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Children’s hospitals fill up amid early wave of respiratory infections

    An intensive care nurse cares for a patient suffering from the respiratory syncytial virus.
    enlarge / An intensive care nurse cares for a patient suffering from the respiratory syncytial virus and is on a ventilator in the pediatric intensive care unit of the Olgahospital in Stuttgart, Germany.

    Doctors across the country are reporting early and dramatic increases in respiratory illness, with many children’s hospitals saying their beds are running out.

    Nearly three-quarters of pediatric hospital beds are full, according to national data collected by the Department of Health and Human Services. Children’s hospitals are full in some areas, including the Washington, DC, and Boston areas.

    Several viruses are behind the wave. As Ars previously reported, health officials have warned of an increase in adenoviruses and enteroviruses, both common respiratory viruses in children. One enterovirus, called EV-D68, is associated with a polio-like neurological condition called acute flaccid myelitis (AFM) in young children, and health officials are bracing for another rise in AFM cases. So far, the CDC has not seen such an increase in this decline.

    However, the latest data from the Centers for Disease Control and Prevention points to a skyrocketing rate of cases of RSV respiratory syncytial (sin-SISH-uhl) virus. RSV is a common respiratory infection that causes cold symptoms in most people, but can become life-threatening in a small percentage of cases, especially in infants and young children with specific underlying health conditions.

    RSV tends to rise later in the winter, peaking in the recent pre-pandemic years in late December. But circulation of the virus started to pick up at the end of the summer this year, and cases are now high, with the latest weekly number of cases as of Oct. 15 at more than 7,000, according to CDC data. The peak of RSV cases in 2021 saw weekly counts typically around 4,000.

    Flu-like activity has started early with this year's data marked on the left with red triangles.
    enlarge / Flu-like activity has started early with this year’s data marked on the left with red triangles.

    And RSV isn’t the only virus starting early this fall. Flu circulation is also starting off unusually strong, and officials worry it could also be a particularly bad flu season.

    The brisk rise of cold-weather viruses has prompted experts to double calls for flu shots and COVID-19 boosters. While reported cases of COVID-19 show no signs of a dramatic rebound, the use of home testing makes it difficult to interpret official cases, and experts expect a winter wave of COVID-19 to be on the horizon, if not already beginning.

    “I think now is a sensible time to get not only the COVID booster, the new bivalent vaccine, but also the flu vaccine,” former FDA Commissioner Scott Gottlieb said in a Sunday interview on CBS News. Face the nation. “At the moment, flu cases are on the rise. It seems like this could be a more aggressive flu season. The predominant strain is currently H3N2 and the vaccine seems to be a good match for the strain.” As such, it looks like the vaccine will be “pretty protective,” he said, and now is “a good time to get it.”

    As for why this fall and winter are getting so rough, experts speculate it’s a combination of pandemic-related disruptions. The global explosion of SARS-CoV-2 transmission, subsequent lockdowns and pandemic reduction efforts have devastated normal transmission cycles of garden variety respiratory viruses. In addition, the postponement of common viruses has created a higher-than-normal number of susceptible young children, as well as adults with waning immunity to previous exposures.