Health care officials brace as RSV and flu cases rise in Minnesota

Health care officials brace as RSV and flu cases rise in Minnesota

Hospitalizations for RSV cases continue to rise in the Twin Cities, primarily among children under one year of age. the most recent state report reflects what doctors are seeing across the countryand raising concerns about how health care systems will handle this surge in infections in the midst of flu season and a potential surge in COVID.

RSV, or respiratory syncytial virus, often presents as a mild cold, with symptoms often include runny nose, fever, cough and sneezing.

“It’s a virus that almost everyone gets very early in life,” said Jeff Sanders, an epidemiologist with the Minnesota Department of Health. “I think most people get infected when they are 2 years old.”

But it can be serious, especially for young children.

“RSV’s particular gift is getting into the lower respiratory tract, it does that much better than any cold virus, and then it spreads throughout the body,” said Dr. Frank Rhame, an infectious disease physician at Allina Health. “When you are less than 6 months old, the tubules [in their lungs] they are small. So if they get swollen, if they get swollen, it’s hard for those babies to move air.”

The virus can also be dangerous for older adults and people with weakened immune systems, worsening certain conditions, such as asthma, and can cause pneumonia or a lung infection.

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Sanders said the state has been seeing a spike in positive cases for months.

“At work right now, we’re just looking week to week to see if there are any signs that RSV is slowing down, or if it’s going to continue this upward trend,” he said.

Nationwide, the rise in RSV cases is already challenging hospital capacity and growing concerns about a “triple demic” of influenza, COVID and RSV. Children’s Minnesota warns patients that you may experience “long timeouts” in their emergency departments, outpatient clinics, and primary care providers because of RSV.

Part of the challenge, according to the MDH’s Sanders, is that viruses like RSV and influenza deviated from their usual cycles when the pandemic hit, making it harder to predict peaks and troughs. Sanders said they are watching to see if viruses return to their pre-pandemic cycles.

While hospitals regularly plan for surges to help them prepare for the season, it’s hard to predict when any one virus will peak, let alone all three.

“Will RSV stay as high as it is? Or will it go down as fast as it went up? Will influenza peak and be at the same level as RSV? Or are you going to take a slower path to it? And the COVID will arrive in the winter months and will they all arrive at the same time? said Patsy Stinchfield, a pediatric nurse practitioner and president of the National Foundation for Infectious Diseases.

Still, Stinchfield isn’t in favor of the “triple-demic” moniker because there are so many other problems hospitals will likely have to deal with at the same time.

“Like adenovirus, rhinovirus, enterovirus and then of course all the other things that kids go to hospitals for,” he said. “So these are things that we don’t have a crystal ball for and they’re very hard to predict.”

A likely factor in why we’re seeing more RSV infections and why experts say this flu season may be worse than in previous years, is that more people are returning to their pre-pandemic lifestyles. As more people return to work in person and children return to school or daycare, there is more opportunity for infection and re-infection.

“On top of that, people go to work and go to school and go to daycare when they have symptoms,” Stinchfield said. “And I think that’s what makes things persistently spread so fast now.”

A graph showing hospitalizations

The number of children in Minnesota with RSV, respiratory syncytial virus, tripled during the month of October. The graph above shows the number of hospitalizations by age in Minnesota.

Courtesy of the Minnesota Department of Health

While there is currently no vaccine for RSV, there are some on the horizon. The pharmaceutical company Pfizer announced on November 1 that it plans to submit a vaccine against the virus to the US Food and Drug Administration before the end of 2022.

Allina Health participated in Pfizer’s vaccine trials in 2020.

“We can’t get good immunity by vaccinating children younger than 6 months,” said Dr. Rhame, who was the principal investigator of the local study. “The only way we can really get immunity against them is by vaccinating their mothers and getting the antibodies across the placenta.”

Meanwhile, UK-based company GSK recently announced that its vaccine candidate has been priority review granted by the agency

For now, experts say the best thing parents can do for their children is to focus on prevention and best health practices, like washing hands, staying home when sick and wearing a mask. A good first step, Stinchfield said, is to make sure your family is up to date on flu and COVID vaccinations.

If a child becomes ill, Stinchfield said there are signs to watch for that indicate a health care provider should be contacted.

“A parent should take their child to the hospital if they have difficulty breathing; Yes [the child] can’t catch your breath; if they are listless or lethargic; if they’re not drinking enough to the point of not having wet diapers or urinating a lot,” Stinchfield said.

But many cases, he said, can be handled at home. Making sure they are well hydrated and breathing well, and giving them pain relievers for headaches and muscle aches.

“Ask yourself: What would I want right now? That’s probably what his son would want too,” she said.

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