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CDC investigating apparent rise in strep A infections in children

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CNN
 — 

The US Centers for Disease Control and Prevention says it’s investigating an apparent increase in invasive group A strep infections, but the rise may indicate a return to typical pre-pandemic levels.

Much like flu and RSV, invasive group A strep infections, known as iGAS infections, were curbed by Covid-19 control measures such as masking and social distancing. But in a statement Friday, the CDC said it’s now hearing from some doctors and state health departments about an increase in iGAS infections among children.

“It’s too soon to say whether iGAS case numbers are just returning to pre-pandemic levels or if they are rising beyond what we would normally expect based on what we know about GAS seasonal patterns,” CDC spokesperson Kate Grusich wrote In an email.

“The recent increases in respiratory viruses, particularly influenza, may also be contributing to a possible increase in iGAS infections. Concurrent or preceding viral infections such as influenza and skin conditions such as chickenpox may increase risk for iGAS infections.”

The Colorado Department of Public Health and Environment said Friday that it is monitoring an increase in pediatric hospitalizations caused by group A strep. The rise follows a drop in cases during the pandemic.

“Cases of invasive group A strep have been increasing in all age groups, but is especially apparent this fall in pediatric patients,” spokesperson Paul Galloway wrote in an email.

There have been 11 reported cases of invasive group A strep in children 10 months to 6 years of age in the Denver metro area since November 1, the department said. Two children have died, but the official cause of death has not been determined, Galloway said.

This month, health officials in the UK advised parents and schools to monitor for strep A infections after the deaths of several children.

The World Health Organization said Thursday that France, Ireland, the Netherlands, Sweden and the UK have reported an increase in iGAS infections and scarlet fever, warning that children under 10 are most at risk.

Group A strep can cause many types of infections, some relatively minor. Strep A, or group A streptococcus, is a bacteria found in the throat and on the skin that usually causes fever and throat infections, such as strep throat or scarlet fever.

More rare are invasive group A strep infections, including necrotizing fasciitis and streptococcal toxic shock syndrome.

Necrotizing fasciitis is sometimes called flesh-eating disease. It’s a rare bacterial infection that spreads quickly and can be deadly, according to the CDC. Group A strep is thought to be the most common cause.

Streptococcal toxic shock syndrome, also known as STSS, happens when bacteria spread into deep tissues and the bloodstream. “STSS can develop very quickly into low blood pressure, multiple organ failure, and even death,” the CDC says.

Strep A is not fatal for most people who become infected, and antibiotics are usually effective at treating them.

There is no vaccine to prevent strep A infections, and the best way to protect yourself from the bacteria is by washing your hands frequently, the CDC says.

“If someone does get sick from a group A strep infection, timely treatment is important, as it can prevent severe illness and complications,” Texas Department of State Health Services spokesperson Lara Anton said Friday.

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Health

CDC investigating apparent rise in strep A infections in children

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CNN
 — 

The US Centers for Disease Control and Prevention says it’s investigating an apparent increase in invasive group A strep infections, but the rise may indicate a return to typical pre-pandemic levels.

Much like flu and RSV, invasive group A strep infections, known as iGAS infections, were curbed by Covid-19 control measures such as masking and social distancing. But in a statement Friday, the CDC said it’s now hearing from some doctors and state health departments about an increase in iGAS infections among children.

“It’s too soon to say whether iGAS case numbers are just returning to pre-pandemic levels or if they are rising beyond what we would normally expect based on what we know about GAS seasonal patterns,” CDC spokesperson Kate Grusich wrote In an email.

“The recent increases in respiratory viruses, particularly influenza, may also be contributing to a possible increase in iGAS infections. Concurrent or preceding viral infections such as influenza and skin conditions such as chickenpox may increase risk for iGAS infections.”

The Colorado Department of Public Health and Environment said Friday that it is monitoring an increase in pediatric hospitalizations caused by group A strep. The rise follows a drop in cases during the pandemic.

“Cases of invasive group A strep have been increasing in all age groups, but is especially apparent this fall in pediatric patients,” spokesperson Paul Galloway wrote in an email.

There have been 11 reported cases of invasive group A strep in children 10 months to 6 years of age in the Denver metro area since November 1, the department said. Two children have died, but the official cause of death has not been determined, Galloway said.

This month, health officials in the UK advised parents and schools to monitor for strep A infections after the deaths of several children.

The World Health Organization said Thursday that France, Ireland, the Netherlands, Sweden and the UK have reported an increase in iGAS infections and scarlet fever, warning that children under 10 are most at risk.

Group A strep can cause many types of infections, some relatively minor. Strep A, or group A streptococcus, is a bacteria found in the throat and on the skin that usually causes fever and throat infections, such as strep throat or scarlet fever.

More rare are invasive group A strep infections, including necrotizing fasciitis and streptococcal toxic shock syndrome.

