Doctors warn of rise in RSV, flu cases in young children
Even before Apryl Panagiotopoulos gave birth to her daughter Eleni just before the holidays, the Naperville mom planned to keep family gatherings from turning into a breeding ground for germs.
"Everybody wants to touch and kiss and hold her, and I made it very clear we don't want any of that because I was concerned about her getting RSV," she said.
But with a vulnerable immune system, her daughter still couldn't fend off the respiratory infection that's straining hospitals with high volumes of patients at the same time as a rough flu season for young children. The predominant flu strain, influenza B, started circulating earlier than usual and tends to strike children more, doctors say.
"The flu can cause similar symptoms of fever, cough, problems with breathing, and so parents should really be on the lookout for both symptoms of RSV or flu," said Dr. Melissa Manrique, a Lurie Children's pediatric hospitalist at Northwestern Medicine Central DuPage Hospital in Winfield.
At first, Eleni had the symptoms of an ordinary cold. But the infant developed a cough and had difficulty breathing.
"I tried to get into the doctor's office, but since so many are sick right now, they didn't have anything open, so they told me to go straight to the ER," Panagiotopoulos said.
Doctors at Central DuPage, where Panagiotopoulos works as a certified nursing assistant, confirmed respiratory syncytial virus, or RSV, a common illness that can cause serious complications, especially for babies.
"Everyone in our area has been seeing a large volume of RSV patients," Manrique said. "We've had multiple times where the hospitals in the area have been full."
Eleni remained on oxygen all four days in the hospital as doctors kept an eye on any signs of dehydration and a fever that reached 101.4. The newborn is still recovering more than two weeks after she fell ill.
"She's just not herself yet," Panagiotopoulos said.
It's still not too late to get the flu shot. With rare exception, the U.S. Centers for Disease Control and Prevention recommends an annual flu vaccine for those 6 months and older, including pregnant women and people with medical conditions.
"If you get the flu and you've been vaccinated, you're much less likely to have severe symptoms, much less likely to need to be hospitalized," said Dr. John Piotrowski, an emergency medicine physician at Advocate Condell Medical Center.
For the Libertyville hospital, Piotrowski said, "it hasn't been a great flu season, but it hasn't been terrible, either. But the RSV numbers are definitely higher than we've seen."
It's too early to say when the flu season -- roughly extending through March -- could peak. Nationwide, 32 flu-related child deaths have been reported to the CDC so far.
At Amita Health Immediate Care and Outpatient Center in Bartlett, one provider saw 12 cases in just four hours Tuesday -- "which is unheard of," said Dr. Sunny Sharma, an internist at the same office.
State public health officials aren't required to track RSV cases, and there isn't a vaccine for that virus.
"Families often hear there is a RSV shot available, but it is only at this time for very premature infants and infants with other significant cardiac problems or heart problems at birth," Manrique said.
Parents should take precaution with simple hand-washing and avoiding people who are sick. The virus spreads through respiratory droplets when someone sneezes or coughs, or through contaminated surfaces.
"I'm a new father, and I have a 7-month-old, and I have never been on as high alert for RSV as I am this year," Sharma said.
What to look for
One of the more serious complications of both flu and RSV is pneumonia.
"There are many patients that do just fine at home with RSV that just have symptoms of runny nose, cough, fever," Manrique said. "However, RSV can be very dangerous, especially for the youngest infants, just given that their lungs are smaller to begin with, and the RSV can cause them to have significant trouble breathing."
A child should be taken to the emergency room if a fever lasts longer than four or five days or there's trouble breathing. Dry diapers also indicate dehydration.
Doctors don't always recommend routine testing, but a nose swab in the pediatrician's office or the hospital will test for influenza and RSV.
As for treatment, RSV patients receive mainly supportive care, helping with hydration and oxygen as needed. Symptoms usually reach their peak between three to seven days, but the cough and congestion can last two to four weeks.
Panagiotopoulos, meanwhile, is relieved to have her daughter at home and urges other parents not to dismiss cold symptoms.
"I'm glad we got to the hospital when we did," she said.