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Spokane, Washington  Est. May 19, 1883

Swell of RSV cases among kids has North Texas hospitals near capacity

Priscilla Velazco keeps a watchful eye on her 16-month-old daughter, Emilia Zarazua, at Loma Linda University Children’s Hospital last December in Loma Linda, Calif. Emilia had fallen ill with respiratory syncytial virus.  (Francine Orr/Los Angeles Times/TNS)
By Marin Wolf Dallas Morning News

DALLAS – A surging number of RSV cases and other respiratory illnesses has filled nearly every pediatric bed at area hospitals, the Dallas-Fort Worth Hospital Council reported Friday.

More than 97% of pediatric beds in the North Texas region are occupied, the hospital group said, and medical centers are treating hundreds of patients a day with difficulty breathing, fevers and other symptoms.

Fort Worth’s Cook Children’s is at full capacity as hundreds of children with RSV and other respiratory illnesses flood emergency departments and urgent cares. On Monday, five intensive care unit patients had to be held in the emergency department as they waited for beds to open.

More than 200 children tested positive for respiratory syncytial virus last week at the hospital system’s Fort Worth medical center. The emergency department is treating around 500 patients a day, leading to overcrowded waiting rooms and long wait times.

Nearby Children’s Health in Dallas reported 382 RSV cases systemwide during the week beginning Oct. 29, the highest case count the hospital system has seen this year.

That’s a 31% increase from the week prior, which saw 291 cases, and a more than 134% increase from the 163 cases seen in the week beginning Oct. 8.

“Winter is here, even though it’s still fall, with the increase of respiratory viruses in full swing,” said Dr. Amy Richardson, assistant medical director of Cook Children’s urgent care centers. “We do anticipate that this problem is going to worsen as we progress through the winter months as opposed to getting better.”

For most children and adults, an RSV infection looks like the common cold and, while uncomfortable, is often not life-threatening. But for some groups, including infants and older adults, the virus can cause complications like the lungs’ small airways becoming inflamed or plugged with mucus.

RSV and flu cases peaked unseasonably early last year as children experienced their first respiratory virus season without COVID-era protections like masking and social distancing. Flu cases are climbing at a slower pace this season, but RSV is causing more severe complications, said Dr. Taylor Louden, medical director of Cook Children’s emergency department.

“This year, RSV seems to be hitting harder; our patients are sicker,” Louden said. “We’re tying up our ICU beds a lot sooner than we were last year during this time.”

Medical providers are urging patients to go to their pediatrician first if their child is experiencing mild symptoms. Patients with mild illness who go to the emergency department may experience wait times of up to 10 hours, Louden said.

Signs a child’s illness has worsened to the point of needing emergency medical attention include difficulty breathing, which can look like a child is breathing faster than usual or the skin between their ribs being sucked in with each breath; a fever that’s been going on for more than five days; and dehydration, which can show through decreased urine output, dry diapers or, in babies, the soft spot on the top of their head sinking in.

It’s difficult to differentiate between respiratory illnesses, especially in children, said Dr. Laura Romano, a hospitalist at Cook Children’s. While it’s important to know whether a child has COVID so that they can properly isolate, the treatment for RSV, the flu or a cold is largely the same.

“It’s just supportive care at home, Tylenol and Motrin as needed for a fever and some nasal saline for congestion,” Romano said.

Federal regulators recently OK’d new RSV protections, including vaccines for adults over 60 and pregnant women and a monoclonal antibody shot for infants. The Centers for Disease Control and Prevention recently issued a health warning that pediatricians should prioritize doses of the antibody treatment nirsevimab for babies at highest risk of RSV complications because of a nationwide shortage.

When this wave of RSV cases will subside is unclear. Health professionals don’t know a virus has reached its peak until after the fact.

“The one thing that the pandemic taught me was not to make predictions about this,” said Dr. Jeffrey Kahn, director of infectious disease at Children’s Health and professor at UT Southwestern.

While COVID-19 and flu cases remain relatively low, the viruses could pick up speed in the coming weeks and months. Anyone 6 months or older is eligible for the flu vaccine, while anyone 6 months or older who hasn’t received a COVID vaccine in the last two months can get an updated Pfizer or Moderna booster.