Necrotizing fasciitis is sometimes called flesh-eating disease. It’s a rare bacterial infection that spreads quickly and can be deadly, according to the CDC. Group A strep is thought to be the most common cause.

Streptococcal toxic shock syndrome, also known as STSS, happens when bacteria spread into deep tissues and the bloodstream. “STSS can develop very quickly into low blood pressure, multiple organ failure, and even death,” the CDC says.

Strep A is not fatal for most people who become infected, and antibiotics are usually effective at treating them.

There is no vaccine to prevent strep A infections, and the best way to protect yourself from the bacteria is by washing your hands frequently, the CDC says.

“If someone does get sick from a group A strep infection, timely treatment is important, as it can prevent severe illness and complications,” Texas Department of State Health Services spokesperson Lara Anton said Friday.

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Health

Flu activity remains high but shows signs of slowing in parts of the US, CDC says

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CNN
 — 

A flu season that hit the United States early and hard is showing the first signs of slowing in parts of the country.

For the first time this season, flu hospitalizations have dropped week-over-week. The week after Thanksgiving was the season’s worst yet, but data published Friday by the US Centers for Disease Control and Prevention shows that flu hospitalizations fell 10% in the week after that.

Still, flu activity remains high nationwide, and this is not a sign that flu has peaked. Like last week, all but seven states continue to have “high” or “very high” respiratory virus activity, according to the CDC.

The holiday season is well underway too, and experts have warned that holiday gatherings could increase the spread of respiratory viruses.

As of December 10, the CDC estimates that there have been at least 15 million illnesses, 150,000 hospitalizations and 9,300 deaths from flu this season.

This season’s cumulative hospitalization rate is higher than it’s been in more than a decade. And even with the signs of improvement, millions more were infected last week, and thousands died.

Health leaders continue to emphasize the importance of vaccination, especially as Covid-19 ramps up again and the strain on hospitals persists.

“We have the tools, we have the infrastructure, and we have the know-how to manage this moment,” White House Covid-19 response coordinator Dr. Ashish Jha said Thursday.

Uptake of both the updated Covid-19 booster shot and the annual flu vaccine is lower than experts would like.

Only about 40% of adults and 46% of children have received their flu shot this season, far below the target rate of 70% set by the US Department of Health and Human Services in the Healthy People 2030 plan.

The CDC on Friday also published new estimates for flu vaccine coverage among adults, which show that vaccine coverage among White people (45%) and Asian people (47%) is much higher than it is for Black people (33%), Hispanic people (28%) and American Indian people (26%). Coverage among pregnant people (44%) is significantly lower than it was for the past two seasons, and coverage in rural areas is lagging behind that in urban and suburban areas.

Flu vaccination rates for seniors are better, with 64% vaccinated this season, but still not high enough for a group that is particularly at risk of severe outcomes from flu. There have been about 88 hospitalizations for every 100,000 people 65 and older this season – nearly three times the average hospitalization rate.

Children younger than 5 have also been hospitalized with flu 1.5 times more often than the overall population.

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Dr. Sanjay Gupta: After two years of Covid-19 vaccines, here’s why they’re still vital

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CNN
 — 

In the United States, approximately 658 million Covid-19 vaccine doses have been administered since they were first distributed exactly two years ago Wednesday.

Framing the significance of preventive measures like vaccines can be challenging, which is why a new report from the Commonwealth Fund and Yale School of Public Health made headlines: According to their modeling of disease transmission across all age demographics and taking into account the existing health conditions in so many Americans, Covid vaccines prevented an estimated 3.2 million deaths and 18.5 million hospitalizations from their introduction in December 2020 to November 30, 2022.

That is why it is surprising to hear, according to a Kaiser Family Foundation analysis of data from the US Centers for Disease Control and Prevention, that from April through August – the last month included in the analysis – there were more vaccinated than unvaccinated people dying of Covid. The vaccinated categories include people who were vaccinated with the primary series and people who had been vaccinated and received at least one non-bivalent booster.

According to a CNN analysis of additional CDC data for September, 12,593 people died of Covid. A CDC sample of the deaths found 39% were unvaccinated, and 61% were vaccinated.

This phenomenon has many people – especially vaccine skeptics, but even stalwart vaccine supporters – confused and wondering if Covid vaccines and boosters are still effective and warranted.

The short answer is yes – but understanding why requires a crash course in statistics. We enlisted the help of Jeffrey Morris, a professor and the director of the Division of Biostatistics at the Perelman School of Medicine at the University of Pennsylvania, who helped us define three key reasons more vaccinated than unvaccinated people are dying of Covid.

One of the main reasons we see more vaccinated than unvaccinated people dying of Covid is a basic one. At this point in time, there are simply many more people who are vaccinated.

