Hospitals in New Jersey are filled with children coughing and struggling to breathe.
But it’s not COVID-19. Or even the flu.
An outbreak of viral respiratory infections is sending children to emergency rooms across the state. The main culprits are enteroviruses and rhinoviruses, as well as some cases of RSV (respiratory syncytial virus), all of which usually produce cold-like symptoms.
But in severe cases, they can cause breathing problems.
“Some of the ICUs are at capacity,” said Dr. Uzma Hasan, director of the division of pediatric infectious diseases at Cooperman Barnabas Medical Center in Livingston, part of RWJBarnabas Health.
Another school year has just started, helping the spread of viruses, and already the wave of cases of respiratory illnesses is filling pediatric hospital beds. The rise in infections has also been helped by the relaxation of masking and other measures against COVID-19, experts say.
Doctors at RWJBarnabas Health are seeing a sharp increase in pediatric enterovirus and rhinovirus cases. These viruses usually cause only mild symptoms. But sometimes they can be serious, especially for those with asthma and certain underlying conditions.
“We’re starting to see our EDs and our floors and our pediatric ICUs (with) a large number of these kids over the last few weeks,” Hasan said Wednesday.
He said it seems to be a national trend. In fact, the Centers for Disease Control and Prevention issued an alert earlier this month warning of enterovirus D68, a rare but serious respiratory infection in children that can cause shortness of breath and become in acute flaccid myelitis, a neurological condition that can cause muscles. weakness and even paralysis.
The state Department of Health also issued an advisory last week to pediatricians and hospitals warning of higher enterovirus and rhinovirus activity in recent weeks. He asked doctors to be on the lookout for AFM, which is often preceded by enterovirus D68 disease.
“The good news is that the vast majority will have mild disease,” Hasan said. “Those who are hospitalized seem to get better pretty quickly.”
Cooper University Hospital in Camden also reported an increase in pediatric respiratory cases, a spokeswoman said.
According to Hasan, enterovirus seems to increase every two years.
“And this year, we’re seeing a significant increase,” he said.
Hasan noted that 2020 was an outlier with particularly low numbers of respiratory infections due to pandemic prevention measures in place, measures that have now largely disappeared.
“The state is monitoring and observing pediatric intensive care unit hospitalizations and census daily across the state,” a spokeswoman for the New Jersey Department of Health said in a statement Wednesday. “The Department is also planning a call with hospitals to assess pediatric capacity.”
Despite the wave of cases, much was learned from the pandemic, according to Hasan.
“We are planning to deal with these increases, coming up with a kind of flow plans to accommodate the largest number of children,” he said.
Although several respiratory viruses are circulating, enterovirus appears to be the main driver of new cases.
“Enterovirus is the predominant virus right now,” Hasan said. “We’re starting to see a small increase in RSV. Influenza – we haven’t seen overwhelming numbers.”
But that could change in the coming weeks and months. He noted that Australia’s flu season, a possible precursor to the US season, showed an unusually high number of cases.
“So we anticipate that the flu numbers will be high this year,” he said.
Hospitals want to get the message out to parents and encourage hygiene measures and proper vaccinations, as Hasan stressed that some children are at higher risk.
“There are some high-risk populations that we know are going to be at risk for serious disease,” he said, “and those are children who have asthma, children who have underlying chronic lung disease. Children with neurological disabilities tend to have serious disease. Children who have congenital heart disease can have serious disease, so they’re already on our radar.”
At Cooperman, she said some children come into the emergency room with difficulty breathing.
“Kids who come into the emergency room, yes, they have signs of respiratory distress, and that’s why they end up being treated with respiratory treatments,” Hasan said. “Sometimes they’re put on steroids if they’re asthmatic, and they’ll usually end up requiring hospitalization and sometimes ICU admission if they’re in severe distress.”
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Spencer Kent can be reached at [email protected].