TOPEKA — In late August, Kansas City resident Victoria Biggs’ 4-month-old daughter, Kinsley, came down with what she thought were allergies.
When the runny nose and congestion hung around longer than expected, Biggs took her to the doctor. Kinsley was almost immediately diagnosed with respiratory syncytial virus, or RSV.
Kinsely’s case was mild, Biggs said, and she was able to treat it with at-home remedies. Kinsley was on the mend after a couple of weeks. A new mom, Biggs said she knew about RSV, but didn’t know it was surging in Kansas.
The highly contagious RSV is usually a winter virus, which means Kansas doctors typically see fewer cases over the summer. This year, however, data from the Centers for Disease Control and Prevention shows state cases of RSV in Kansas took off in August.
Stephanie Kuhlmann, a pediatric hospitalist at Wesley Children’s Hospital in Wichita, said the unexpected influx of RSV cases has taxed the hospital system.
“We’re dealing with such severe staffing shortages, nurse staffing issues and respiratory therapy staffing shortages due to the pandemic,” Kuhlmann said. “Having a bunch of kids now with RSV is just kind of straining some of our hospital resources.”
Usually, RSV is easy to predict, she said. Because the summer surge was unexpected, doctors couldn’t plan for the waves of cases.
Mike Lewis, a pediatrician at the University of Kansas Health System who oversees the pediatric intensive care unit, noted the usual predictability of the virus and said during a typical RSV season, there’s a three- to four-week spike in cases before a decline.
“In the summer, you might see an occasional RSV kid, but nowhere even remotely close to this,” Lewis said. “On top of that, this last winter, RSV and flu were fairly nonexistent. There were occasional cases. And that’s not just here locally, this is across the country as well.”
The low flu activity was likely due to COVID-19 mitigation efforts. Those were also probably responsible for the quiet RSV season, Kuhlmann said. When mitigation efforts relaxed, RSV cases rose.
“I know pediatricians’ clinics have really struggled to keep up, because on top of all of the RSV the summer’s a very busy time for pediatricians in the outpatient setting,” Lewis said. “We have a lot of kids who are having their kind of once-a-year visit to go back to school.”
RSV typically presents as a cold, with symptoms including a runny nose and fever. However, the virus can cause respiratory complications in younger and older patients. On average, RSV is responsible for about 58,000 hospitalizations in children under 5 in the United States.
Kuhlmann said there have been a few COVID-19 pediatric cases at the hospital over the last few weeks, though the big effects come from the strain on resources.
“The hospital I work in serves both adult patients and pediatric patients, and so when you have a high percentage of … those resources being taken up by adult COVID patients, that certainly uses up the resources that we need also for a busy pediatric unit,” she said.
In late August, Kansas hospitals were nearing capacity or had already reached it because of a COVID-19 spike.
Wesley has spent time in the past few weeks on transfer closure, which means it couldn’t take patients from referring areas. Kuhlmann also indicated they have spent some time on diversion, meaning they couldn’t take patients locally and could only treat emergency room cases.
“A lot of that is (because) some days we’re at capacity running all our beds due to RSV and other related illnesses,” she said. “Sometimes it’s (because) we’re at capacity from just nursing shortages.”
Lewis said many people wonder if there will be another spike in RSV later this year, and if so, how hospital systems would cope.
“There’ve been many sleepless nights amongst pediatric hospital-based doctors trying to find one place to take a kid,” he said. “We’ve had to take kids from Wichita, which has a very robust pediatric hospital-based system.”
In August, the University of Kansas Health System saw 48 positive RSV tests and 14 RSV admissions. In the past two weeks, Lewis said, providers have seen a slight downward trend in cases.
Kuhlmann said while she saw cases drop two or three weeks ago, they rose again in the past week.
There is no vaccine for RSV, though that could change. The Alliance for Multispecialty Research is running clinical research studies on a potential RSV vaccine across the United States, with one location testing in Kansas City.
The virus is very contagious and spread through respiratory droplets, Kuhlmann said, so frequently disinfecting surfaces helps diminish the risk of contracting the virus.
“Certainly keeping kids home and adults staying home when they’re sick and not feeling well will help prevent” RSV, she said. “It’s the same as any of the other COVID mitigation factors with masking, distancing (and) hand washing.”
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