Think of it like this: If we round the September deaths to 13,000 and use the CDC sampling percentages, approximately 7,800 were vaccinated and approximately 5,200 were unvaccinated. The conclusion might be that you are far more likely to die if you are vaccinated. And, mathematically that would be true based on the raw numbers alone. If you stopped your analysis at this point, you will have committed a statistical error known as a base rate fallacy.

If instead, you take the extra step of accounting for the total number of fully vaccinated adults 18 and older in the United States (around 203 million) versus the total number of unvaccinated adults (around 55 million), a very different picture emerges.

Among the vaccinated population, 7,800/203 million died in September, which equals a rate of 38 deaths for every 1 million people. For the unvaccinated population, 5,200/55 million died, which equals a rate of 95 deaths for every 1 million people. That means an adult who is unvaccinated is roughly 2.5 times more likely to die than one who is vaccinated.

“You have to take into account the size of those groups,” explained Morris, who also publishes a blog, COVID-19 Data Science, to “just communicate what the emerging data suggest.”

There is another important difference when looking at the vaccinated versus unvaccinated populations in the United States. The vaccinated population skews older and has more health conditions. These are the same groups that are much more likely to have worse outcomes, like hospitalization and death, when infected with SARS-CoV-2, the virus that causes Covid-19. For example, CDC data show more than 90% of deaths through mid-November have been in those 65 or older.

“So those things lead to a higher risk of death and also a higher probability of being vaccinated,” Morris said. “That’s the key: if the vaccine uptake of those high-risk groups is high enough, then we can have a majority of the hospitalized or fatal cases be higher in the vaccinated population.”

You are more likely to die if you are older, and also more likely to be vaccinated if you are older. It does not mean vaccination is more likely to lead to death.

So if age isn’t taken into account when assessing vaccine efficacy, it can lead to something known as Simpson’s paradox, where a trend can appear to be the opposite of reality.

Morris said those kinds of errors not only result in a serious underestimation of the benefit of vaccines but also to downright wrong conclusions, even flipping the results – in this case, making it appear that vaccines increase the risk of death.

This happened in August 2021, with a study out of Israel – a highly vaccinated country – showed 60% of those hospitalized with severe Covid were fully vaccinated, causing misinterpretation and raising questions about the continued value of vaccination.

Morris said he has also seen Simpson’s paradox when people look at the rate of Covid deaths before vaccines were rolled out in 2020 versus since then, or comparing countries with higher vaccination rates to countries with lower vaccination rates.

“It’s a lot more subtle, but the pandemic has provided a number of pure examples of it. So the bottom line with all of that is, we can’t accurately assess the effects of vaccines from simple summaries,” Morris said, however “seemingly intuitive” they may appear.

A more telling and accurate comparison is between the death rate per 100,000 among unvaccinated people compared to the death rate of vaccinated people, adjusted for age.

CDC data show that for the week of September 25, people age 12 and older who were unvaccinated had a death rate of 1.32 per 100,000. Those who were vaccinated (but without an updated, bivalent booster) had a death rate of 0.26 per 100,000. And those who were vaccinated and boosted had a death rate of 0.07 per 100,000.

Broken down further by age, the numbers are even starker: The death rate during that week for those in the oldest age group, 80 and above, was 14.16 per 100,000 for the unvaccinated, 3.69 for those who were vaccinated but had not received the bivalent booster, and 0.0 for those who were vaccinated and boosted.

Overall, the CDC estimates that for the whole month of September, among those 12 and older, there was an almost 15 times lower risk of dying from Covid-19 for the vaccinated and boosted compared to the unvaccinated.

Unfortunately, uptake of the booster is low: Only 13.5% of the US population 5 and older is vaccinated and has gotten the new updated (bivalent) booster. Among those 65 and older, that percentage is 34.2%.

It’s not to say that vaccines are entirely risk free. For example, in people – especially males – between the ages of 5 and 39, there were 224 verified cases of myocarditis or pericarditis, inflammation of the heart and lining, reported to the CDC after vaccination with an mRNA vaccine between December 14, 2020, and May 31, 2022. But that was out of almost 7 million vaccine doses administered.

A study examining those figures found myocarditis/pericarditis occurred within seven days approximately 0.0005% of the time after the first dose, 0.0033% of the time after the second dose of the primary series, and 0.002% after the first booster – but it varied by age and sex, and was much more common among 16- to-17-year-old males after a second shot or a booster.

According to a separate analysis of nearly 43 million people in England, the researchers found that for younger men, the Moderna vaccine in particular had the highest rates of post vaccine myocarditis – although this number was still very low, 97 per million people exposed (0.0097%) – leading some to suggest a different vaccine for that age group or a longer interval between vaccine doses.

Statistical optical illusions aside, the fact is, there are more so-called breakthrough cases among the vaccinated. They have always existed. Since December 2020, we have known these vaccines are not 100% effective at preventing severe illness and death, let alone infection. When vaccines were first introduced, their efficacy was estimated to be an astonishing 95% against severe illness and death. They even protected people at a very high rate against infection.

