Florida children hit by virus tsunami

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Florida children are affected by a host of viruses that have nearly disappeared during the pandemic, and some illnesses that would normally be mild are sending children to the hospital.

“All of these viruses are back and they’re all blooming at the same time,” said Dr. Jessica Prince, medical director of the pediatric emergency department at Palm Beach Children’s Hospital. “We see children getting sick as a result, they catch one virus and then they start again with another.”

In other parts of the country, respiratory syncytial virus (RSV) is causing overcrowding at children’s hospitals, but in Florida doctors say a variety of respiratory illnesses are sending them to the ER, with the flu surging. . COVID-19 infections have not yet started to rise among children in Florida, but experts expect an increase soon.

“I think we’re potentially seeing the same percentage of children being admitted to hospital – around 10-15% – but a higher number because there are just more children getting sick right now.” said Prince.

Due to COVID precautions during the pandemic, children had little opportunity to develop immunity. As children return to school and take off their masks, respiratory infections such as adenovirus, parainfluenza and rhinovirus are back in full force.

It’s unusual for children to catch more than one at a time, but some young patients admitted to Palm Beach Children’s Hospital have two or even three viruses at the same time. “Children’s immune systems aren’t what they used to be,” Prince said.

Prince also sees viruses lasting longer. “Parents come in and their child isn’t much better at 5, 6, 7 days. In the past, we said in about a week you’ll start to see improvement, but we don’t see it all the time now.

This blow is also impacting parents, notes Dr. Katelyn Jetelina, author of the Your Local Epidemiologist newsletter. “The latest data from the Department of Labor revealed absences from work due to child care issues reached a record high last month – higher than in the past two years of the pandemic,” said she wrote in her November 10 newsletter. “If you’re home with a sick child right now, you’re not alone.”

Many childhood respiratory infections share common cold and flu-like symptoms: fever, runny nose, and cough. Pediatricians say parents should make sure their kids are well hydrated and give them over-the-counter medications, like ibuprofen, if they have a fever. But parents should closely monitor the progression of the virus.

At Nicklaus Children’s Hospital in Miami, children arrive with high fevers, dehydration, difficulty breathing and pneumonia, needing oxygen or intravenous fluids. “If they don’t respond to initial treatment or need more help breathing, we admit them,” said Dr. Marcos Mestre, vice president and chief medical officer at Nicklaus Children’s Hospital. “Last month we admitted more patients than during the entire pandemic.”

Mestre said the viruses in circulation aren’t more severe this fall, they’re just here in greater numbers. The only virus that can cause serious complications in young children is RSV, a common and contagious virus that causes cold symptoms in the respiratory tract. In babies, it can cause bronchiolitis or inflammation of the lungs,

Broward Health Medical Center in Fort Lauderdale reported that it was to open overflow units for pediatric intensive care patients with RSV in early October.

“Young infants have never seen respiratory viruses in their lifetime,” notes Mestre. “They didn’t create antibodies.”

You can catch RSV at any age, Mestre said, but in young children, their small airways put them at increased risk of difficulty breathing if they become inflamed.

Mestre said Florida, overall, doesn’t have the large number of children with RSV right now than other states.

“RSV in Florida does not follow the standard of other states,” he said. “We tend to see more all year round.”

Mestre said if his hospital were to see an increase in admissions, he prepared by designating areas that could become patient rooms.

Dr. Mona Amin, a pediatrician with Pediatric Associates in Fort Lauderdale, said only the flu has an antiviral treatment if caught within 48 hours of symptom onset. “For all other respiratory viruses, there is no treatment, just supportive care,” she said.

She says a parent will want to see the pediatrician if a child’s fever doesn’t go away with fever medication.

“Sometimes with the inflammation, bacteria can come and colonize, and a virus develops into bacterial pneumonia or ear infection. That’s when we have to treat ourselves with an antibiotic,” she said.

Amin, who said she herself was recovering from a persistent respiratory infection, said most circulating viruses take longer. “A lot of parents tell me that they or their child has persistent symptoms. They are able to go about their business, but their cough or congestion persists.

Prince of Palm Beach Children’s Hospital said that with babies, it can be more difficult to know when to go to the pediatrician or to the hospital. “If your baby is irritable with a fever, you may want to have a pediatrician do a more detailed investigation to make sure you don’t miss anything.”

“The symptoms of many viruses overlap significantly,” said Dr. Mobeen Rathore, pediatric infectious disease specialist at UF Health Jacksonville.

A pediatrician will likely start with a COVID-19 test and a flu test, which have quick results and can be done in the office.

“COVID accounts for less than 2% of our admissions,” Rathore said. “It’s the lowest of any virus right now, but it may rise.”

There are PCR and antigen tests for RSV, but they require a laboratory to process the results. There is no medication specifically to fight RSV. The only treatment is to help relieve symptoms.

Children and adults can get RSV more than once, even in the same season, but they probably won’t get as sick as children under 3 years old.

With so many viruses circulating, Florida pediatricians are advising parents to wash their hands and toys often.

“Keep your children home if they are sick. It’s really courtesy. Ameen said. “I know it’s inconvenient to have a sick child, but you can’t let your child go back to school if they have a fever. A feverish child should not be surrounded by peers. He should rest at home.

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Rathore advises teaching your child good cough etiquette to prevent droplets from spreading through the family.

“With respiratory illnesses, it’s hard to predict who will end up in hospital,” he said. “Use parental common sense, make sure your child is sleeping, and if he’s not getting better, call your pediatrician. Only a small number will need to see a health care provider, and a tiny number will end up being admitted. »

“Vaccination is really the number one tool we have,” Rathore said.

At his hospital, he has seen an increase in the number of children admitted with complications from the flu in recent weeks, mainly severe pneumonia. “All of them had the flu, then they got sicker.”

Although the flu shot doesn’t always perfectly match the predominant strain in any given year, pediatricians say it could mean the difference between mild illness and severe disease.

“I strongly advise children to get vaccinated,” Rathore said. “I think it’s going to be a bad flu season.”

Sun Sentinel health reporter Cindy Goodman can be reached at [email protected]

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