children get RSV by the time they are 2 years old, Nagappan said, but only a small number diagnosed need to be hospitalized. Most RSV infections go away on their own in a week or two.

Parents should be watchful for symptoms such as labored breathing and lack of appetite. Contact the child's pediatrician about any concerns, Nagappan said, and don't hesitate to seek emergency care if an infant or child appears to be experiencing breathing difficulties during the night.

"The younger they are, the more vulnerable they are," Nagappan said.

RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) in children younger than 1 in the United States, according to the CDC.

Lab test results from various hospitals across North Carolina show that RSV cases have increased significantly this fall, according to state data.

"Atrium Health Wake Forest Baptist has seen a substantial increase in children with RSV and respiratory illnesses other than COVID-19 in primary care and outpatient clinics and emergency departments throughout our health system," spokesman Joe McCloskey said Monday in an email. "We are seeing more of these cases than we typically see in the early fall."

It's not known why RSV seems to be affecting more children or what's led their symptoms to be so severe. Nagappan questions whether young children who weren't previously exposed to RSV during mask mandates and social distancing during the COVID-19 pandemic are just now contracting it.

"It's all theoretical," he said about the pandemic's impact on this wave of RSV cases.

Dr. David Priest of Novant Health said RSV is typically seen in the winter, but it unusually began appearing in summer 2021.

"(Pandemic precautions) really just changed the circulating pattern of these viruses," Priest said recently.

Hospitals, however, now have more means to identify who may have COVID-19 and the flu — or RSV.

As far as preventing the spread, Nagappan encourages residents to make sure their hands are cleaned thoroughly and to consider masking around infants and others at risk.

State health officials said that while there is no vaccine available at this time for RSV, DHHS "encourages everyone to receive age-appropriate flu and COVID-19 vaccines since all three viruses are currently circulating."

Nagappan said the young children coming to Moses Cone with RSV have been sicker than he's used to seeing.

"If you know a nurse who works there, hug them," he said. "We hope it's going to peak soon, but we just never know."


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