But the efficacy keeps ticking downward. Part of it is waning immunity: Over the course of several months, antibody levels fade away – that’s just how the body works – even though there is still some protection, thanks to B cells and T cells. Getting boosted – or catching Covid – can help increase antibody levels for a few months at least. Between those two options, it’s far safer and less disruptive to get a booster than to risk illness.

Meanwhile, new variants keep cropping up, and they are increasingly able to evade our immune system. Unlike earlier variants, including the highly transmissible Delta variant, descendants of the Omicron lineage are escape artists.

“The emergence of Omicron at the end of 2021 was a game changer, as Omicron and its subsequent subvariants demonstrated strong immune evasion properties, with mutations in the spike protein and especially the [receptor binding domain] that reduced the neutralizing ability of the vaccine-induced antibodies,” Morris noted. The result is a great reduction in vaccine efficacy against infection, as well as against severe and fatal disease.

This actually means it’s more important to get boosted, especially if you are in a high-risk category, and as the weather gets colder and we gather indoors to spend time together.

The newest booster – the bivalent booster – is designed to protect against the original SARS-CoV-2 virus and against the more recent Omicron subvariants, although how much and for how long is still unknown.

Covid cases, and deaths have slowed down in recent months, but those numbers are trending up like they’ve done during the holidays in previous pandemic years. For the week of December 7, weekly new cases topped 65,000 and Covid claimed the lives of almost 3,000 people. Both represent an increase of around 50% from the week before, according to CDC data.

All of this is happening at a time when hospitals are already full of patients sick with the flu and RSV.

I know we’re all tired of hearing that we need to roll up our sleeves and get yet another Covid-19 booster.

But remember, many of us get the flu shot every year: We don’t assume we are protected from a flu vaccine a year ago. We get the shot even in seasons when the flu vaccine is much less effective than the Covid vaccine (the latest one appears to be a good match). We don’t call it a booster – it’s just the annual flu vaccine. And we don’t track the rate of so-called breakthrough flu infections; unlike Covid, we don’t routinely test people for flu unless they are demonstrably sick, so we have no way of knowing how many people, vaccinated or not, are infected and asymptomatic or mildly ill.

For some diseases, like measles, a single vaccine or a previous infection provides us with a near lifetime of protection. Even though we hoped for a one-and-done scenario when the Covid vaccines rolled out two years ago, the virus didn’t lend itself to that. Newer vaccines are being studied that could offer far more durable protection.

Analyzing all of this data without falling into the trap of a base rate fallacy or Simpson’s paradox isn’t easy, as you can see. And it is also clear the overall effectiveness of the vaccines have waned over time and with new variants.

However, two years later, a more thorough statistical analysis of vaccine effectiveness shows they are still cause for celebration.

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Health

Covid, RSV and flu: A trifecta of respiratory viruses is taxing hospitals across the nation

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Los Angeles
CNN
 — 

Across the country, overflow health care workers are struggling to catch their breath as hospitals fill with sick patients battling a trifecta of respiratory illnesses – Covid-19, RSV and the flu.

“We’ve seen a real increase in cases … particularly since Thanksgiving,” said Dr. Christopher Longhurst, chief medical officer at UC San Diego Health, who added that the hospital is facing a respiratory surge. “Covid is up. The flu is up and other respiratory viruses are up as well.”

The situation is so overwhelming at UC San Diego Health, the hospital had to create space to triage patients by setting up tents in parking lots and using other unconventional spaces. The hallways in the emergency department are also full of temporary beds for patients who were admitted but are awaiting hospital beds.

“We have not had to reconfigure conference room space to care for patients even during the Covid pandemic,” said Longhurst, who explained that UC San Diego Health has experienced an equal number of Covid patients as patients with other respiratory viruses. “These are really unprecedented times.”

Last week, hospitals across the nation were the fullest they have been throughout the pandemic, reaching 80% capacity, which is an 8 percentage-point jump in two weeks. That’s also the highest level since the Omicron surge in January. This week, hospital capacity has improved slightly.

While RSV appears to have peaked in the US, both Covid and flu infections are on the rise.

All but seven states are experiencing high or very high respiratory virus activity, according to the Centers for Disease Control and Prevention. The CDC advises that people in areas with high Covid-19 community levels wear a mask.

Dr. Jeff Smith, executive vice president and chief operating officer for hospital operations at Cedars-Sinai Medical Center in Los Angeles, said the “extreme, rapid rise” of RSV from October into November was likely “the most RSV we’ve seen in the past decade.”

“And now we’ve seen a rapid decline (in RSV),” said Smith. “That has overlapped this Covid rise, which has happened a little bit slower and a little bit later, and then now is superimposed by this very rapid rise in influenza.”

