Children’s hospitals in Louisiana are coping with a surge in admissions and ER visits due to a handful of respiratory viruses. While it’s not unusual to see viruses surge as the weather gets colder, it is rare to be dealing with so many at once, leading to hospitals that are brimming with sick kids.
“We’ve got a full house,” said Dr. Mark Kline, physician in chief at Children’s Hospital New Orleans. “We stay at capacity.”
Hospitals are seeing an unusual constellation of these viruses. Rhinovirus and enterovirus, which typically cause symptoms associated with the common cold, are responsible for most of the illness. The two viruses are indistinguishable from one another on the tests most hospitals use. Tests given at Children’s for these viruses are coming back positive 40% of the time – an “extraordinary figure,” said Kline.
In Baton Rouge, it’s even higher at about 50%, said Dr. Michael Bolton, a pediatric infectious disease specialist at Our Lady of the Lake. The Acadiana area has not yet seen the same upticks, but there’s a sense that it’s inevitable.
Families gather outside a Children’s Hospital vaccine bus in the parking lot of Rouses on Tchoupitoulas Street in New Orleans on Wednesday, August 31, 2022.
“I am expecting it soon, as kids are in school unmasked and those viruses are around,” said Scott Hamilton, medical director of Ochsner Lafayette General’s pediatric emergency room.
The Centers for Disease Control and Infection issued a health advisory earlier this month about the increase. Further testing showed that there has been an uptick of a particular strain of enterovirus called D-68 that causes polio-like paralysis. Most hospitals don’t have the testing for that strain, and Kline said Children’s in New Orleans has yet to see a case.
Influenza A is also showing up earlier and at higher numbers than typical, with about 19% of tests coming back positive at Children’s. Flu season typically doesn’t start gearing up until October. Adenovirus, another cold- or flu-like illness, is showing up in about one in ten kids at Children’s.
Respiratory syncytial virus, or RSV, is also plaguing children and worrying parents. While enterovirus and rhinovirus are the most diagnosed, kids with RSV are more likely to be admitted to the ICU, said Bolton. The number of tests coming back positive for RSV is about 1 in 5 at OLOL recently.
The only silver lining, physicians say, is that COVID cases remain low among kids right now, though it’s unclear if that will last throughout the winter. At Children’s, tests come back positive for COVID about 2% of the time. At the peak last summer, it was around 30%.
‘I don’t think we can get any more full’
The recent surge in illness is more than any previous COVID increase. In July 2021, children’s hospitals saw a swift spike in admissions due to COVID. They’re more full now than they were then.
“Last summer when we got to an inpatient census of 160, we felt like we were full. The census this afternoon is at 182,” Kline said Thursday.
And it’s not just in Louisiana. Kline said children’s hospitals in Birmingham, Atlanta and Texas are full, too, according to colleagues there.
The sheer number of viruses pelting the pediatric systems at once comes at a time when hospitals are typically preparing staff to care for patients during the winter, their busiest season.
“Kids invariably are going to be exposed and get infected with some of these things over time,” said Kline. “When four or five are co-circulating, it’s a strain on the health system.”
Like many hospital employees experienced over the last few years, an influx of patients can lead to exhaustion among staff. Hospitals typically count on a slower summer to prepare and regroup for the respiratory virus season from October until spring.
“If you’re on the go the entire time, you’re on your feet, you’re at the patient’s bedside, you don’t get that respite of, ‘This what I did well today, this is what I can do better tomorrow,’” said Bolton. Instead, workers are just trying to get through the day, knowing they have to come back to the same busy day tomorrow.
It’s not clear what is causing the spike, but returning to pre-pandemic habits without masks as school starts up may be a factor. A lack of immunity from decreased exposure to viruses over the last few years may also be contributing.
“There’s sort of a cohort of young children out there at this point who have not become infected with these viruses over last couple years,” said Kline. “Now that masks have been dispensed with, these viruses are finding a lot of susceptible hosts.”
Pediatricians recommend children stay up to date on their vaccinations, including COVID-19 and the flu shot.