Respiratory virus, posing a danger to infants, arrives early in Stanislaus County
A seasonal respiratory virus that can be a danger to infants has surfaced early in the Northern San Joaquin Valley.
Respiratory syncytial virus, or RSV, may cause bronchial infections and pneumonia in babies, according to a California Department of Public Health advisory.
It also can cause severe illness in adults older than 65.
State health officials watched RSV emerge in the second half of September, when infectious disease surveillance showed almost 5% of people with respiratory illness tested positive for RSV. Usually, significant levels of RSV don’t appear in California until late November, the state advisory said.
As cases have surged across the country, hospital emergency departments in Stanislaus County are seeing children come in this week with the typical symptoms — fever, cough, wheezing and runny nose.
“It’s unusual seeing it this early,” said Dr. Chitra Dharmar, a pediatrician with Kaiser Permanente in Modesto.
Dr. Millard Johnson, a hospital physician specializing in pediatrics, said Tuesday there’s been a big uptake in RSV admissions at Doctors Medical Center and Memorial Medical Center in Modesto.
The vast majority of patients are infants less than a year old, he said. The hospitals also are caring for older children, such as kids with asthma whose condition was worsened by RSV, he said.
“I’ve done this for 20 years and we had some really bad years,” Johnson said. “The difference is we’re seeing (RSV) early this year. It’s only November and we’re busy. Usually, the peak is in January and February.”
Johnson said an influx of influenza and COVID-19, on top of RSV, could make for an extremely difficult winter.
Doctors cited a theory to explain the RSV surge: As COVID-19 raged the past three years, the social distancing and masks cut down on the normal amount of respiratory infections among children. Since the COVID restrictions were lifted, the respiratory illnesses like RSV and influenza are coming back this fall.
Dharmar said parents are reaching out to pediatricians if their children have any coldlike symptoms.
“Most often, we see children with only mild (RSV) symptoms lasting one or two weeks,” Dharmar said, noting that RSV for most people is similar to a cold.
Sometimes, the viral infection may reach the lower respiratory tract, inflaming the airway passages to the lungs in a condition called “bronchiolitis.” An RSV infection also may cause pneumonia.
Less than 2% of infected infants need to be hospitalized, according to the Centers for Disease Control and Prevention.
“Our numbers are steadily increasing,” said Zara Arboleda, a spokesperson for Valley Children’s Hospital in Madera. The hospital’s 12-county service area includes Stanislaus County.
Two weeks ago, the number of patients testing positive for RSV was 10% at Valley Children’s hospital. It jumped to 19 percent last week, Arboleda said.
“Our emergency room is filling up, but we are urging people to call their primary care provider first unless they have a medical emergency,” Arboleda said.
When to be concerned
The CDC advises parents to seek medical attention if their child has difficulty breathing, signs of dehydration or worsening symptoms.
Dharmar said parents should be especially concerned if their baby has trouble breathing, the child’s nostrils are flaring and belly muscles are flexing to take in breaths. Lips turning purple or blue is also a sign of a medical emergency and parents should seek immediate help.
Young children with severe illness are given supportive care in the hospital, may be placed on oxygen or given nebulizer treatments to help with wheezing.
Dharmar said children under 2 who are brought to the hospital with serious illness may be given a single swab test to see if they have COVID-19, RSV or influenza.
Johnson said the RSV admissions have recently fluctuated between 15 and 25 young patients between Doctors and Memorial hospitals in Modesto. The children are given supportive care in the hospital, as nurses suction mucus from noses, provide supplemental oxygen and intravenous fluids to keep them hydrated.
Many patients are released in two or three days, if their condition turns around, but some are in the hospital much longer, Johnson said.
Johnson said the high-risk groups for RSV are prematurely born children, infants less than six months old and kids with lung or heart disease.
Johnson said local hospitals like Doctors Medical Center were watching the RSV surge on the East Coast and prepared ahead-of-time for a wave of admissions here.
Health professionals try not to sound too much alarm over RSV because most everyone will contract it without serious illness by their second birthday. The state has identified two RSV deaths this fall, including a child and older adult.
Dharmar said the seasonal virus is especially a concern for young children with weak immune systems or underlying health conditions and for premature infants.
To prevent spreading RSV, parents can wash their hands before holding their babies and should cough into their sleeves. They should not share cups and should wear masks if they have a cough or cold.
Other precautions are not smoking around babies, and to not take premature infants to crowded places.