Yet the surge of this virus trio is still not as bad as Covid was during the apex of the pandemic.

“The most powerful factor by far is probably the vaccines, but the other one is the cumulative number of infections we have all had which is now called natural immunity,” said Dr. Edward Jones-Lopez, an infectious disease specialist at Keck Medicine of the University of Southern California.

“Unfortunately, there’s still about a third of the country … where despite all the evidence of safety and efficacy, people are still not getting vaccinated,” he said.

There are vaccines for both Covid and the flu, but not for RSV. All three of the viruses present very similar symptoms – fever, cough and upper respiratory symptoms – so testing is required to determine which illness it is and recommend treatment.

And just because a patient has one virus doesn’t mean they can’t get the other two as well.

“I’ve seen one case of three infections occurring at the same time,” said Jones-Lopez. “These are independent viruses that can infect the same individual and, obviously, the more viruses, the more infections you have … the higher the risk of one of them leading to more serious disease.”

Mask mandates have not yet returned, but virus spikes in New York, Los Angeles and Seattle have led health departments to recommend people mask up indoor and in crowds.

But as friends and family gather this month, health officials are concerned.

“I certainly would recommend that if you are elderly or have an illness that makes you immunocompromised or particularly susceptible to infection, I would encourage wearing a mask now,” said Smith of Cedars-Sinai Medical Center. “It’s the best protection that we have for anyone else who is concerned about transmission.”

Or, as Longhurst put it, “Wear a mask during the holiday season and don’t kiss those sick babies.”

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US

Masks will now be required at these places in Alameda Co. due to rising COVID levels

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OAKLAND, Calif. (KGO) — COVID hospitalizations are increasing throughout the state. The last time California had over 4,000 people in the hospital with COVID was in July.

“I think the challenge is that the numbers are rising and we don’t know where this peak will plateau,” said Dr. Jahan Fahimi, medical director of the Emergency Department at UCSF.

Dr. Jahan Fahimi says their hospital is not stressed yet.

“In many cases, its patients who are hospitalized for something else who also happen to have COVID. It’s not necessarily that COVID itself that is causing them to be hospitalized,” said Dr. Fahimi.

RELATED: Flu, COVID cases surging in CA; CDC suggests masking indoors to minimize spread

As hospitalizations increase, statewide transmission levels are changing. According to the CDC, the majority of the state is in yellow meaning under the medium COVID -19 community levels of transmission.

“We have seen our numbers sort of subtly increasing since mid-October. Yesterday, we moved from CDC’s yellow into CDC medium level,” said Dr. Joanna Locke, COVID clinical guidance lead for Alameda County Health Department.

In Alameda County, as of Thursday, the seven-day average case rate is 21 cases per 100,000 residents and 149 people are in the hospital with COVID-19. Now, they are updating their mask requirements.

County health officials say that per California state law, they must now re-implement mask requirements in high-risk settings besides healthcare. These include:

  • Homeless shelters
  • Emergency shelters
  • Heating and cooling centers (staff and residents)
  • Alameda Co. correctional and detention facilities

“We are aligned with the state masking guidance. We have not instituted any new requirements ourselves here in Alameda County, but according to the state when we move into medium certain locations, we need to require masking for staff and residents,” said Dr. Locke.

What about the state? In a statement, California’s Department of public health states:

“We are empowering Californians to take voluntary actions, including masking in public indoor settings, and getting the flu shot and updated COVID-19 booster, to protect themselves and their families from multiple respiratory viruses circulating in the state. We are not considering a statewide masking mandate at this time. As always, local governments may implement separate and more strict policies.”

Despite the increase in hospitalizations, Dr. Locke is hopeful.

“This is certainly something that we anticipated. We are in a much better place now,” said Dr. Locke.

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Health

RSV, flu and COVID-19: How can you tell the difference? Here’s when to see a doctor, stay home amid tripledemic warnings

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SAN FRANCISCO — Doctors are seeing multiple different viruses circulate the community at increased rates.

The triple threat – or “tripledemic” – of influenza (flu), COVID-19 and respiratory syncytial virus (RSV) have many of the same symptoms in common, and it is hard to tell which one you’ve caught.

We talked to Dr. David Hoffman, pediatric hospitalist at MarinHealth Medical Center, to share his insights on how to tell them apart and when you should and shouldn’t worry.

“While it’s impossible to know for sure which one of these viruses you have without testing, there are some distinctive symptoms for each virus,” Dr. Hoffman said.

Here are some symptoms of each and a guide on what to do if you or a family member is falling sick.

Influenza

Overview

The flu typically comes on very suddenly with an incubation period of one to four days, unlike COVID-19, which tends to have a gradual onset of symptoms. Typically, people feel more miserable with the flu than with other types of viruses, and it often comes with a sore throat, nausea, body aches, vomiting, or even diarrhea. A distinctive sign of the flu can be a very high fever — as high as 103 or 104 Fahrenheit. Fever is just the body’s way of fighting the infection and is not dangerous in and of itself.

