Early surge of flu, viruses in children this fall overwhelms hospitals

In Georgia and elsewhere, a common childhood virus, RSV, is combining with the seasonal flu to cause serious illness

Alexis Ruby’s baby boy was born on Oct. 3, a robust 8-pound, 9-ounce baby with a full head of brown hair. But within days, he started getting a stuffy nose. The newborn’s breathing appeared labored, and the healthy pink tinge to his skin gave way to a purplish hue.

Ruby took baby Lincoln to an urgent care clinic in Athens close to home, but by the time they arrived, his oxygen levels were so low he was rushed by ambulance to Children’s Healthcare of Atlanta’s Scottish Rite hospital.

Around the country, children are getting sick earlier this fall and in much higher numbers. Multiple viruses are surging at the same time, leading to a crush of patients at pediatric hospitals across the country.

“We are just in October,” said Dr. Ingrid Camelo, a pediatric infectious disease physician at the Medical College of Georgia and Children’s Hospital of Georgia, who is bracing for the situation to even worsen over the coming months. She also said she has seen multiple young patients who are sick with two or three viruses at once. “I think we are headed into a very complicated season with all of these viruses (spreading) and winter coming.”

Doctors attribute the outbreak to several causes: seasonal influenza; rhinoviruses, which are the most common cause of colds; and respiratory syncytial virus, or RSV, an upper respiratory illness common among children under age 5.

There’s no vaccine for RSV and by the age of 2, nearly all children have had the virus. Symptoms often look like a common cold and can include a runny nose, congestion, and fever.

But in some cases, RSV can turn dangerous, especially among infants, leading to breathing trouble and complications such as pneumonia. Lincoln was diagnosed at Children’s with RSV and was among those who become critically ill: he needed to be placed on a ventilator and required a feeding tube for nourishment. He has since begun to improve, although he’s still hospitalized.

“Since we’ve been here for over a week, I’ve seen so many babies leave, and then immediately ... replaced with another baby,” said Ruby. “The turnover is so incredibly fast and so many babies.”

Children’s Healthcare of Atlanta said earlier this month they have seen an “unprecedented” number of sick children, forcing them to expand their emergency room with a tent erected in a parking lot. The hospital is also urging non-pediatric ERs to care for some children, especially older teens, instead of moving them to Children’s, according to a spokesperson.

Credit: Contributed

Credit: Contributed

On Monday, a hospital spokesperson said they are continuing to see unusually high numbers of patients, and while she declined to provide specific numbers, said the surge is two to three times their normal volume of patients.

Currently, according to the hospital system’s website, emergency room wait times are more than three hours long at all Children’s Healthcare of Atlanta Hospitals. Children’s doctors are in conversation with other non-pediatric hospital emergency rooms to help ensure they can get the care they need at other, non-pediatric hospitals.

The spike in respiratory illnesses is filling up hospitals across the country, and other hospitals in Georgia, including the Children’s Hospital of Georgia in Augusta, are also seeing a surge of pediatric patients sick with respiratory viruses.

Nationwide, nearly 75% of staffed inpatient pediatric beds are occupied, according to a Monday report from the U.S. Department of Health and Human Services. And while three states in the Northeast report up to 94% of pediatric beds are occupied, the situation appears less dire in Georgia where 65% of pediatric beds are occupied, according to the latest report.

More about RSV

What is it? Respiratory syncytial virus, or RSV, is a common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be serious, especially for infants and older adults.

It’s not just a cold: The symptoms may look like a cold and include a runny nose, cough, and fever. But if an infant’s runny nose and cough turn into more serious breathing trouble, the problem could be RSV, which is potentially life-threatening for little lungs. In children who were born prematurely and in those with other medical conditions such as lung or heart conditions, an RSV infection can be more severe.

When to call the doctor: Seek medical care if your child has any of the following symptoms of RSV: Difficulty breathing or fast breathing with tugging of the chest muscles; gray or blue-tinged skin color around the lips or fingernails; wheezing; lethargy or extreme tiredness; refusal to drink liquids or breastfeed; decreased number of wet diapers

Who can get RSV? Everyone can get RSV. But it causes the most threat to infants, older adults and other vulnerable people, who can get serious airway and lung infections. Among U.S. kids under age 5, RSV typically leads to 58,000 hospitalizations and up to 500 deaths in a year. For adults 65 and older, RSV causes 177,000 hospitalizations and 14,000 deaths yearly.

How long does an RSV infection last? People infected are usually contagious for three to eight days. Babies and people with weakened immune systems can spread RSV for up to four weeks. There is no vaccine for it, although several candidates are in testing.

SOURCE: Children’s Healthcare of Atlanta, The Associated Press

COVID-19 is the source of some pediatric illnesses at Children’s, but the numbers are low compared to other viruses currently circulating.

“I think a lot of parents feel helpless when they hear these numbers and the news and what to do, and ‘I don’t want my children to get sick,” said Dr. Andi Shane, division chief for pediatric infectious disease at Children’s Healthcare of Atlanta and Emory University. “Vaccination, vaccination, vaccination. “

She said nearly all of the children hospitalized with the flu are not vaccinated.

Dr. Robert Wiskind, a pediatrician with Peachtree Park Pediatrics, said it’s not unsual to see RSV cases rise this time of year. What stands out for Wiskind is the early ramp-up of the flu.

“It’s rare to see children with the flu in October,” he said. “And I am seeing lots of it.”

During the COVID-19 pandemic, as people stayed home and wore masks, flu and RSV cases fell to historically low levels. Many people, especially young children, didn’t develop immunity because they weren’t exposed to illnesses. Now, amid the loosening of COVID precautions, virus cases are sharply rising, and doctors are bracing for an especially severe season of viruses that’s already taking root.

Georgia is one of five states in the country with “high” flu activity, according to the latest CDC flu activity map. The Georgia Department of Public Health reports an estimated 5.9% of patient visits to doctors were for flu or flu-like illnesses during the week ending Oct. 15, according to the most recent week for which numbers are available. That’s up from 5.6% from the previous week. There were 77 people in metro Atlanta hospitalized with influenza during the week ending Oct. 15, and so far this season only one adult has died as a result of the flu in Georgia, according to DPH.

ExploreComplete coverage of COVID-19 in Georgia

The 2017-2018 flu season was one of the most brutal in recent years, with close to 150 people dying in Georgia and more than 3,000 people hospitalized in metro Atlanta.

More than a week since being admitted, Lincoln is steadily improving, is no longer on oxygen, and is expected to go home within a couple of days. Meanwhile, Ruby’s toddler daughter, Charlotte, also has RSV and is recovering at home, being cared for by grandparents.

Despite the busy, crowded conditions at Children’s, Ruby lauded the level of care from doctors and nurses. A social worker at the hospital helped Ruby and her husband get lodging at a nearby Ronald McDonald House, which provides parents a place to stay close to their hospitalized child for little to no cost.

Ruby said her advice to parents is to trust their instincts. She said her children’s pediatrician didn’t seem overly concerned during a conversation over the phone because Lincoln was not running a fever.

“But I just knew things were not fine so I took him to the doctors and they literally said if you waited any longer it would not have been good,” she said.

AJC data journalist Stephanie Lamm contributed to this article.