Not just COVID: Virus experiences unprecedented summer surge in Louisiana, hospitalizing babies | New

Kristopher Head’s godmother worried more and more about him with every breath he had been struggling to swallow over the past week.

A pediatrician had given the 20-month-old baby antibiotics and respiratory treatment, but it appeared his condition was getting worse. After a particularly disturbing night, her godmother and guardian, Victoria Spain Robinson, promised her that she would take her to the hospital when the day came.

They drove from Denham Springs to Baton Rouge, and in the emergency room at Our Lady of the Lake Children’s Hospital, medical providers diagnosed her with respiratory syncytial virus, better known as RSV.

The diagnosis was a paradox, both surprising and disappointing. RSV cases are on the rise in southern states – the Louisiana Department of Health has officially branded this season as RSV – and the Centers for Disease Control and Prevention has issued a warning about the spread.

But the RSV generally does not soar in the summer. It is in fact a winter virus which is the main cause of hospitalization in babies under the age of 1. For hospitals, the fact that hospitals were jam-packed with little ones with RSV in mid-July is unprecedented, according to providers.

“This is the first time that I have seen a large-scale summer epidemic in the past 20 years,” said Dr. Jay Hescock, who works for the Children’s Hospital of New Orleans as chief of LSU Health Hospitals Section.

Pediatricians say they are exhausted, working longer hours and extra shifts, burning personal protective equipment and wondering if the increase in the number of cases will stop. Children’s hospitals in Louisiana are scrambling to find enough beds and staff to handle all RSV cases, and many have had to stop accepting transfers from other hospitals with their own overflowing buildings.

As the delta variant of the coronavirus moves through Louisiana – largely affecting adults so far – the RSV is sweeping through children, many of whom have been locked up for more than a year amid restrictions on coronaviruses that have recently been lifted.

“We knew the RSV would come back and it would be serious,” said Dr. Andres Carrion, pediatric pulmonologist at Our Lady of the Lake Children’s Hospital. “We see it early on. What worries me is that we may not have flattening. It could be a very long winter.

Our Lady of the Lake Children’s Hospital, for example, has seen an average of 90 inpatients in recent weeks, with as many as 10 to 15 waiting for inpatient rooms to become available at any given time. As of last summer, however, the hospital was averaging half or even three-quarters lower numbers, with an average count ranging from 32 to 45.

The state Department of Health considers RSV season when the RSV test positive rate is greater than 10%. The state remained below that number until mid-May, when positive RSV cases jumped nearly 10 percentage points to just under 20%. Cases have continued to increase since then, and RSV positive cases in early July reached nearly 30%.

These numbers still don’t give a full picture of the state’s outbreak. Children in hospital are tested for the virus, but some pediatricians do not recommend testing milder cases of RSV because there is no cure. Confirming your diagnosis does not usually change the treatment of typical symptoms of a virus: making sure children are properly hydrated, that they have no difficulty breathing, and that their airways are clear.

More cases, worse cases

As people wore masks, avoided large gatherings and washed their hands more than usual to stem the spread of the coronavirus last year, other viruses also fell. RSV was one of them, as was the flu.

But “as soon as things relaxed with the COVID restrictions, we had one thing after another,” said Dr Ashley Lucas, medical director of pediatric primary care at Notre-Dame du Lac.

First it was croup, a virus that affects the upper respiratory tract. Then it was foot and mouth disease, also caused by viruses that can lead to rashes around the mouth as well as cold-like symptoms.

But RSV’s surge has been the worst yet. For adults and older children who have had it in the past, RSV usually looks like a common cold. But for babies and toddlers, it can lead to pneumonia and bronchiolitis.

“The cases we are seeing right now are definitely more than what we are used to seeing during the regular season, and the severity is definitely worse than before,” said Dr. Reynaldo dela Rosa, pediatric resuscitator Lafayette. who supervises the pediatric intensive care unit at the Notre-Dame de Lourdes hospital for women and children.

“We hope it will reverberate, but there is no sign of it,” he added.

He advised parents and guardians to closely monitor babies if they are not eating, have a high fever, or seem to be straining when trying to breathe. Seeing the muscles in his back or chest contracting as he breathes is a sign that “the baby is trying as hard as he can to breathe in air to breathe and survive.”

That’s what worried Robinson, 44, about his godson, Kristopher. He was micro-premature at birth, weighing just over a pound, so he already had lung problems. His family affectionately calls him “fat daddy,” a nickname that shows how much he’s grown since birth.

When Robinson brought him to the hospital, there were no free beds to admit him immediately because of all the other cases of RSV – and various other illnesses – filling the hospital. They spent the night in an emergency room and Kristopher was admitted the next morning.

It has become a recurring theme in the latest outbreak: Hospitals don’t necessarily have enough beds or staff to keep pace.

“Most of the hospitals that take care of pediatric patients weren’t necessarily well equipped to deal with this summer wave,” Hescock said. “It creates problems in finding places that will care for children with this disease and others. “

“They were all full,” said Dr Catherine O’Neal, Chief Medical Officer of Notre-Dame du Lac. “No beds available for weeks as they are full of critically ill children who have respiratory viruses, mostly RSV.”

And while the cases in adults are usually milder, they also get sick with RSV, O’Neal said. She said that since patients don’t know whether their symptoms are related to COVID-19 or RSV, it puts a bit of “blinders on the rise in COVID that’s here.”

While Kristopher was staying at Our Lady of the Lake Children’s Hospital – the most comprehensive since it opened in late 2019 – providers gave her oxygen, intravenous fluids and increased the frequency of her Albuterol, which helps to breathe. Robinson stayed by his side.

“I was like, Kristopher, you have to get rid of this oxygen; Nanny is ready to go home, ”she said with a laugh.

“These babies are precious”

Most children get RSV for the first time before they are 2 years old. But providers who see them say their patients run the gamut from newborn to toddler to child, in large part because most haven’t gone through the cycle of epidemics – and reinforcement. of the immune system – during the winter months.

“These children were so well protected that they were not exposed,” said Dr. Erin Hauck, vice-chief of the pediatrics division at Our Lady of the Lake.

Dr Brooke Dismukes, a pediatrician at Ochsner Children’s Hospital in Jefferson, said she was seeing more children aged 3 and 4 with more severe cases of RSV this summer who had never had one before.

“It looks exactly like what it would look like in our winter months,” she said.

One of the youngest inpatients with RSV in the state was Lilliana Credeur, of Saint-Martinville, hospitalized just 3 weeks old. Her mother said a sibling caught the virus at daycare, which is likely how it spread to the newborn baby. Lilliana was released after more than a week of treatment at Notre-Dame de Lourdes Hospital for Women and Children.

“The poor baby couldn’t eat for four days; they had it right under the fluids, ”said her mother, Ashley Credeur, 38.

Despite its high hospitalization rate, RSV is rarely fatal in the United States, although it can be particularly serious in children who already have difficulty breathing, and sicker ones may require intubation. Even for those with milder cases, it can be a miserable task without easy remedies. Children who suffer from it often have a fever, cough and little appetite.

It is also easily spread – through respiratory droplets, such as coughs, and on infected surfaces. After Kristopher was hospitalized, Robinson said she began warning her neighbors and friends to keep their babies at home and to stay away from crowds. She said she wanted to share her story in hopes of helping another family avoid having to hospitalize their little one.

“These babies are so precious,” she said. “I tried to warn people: stay away.

Editor Emily Woodruff contributed to this report.