Dr. Rochelle Walensky, the CDC director, said, “Hospitalizations for flu continue to be the highest we’ve seen for this time of year in a decade. If you do get sick, present yourself to your provider for early care. There are good antivirals to treat both flu and COVID-19.”

The CDC is again suggesting people voluntarily wear masks indoors to reduce their chances of getting sick in the next few weeks.

It’s not too late to get both vaccines – experts say you start getting protection within a week with a booster.

Distinctive characteristic

The most distinctive sign of the flu can be a very high fever in the 103 to 104 range.

Flu symptoms include:

  • Fever
  • Chills
  • Headache
  • Runny nose
  • Nausea
  • Fatigue
  • Loss of appetite
  • Sore throat

COVID-19

Overview

“The coronavirus has become familiar to most of us, and the signs are similar to flu and RSV. To complicate it further, some people become very ill, while others have very mild symptoms, and others show no symptoms at all. While most people develop symptoms within the first week after exposure, symptoms can occur from two up to 14 days after exposure to the virus.”

Distinctive characteristic

“Unlike other viruses, COVID-19 can affect other areas of the body outside of the lungs and, in some instances, cause long-term effects,” Dr Hoffman says.

COVID-19 symptoms include:

  • Cough
  • Brief fever
  • Shortness of breath
  • Abdominal pain
  • Loss of taste or smell
  • Congestion
  • Fatigue
  • Sore Throat
  • Nausea or vomiting
  • Diarrhea
  • Muscle or body aches
  • Headache

RSV

Overview

RSV is a virus that many adults would have already caught and it generally just causes cold symptoms for adults. “If you think back to that cold that you got that just wouldn’t go away, you kept having congestion and perhaps a cough that lasted longer than usual, there’s a decent chance that that was RSV. And again, symptoms of flu can include fever, chills, headache, runny nose, or congestion, nausea, fatigue, loss of appetite and sore throat,” Dr. Hoffman said.

RSV causes a runny nose, congestion, and cough for most people. According to Dr. Hoffman, RSV has a greater likelihood of causing severe illness in very young children, especially those born premature or who have lung disease or heart disease. The most distinctive symptom that some children infected with RSV will exhibit is wheezing. Wheezing is a high-pitched sound with each exhalation.

“For most people, and even most kids, RSV doesn’t cause a dangerous illness. But it does in a subset of kids. Even kids with significant illness that require hospitalization are usually going to do just fine. Maybe they’ll need a little bit of oxygen, maybe they just need to be watched closely. RSV is most likely to cause significant or, you know, more concerning illness in very young children and very old adults,” Dr. Hoffman said.

Distinctive symptom

The most distinctive symptom that some children infected with RSV will exhibit is wheezing, a high-pitched sound, with each exhalation.

RSV symptoms include:

  • Runny nose
  • Decreased appetite
  • Coughing
  • Sneezing
  • Fever
  • Wheezing

When to see a doctor

Dr Hoffman says to seek medical care right away if these symptoms appear:

  • Trouble breathing
  • Pain or pressure in the chest
  • New confusion
  • Inability to wake up or stay awake
  • Bluish lips or face
  • Severe abdominal pain
  • Refusing to eat and drink

When should I keep my child home?

If your child is exhibiting any symptoms of RSV, flu, or COVID-19, health experts advise you to keep your child home from school to avoid spreading the virus to other people. It doesn’t matter which of the viruses is the culprit. Caution should be taken to prevent the spread.

Prevention: How to keep your child from getting sick

Prevention is the best medicine, particularly with these viruses. These suggestions are good ideas to avoid seasonal viruses:

  • Get your child vaccinated for flu, COVID-19, pneumococcus, and pertussis.
  • Wash your hands regularly or use hand sanitizer.
  • Sanitize high-contact surfaces, such as desks, tables, and doorknobs, if someone in your household is sick.
  • If your child is sick, have them stay home to avoid spreading the illness.

“Everyone’s talking about RSV but we do see other viruses in the community as well, like metapneumovirus, which can cause bronchitis or significant respiratory infection, or viral pneumonia. There are thousands of viruses that we don’t have tests for so we don’t know exactly which virus it is, but we’re definitely seeing more of many different respiratory infections,” Dr Hoffman said.

He says the most important message he wants to impart to parents is you can do a lot more harm to yourself by being overly concerned.

“By being anxious and increasing stress, you therefore are making yourself more susceptible to all types of illness, chronic disease, and infection,’ Dr. Hoffman says.

“That said, I do think that everyone should do whatever they can do to protect themselves from all of the respiratory illnesses and other vaccine preventable illnesses out there. He encouraged all pregnant mothers to get their pertussis vaccines during their pregnancy to ‘cocoon’ their unborn child, and preventing by preventing themselves from getting pertussis,” he says.

