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A New York City children’s hospital recently experienced a spike in respiratory syncytial virus (RSV) cases and is urging others to prepare for the same.
“Although our early findings cannot predict the height of the RSV surge or how long it may last, it does suggest that institutions should plan ahead for an increase in pediatric emergency visits and potentially a need for increased pediatric ICU capacity in the coming weeks,” pediatric infectious disease doctors from Maimonides Children’s Hospital wrote in a new report.
RSV cases typically are at their highest in the fall, a pattern that held true for the Brooklyn hospital from 2016-’19. But the hospital did not have any cases from September 2020 through January 2021. Its first confirmed RSV case was in February this year, and cases climbed to 295 by early May, according “Delayed Seasonal RSV Surge Observed During the COVID-19 Pandemic,” (Agha R, Avner JR. Pediatrics. June 9, 2021, https://doi.org/10.1542/peds.2021-052089).
RSV patients this year were younger and had more severe illness than in the 2019-’20 season. The median age of the hospital’s RSV patients this year was 6 months, while last season’s median was 17 months. About two-thirds of the patients this year were admitted to the hospital and 81% of those admitted were in a pediatric intensive care unit (ICU), up from 45% of admitted patients treated in the ICU last season. Six children this year required support from a ventilator.
Data also show RSV patients have stayed in the hospital for about four days this year compared to a median of three days in the 2019-’20 season.
“Our data indicates more severe disease in younger infants possibly due to diminished immunity from lack of exposure to RSV in the previous season,” authors wrote. “Continuing closures of day care centers and virtual schooling may have resulted in less spread of the disease to older children.”
Meanwhile, flu activity at the hospital has been minimal. COVID-19 cases increased in March but have since gone down.
As more children return to classrooms and more people eschew face masks and physical distancing, other hospitals may see similar RSV surges, authors wrote. They urged hospitals to prepare and recommended clinicians extend monthly preventive palivizumab for infants at risk of severe RSV disease.
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