On Sunday night, 4-month-old Aesop Light was comfortable and alert. By Monday morning, he was struggling to breathe.
Aesop’s parents, Corey and Tara Light, took him to an emergency room near their home within the Chicago suburbs, however it did not have a kid’s wing, so Aesop was rushed by ambulance to a different hospital an hour away. He tested positive for respiratory syncytial virus, or RSV, a typical virus that causes lung infections.
Aesop’s condition “went downhill really fast,” Tara said.
Hospitals across the country have reported a surge in RSV cases over the past three to 4 weeks. The virus began circulating in the summertime, to doctors’ surprise, because it often peaks in winter.
For a lot of kids, RSV symptoms appear like a typical cold. But for others — young babies or children with lung diseases or weakened immune systems — symptoms might be more severe.
“Those who are inclined to get essentially the most sick are the infants below 4 months. After which those who’re older who are inclined to get most sick are those that have another medical conditions,” said Dr. Sameer Kamath, chief medical officer for Duke Kid’s Hospital and Health Center.
RSV can result in bronchiolitis, an infection that causes airways to turn out to be inflamed and clogged with mucus, making it difficult to breathe. If the infection travels to the lung sacs, it will possibly end in pneumonia.
In accordance with the Centers for Disease Control and Prevention, RSV leads to around 58,000 annual hospitalizations and 100 to 300 deaths amongst children under 5.
Aesop was moved to a pediatric ICU on Tuesday after his heart and respiratory rates soared. Tara has been staying with him within the hospital, since she still breastfeeds. Meanwhile, Corey has been driving forwards and backwards to deal with their three other kids.
NBC News spoke with six doctors across five states — California, Illinois, Massachusetts, North Carolina and Rhode Island — all of whom said pediatric hospital bed capability has been strained because of an influx of RSV patients.
“We’re really having a capability problem like I’ve never seen before,” said Dr. Charlotte Boney, pediatrician-in-chief at Baystate Kid’s Hospital in Springfield, Massachusetts.
The CDC said it doesn’t keep a national count of RSV cases, hospitalization or deaths, however it tracks changes within the virus’ spread.
“We’ve observed an increase in RSV in multiple U.S. regions, and a few regions are nearing seasonal peak levels,” a CDC spokesperson said.
Last week, nearly 5,000 tests got here back positive, based on CDC data. That is not removed from the number in the identical week of October 2021 but far higher than in October 2020.
Boney said her hospital experienced the next volume of patients in September than ever recorded, lots of whom had RSV. Her pediatric ICU was closed to latest patients on Wednesday because no beds were available.
During a standard winter, her emergency room might see around 100 children a day, Boney said. It’s now seeing about 130 to 150. Many RSV patients in Massachusetts are being transferred to nearby states, she added.
Dr. Michael Koster, director of pediatric infectious diseases at Hasbro Kid’s Hospital in Windfall, Rhode Island, said his hospital has been treating some RSV patients from over 100 miles away.
Kamath said that in the realm around Raleigh, Durham and Chapel Hill, “there have been nights when there was one bed available between three institutions, which could be very scary.”
At Comer Kid’s Hospital in Chicago, hospital and ICU beds have been full for over a month. Dr. John Cunningham, the hospital’s physician-in-chief, said the emergency room is seeing a 150% higher volume than its usual for October. He said the hospital is treating around 10 to 30 RSV patients at a given time, so that they occupy a big share of its 30 ICU and 60 emergency beds.
Cunningham’s hospital is directing some patients to other facilities, but it will possibly take 24 hours for a transfer, and a toddler’s condition could easily deteriorate in that point.
“Depending on the severity, it isn’t an exaggeration to say minutes, hours matter,” said Dr. Benny Joyner, medical director of the pediatric ICU at UNC hospitals in Chapel Hill, North Carolina.
In San Diego, 50 patients have tested positive for RSV over the previous couple of days at Rady Kid’s Hospital, based on Dr. John Bradley, the hospital’s medical director of infectious diseases. He said the amount of RSV patients is “two to 3 times what we have ever experienced.”
“In mid-October, an epidemic of RSV is essentially unheard of in San Diego,” Bradley added.
What a severe RSV case looks like
Doctors said RSV is spreading earlier this yr and leading to more severe illness in some kids because many children weren’t exposed to respiratory viruses earlier within the pandemic because of masking and social distancing.
“All those infection control measures protected us from all these viruses. Now everyone has relaxed those measures and these viruses are back with a vengeance,” Boney said.
Doctors said they’ve seen many young kids who contracted RSV from an older sibling, who in turn was infected in school or day care. That is how the Light family thinks Aesop got sick: They’ve a daughter in first grade, a son in pre-kindergarten and a 2-year-old daughter at home. The whole family had cold-like symptoms last week.
“It’s totally much a contact illness,” Cunningham said. “Hand hygiene is actually the important thing thing. The key way that it disperses is definitely by direct contact, fairly than by anyone coughing on you.”
Doctors said parents shouldn’t worry about every cough or runny nose, but they need to look out for signs that a toddler is lethargic or respiratory hard or fast.
“In case your child, especially under the age of two, is flaring the nostrils, grunting, head bobbing otherwise you’re seeing sucking in across the collarbones or ribs, that is far more concerning,” Koster said.
Kamath said many children who show as much as the hospital aren’t in a position to eat or drink because they’re respiratory so rapidly. In case your child cannot eat liquids, Joyner said, “that is a harbinger that it is advisable bring them in and get them evaluated.”
Aesop Light showed lots of those warning signs, Corey said. Doctors told the Lights that their son needed oxygen support and tubes inserted into his nostrils to suction the mucus from his airways.
On Thursday, Aesop was finally in a position to breathe on his own.
Children hospitalized with RSV typically recuperate inside two to 3 days, though “a small minority do find yourself within the ICU, after which sometimes even on the ventilator,” Kamath said.
ICU patients are inclined to recuperate inside per week, based on Joyner.
RSV vaccines and coverings are on the horizon
Apart from respiratory tubes, ventilators and supportive care like steroids or fluids, doctors do not have some ways to treat RSV.
“There is no such thing as a Paxlovid-like drug for RSV. There is no such thing as a Tamiflu drug like we’ve got for influenza,” Boney said.
One drug, a monoclonal antibody called Synagis, is approved for babies at high risk of severe RSV, resembling those born premature or with chronic heart or lung problems. But doctors said they provide that treatment sparingly.
Nonetheless, Bradley said his San Diego hospital is about to take part in a clinical trial of an RSV antiviral from Pfizer later this yr.
“I’ve already told Pfizer, ‘Hurry up, get the study up and running,'” he said. “We’re being overwhelmed with RSV, so it would be easy to check the drug at once.”
Pfizer can also be testing an RSV vaccine candidate, which was found to be nearly 86% effective in stopping severe illness in a late-stage trial of older adults. One other RSV vaccine candidate, from pharmaceutical company GSK, was found to be around 83% effective against the disease amongst adults ages 60 and up, based on data released Thursday.
Bradley predicted it is going to like take one other few years for an RSV vaccine to turn out to be available. Within the meantime, he said, oxygen support is very effective.
“It’s purely a lung infection. This virus doesn’t go anywhere else within the body the way in which influenza does,” he said, adding that “once they get oxygen and the lungs work, the children actually feel OK.”