Similarly, he urged kids to get the pneumococcal vaccine (whooping cough).

“Get the COVID-19 and flu vaccine for kids and adults. The flu vaccine will make you perhaps feel like you have a very mild cold but that’s a lot better than getting seriously ill, or even dying from influenza. So a lot of people choose not to get the flu vaccine because they don’t like that. But really the benefits are much greater than the very small risks of getting the flu vaccine or the inconvenience of getting the flu vaccine,” Dr. Hoffman said.

“I don’t think that it’s a great idea to rush to your pediatrician’s office or your primary care provider’s office just to get tested, to try and figure out which one of these you have, aside from perhaps doing COVID-19 testing because most people who get RSV and flu and COVID-19 are going to do just fine. And so it’s really only about dictating whether or not you need to isolate strictly and for how long,” he said.

The fact is that these respiratory viruses tend to crop up with similar symptoms, such as cough, runny nose, and fever. Fortunately for most children, it doesn’t matter which of these, or the thousands of other viruses causing respiratory illnesses or colds, your child has. Most children will recover from all of these viruses on their own, without receiving medical treatment and without serious complications. If your child is sick, consider testing for COVID-19 first to inform if and how long you need to isolate your child at home.

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Health

String of Child Deaths from Strep A Alarm Health Officials

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Photo: Shutterstock (Shutterstock)

A common bacterial infection known as Strep A has likely killed over a dozen children in the UK in recent months. On Friday, health officials reported yet another fatality linked to the bacteria, which can, in rare cases, cause a more invasive and life-threatening infection. There are likely several reasons why the outbreak appears to be more severe than usual, though government experts have ruled out the possibility of a more virulent strain behind it.

At least 13 children in England have died within a week of developing a severe Strep A infection since September, according to an update released Thursday from the UK Health Security Agency (UKHSA), while two suspected deaths have been reported in Ireland and Wales. Officials with the UKHSA and the Brighton & Hove City Council jointly announced the latest suspected death Friday, though it’s not yet clear whether this death is in addition to the official tally, according to the BBC. At least 60 deaths overall have been reported in England.

Strep A, also known as group A streptococcus, are bacteria that can cause a variety of infectious diseases along different parts of the body, including strep throat, scarlet fever, and impetigo. Typically, these infections only cause mild illness or can be managed effectively with antibiotics. But every once in a while, they can cause much more serious trouble. The particular form of Strep A tied to these deaths is called invasive group A streptococcus (iGAS) disease, which happens when the bacteria (or their toxins) reach more vulnerable parts of the body like the bloodstream. Once there, the infection can rapidly trigger life-threatening symptoms like septic shock, organ failure, or necrotizing fasciitis (the “flesh-eating” disease)

Strep A outbreaks do occur regularly, but the typical season for it in the UK starts in the beginning of the year. This season is on track to be the most widespread and deadliest in recent years. The last severe Strep A season occurred between 2017 to 2018, which ultimately caused 355 deaths in total, including 27 deaths in children.

A 2019 study found evidence that the recent emergence of new Strep A strains contributed to large spikes of scarlet fever reported in the UK over the latter half of the 2010s. But according to the UKHSA, there’s no data suggesting that a new variant is responsible for the intensity or greater rate of cases seen this year.

Instead, they argue the rise is likely the result of “increased susceptibility to these infections in children due to low numbers of cases during the pandemic, along with current circulation of respiratory viruses.” This year has seen the return of respiratory infections like the flu and RSV in the UK and elsewhere, often in waves outside of their usual season. And it’s known that people can be more vulnerable to developing iGAS if they catch Strep A while sick with another infection like the flu.

Like the UK, the US has been seeing high levels of flu and RSV activity this fall and winter, while cases of covid-19 are currently lower than they have been during the past two winters but are increasing lately. And the Centers for Disease Control and Prevention is looking into whether there’s been an increase in iGAS cases among children in the U.S. this year as well.

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Health

Flu surged in the United States after Thanksgiving, data shows

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CNN
 — 

Flu surged in the United States after Thanksgiving, bringing the most severe week yet in a season that hit the county extra early. More than a third of all flu hospitalizations and deaths so far this season were reported in just the past week, and cases also jumped nearly as much.

New data from the US Centers for Disease Control and Prevention estimates that there have been at least 13 million illnesses, 120,000 hospitalizations, and 7,300 deaths from flu so far this season.

The latest update captures data through December 3 and is the first full week of data post-Thanksgiving. It shows that respiratory virus activity remains elevated across the country amid a flu season that hit the country early and hard – and health officials have warned that gathering indoors during the holidays may lead to rising cases.

All but seven states are experiencing “high” or “very high” respiratory virus activity, according to the CDC. States with moderate, low, or minimal activity are Alaska, Hawaii, Michigan, New Hampshire, South Dakota, Vermont and West Virginia.

