Rising RSV cases in children bring North Texas hospitals near capacity

A growing number of cases of RSV and other respiratory illnesses have occupied nearly all pediatric beds in area hospitals, the Dallas-Fort Worth Hospital Board reported Friday.

More than 97% of pediatric beds in the North Texas region are occupied, the hospital group said, and medical centers treat hundreds of patients each day with breathing difficulties, fevers and other symptoms.

Cook Children’s in Fort Worth is at capacity as hundreds of children with RSV and other respiratory illnesses flood emergency rooms and urgent cares. On Monday, five patients in the intensive care unit had to be held in the emergency room while waiting for beds to open.

More than 200 children tested positive for respiratory syncytial virus last week at the Fort Worth Hospital System Medical Center. The emergency department treats approximately 500 patients per day, leading to overcrowded waiting rooms and long wait times.

Neighboring Dallas Children’s Health Center reported 382 cases of RSV systemwide in the week beginning Oct. 29, marking the highest number of cases the hospital system has seen this year. This represents an increase of 31% from the previous week, which saw 291 cases, and an increase of more than 134% from the 163 cases seen in the week beginning October 8.

“Winter is here, even though it’s still fall, with the rise of respiratory viruses in full swing,” said Dr. Amy Richardson, associate medical director of Cook Children’s Urgent Care Centers . “We anticipate this problem will get worse as we progress through the winter months rather than getting better.”

For most children and adults, an RSV infection is like a cold, which, although uncomfortable, is often not life-threatening. But for some groups, including infants and the elderly, the virus can cause complications such as inflammation or blockage of the small airways in the lungs with mucus.

RSV and flu cases reached an unusual peak early last year, as children experienced their first respiratory virus season without COVID-era protections, like masking and social distancing. Flu cases are increasing at a slower rate this season, but RSV causes more serious complications, said Dr. Taylor Louden, medical director of Cook Children’s emergency department.

“This year, the RSV seems to hit harder; our patients are sicker,” Louden said. “We are blocking our intensive care beds much earlier than last year during this time.”

Medical providers urge patients to see their pediatrician first if their child has mild symptoms. Patients with mild illness who go to the emergency department can experience wait times of up to 10 hours, Louden said.

Signs that a child’s illness has worsened to the point of needing emergency medical attention include difficulty breathing, which may make a child feel like he or she is breathing faster than usual or that the skin is tight. his ribs are sucked in with each breath; a fever that lasts for more than five days; and dehydration, which may manifest as decreased urine output, dry diapers, or, in babies, a sinking soft spot on the top of the head.

It’s difficult to tell the difference between respiratory illnesses, especially in children, said Dr. Laura Romano, a hospitalist at Cook Children’s. While it is important to know if a child has COVID so they can isolate properly, treatment for RSV, flu or colds is largely the same.

“It’s just supportive care at home, Tylenol and Motrin if needed for a fever and nasal saline for congestion,” Romano said.

Federal regulators recently approved new protections against RSV, including vaccines for adults over 60 and pregnant women and a monoclonal antibody shot for infants. The Centers for Disease Control and Prevention recently issued a health warning that pediatricians should prioritize doses of the antibody treatment nirsevimab for babies most at risk of RSV complications due to a shortage in the national scale.

It is unclear when this wave of RSV cases will subside. Medical professionals only know after the fact that a virus has reached its peak.

“The one thing the pandemic has taught me is not to make predictions about this,” said Dr. Jeffrey Kahn, director of infectious diseases at Children’s Health and a professor at UT Southwestern.

Although COVID-19 and flu cases remain relatively low, the viruses could accelerate in the coming weeks and months. Anyone 6 months or older is eligible for the flu vaccine, while anyone 6 months or older who hasn’t received a COVID vaccine in the last two months can receive an updated Pfizer or Moderna booster .