There have been about 26 flu hospitalizations for every 100,000 people – a rate that hasn’t been this high at this point in the season in more than a decade.

Nearly 26,000 people were admitted to the hospital for flu last week, filling about 6,000 more beds than the week before. About 1 in 4 lab tests were positive for flu last week and nearly 1 in 10 deaths were due to pneumonia, influenza or Covid-19 – well above the epidemic threshold of about 6%.

Data from Walgreens that tracks prescriptions for Tamiflu and other flu treatments suggests that flu hotspots spread from El Paso to southwest Virginia.

Last year’s flu season was relatively mild, but the number of flu illnesses, hospitalizations and deaths that have been reported so far in the current season have already surpassed the total number recorded throughout the entirety of last season.

Hospitals are more full now than they’ve been throughout the Covid-19 pandemic, according to a CNN analysis of data from the US Department of Health and Human Services.

About 80% of hospital beds are in use nationwide, jumping 8 percentage points in the past two weeks.

Hospitals have been required to report capacity information since mid-2020 as part of a federal effort to track the effects of the Covid-19 pandemic.

Hospitals have been more than 70% full for the vast majority of that time. But they’ve been 80% full at only one other point: in January, during the height of the Omicron surge in the US. Back in January, about a quarter of hospital beds were in use for Covid-19 patients. But now, only about 6% of beds are in use for Covid-19 patients, according to the HHS data.

In a statement on Friday, Nancy Foster, vice president for quality and patient safety with the American Hospital Association, says that an influx of flu patients is a key reason why hospitals are filling up, but they’re also facing RSV and illnesses in people who put off care during the pandemic.

“Workforce shortages have not only made it more challenging for hospitals, but also have diminished the number of patients who can be cared for in nursing homes and other post acute care settings,” the statement said. “Thus, patients are spending more time in hospitals, awaiting discharge to the next level of care and limiting our ability to make a bed available to a patient who truly needs to be hospitalized.”

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Health

Flu surged in the United States after Thanksgiving, data shows

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CNN
 — 

Flu surged in the United States after Thanksgiving, bringing the most severe week yet in a season that hit the county extra early. More than a third of all flu hospitalizations and deaths so far this season were reported in just the past week, and cases also jumped nearly as much.

New data from the US Centers for Disease Control and Prevention estimates that there have been at least 13 million illnesses, 120,000 hospitalizations, and 7,300 deaths from flu so far this season.

The latest update captures data through December 3 and is the first full week of data post-Thanksgiving. It shows that respiratory virus activity remains elevated across the country amid a flu season that hit the country early and hard – and health officials have warned that gathering indoors during the holidays may lead to rising cases.

All but seven states are experiencing “high” or “very high” respiratory virus activity, according to the CDC. States with moderate, low, or minimal activity are Alaska, Hawaii, Michigan, New Hampshire, South Dakota, Vermont and West Virginia.

There have been about 26 flu hospitalizations for every 100,000 people – a rate that hasn’t been this high at this point in the season in more than a decade.

Nearly 26,000 people were admitted to the hospital for flu last week, filling about 6,000 more beds than the week before. About 1 in 4 lab tests were positive for flu last week and nearly 1 in 10 deaths were due to pneumonia, influenza or Covid-19 – well above the epidemic threshold of about 6%.

Data from Walgreens that tracks prescriptions for Tamiflu and other flu treatments suggests that flu hotspots spread from El Paso to southwest Virginia.

Last year’s flu season was relatively mild, but the number of flu illnesses, hospitalizations and deaths that have been reported so far in the current season have already surpassed the total number recorded throughout the entirety of last season.

Hospitals are more full now than they’ve been throughout the Covid-19 pandemic, according to a CNN analysis of data from the US Department of Health and Human Services.

About 80% of hospital beds are in use nationwide, jumping 8 percentage points in the past two weeks.

Hospitals have been required to report capacity information since mid-2020 as part of a federal effort to track the effects of the Covid-19 pandemic.

Hospitals have been more than 70% full for the vast majority of that time. But they’ve been 80% full at only one other point: in January, during the height of the Omicron surge in the US. Back in January, about a quarter of hospital beds were in use for Covid-19 patients. But now, only about 6% of beds are in use for Covid-19 patients, according to the HHS data.

In a statement on Friday, Nancy Foster, vice president for quality and patient safety with the American Hospital Association, says that an influx of flu patients is a key reason why hospitals are filling up, but they’re also facing RSV and illnesses in people who put off care during the pandemic.

“Workforce shortages have not only made it more challenging for hospitals, but also have diminished the number of patients who can be cared for in nursing homes and other post acute care settings,” the statement said. “Thus, patients are spending more time in hospitals, awaiting discharge to the next level of care and limiting our ability to make a bed available to a patient who truly needs to be hospitalized.”

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