Is your kid sick? South Florida seeing more respiratory illness — here’s what to know

Doctors at children’s hospitals across South Florida have noticed an increase of kids sick with respiratory illnesses this year.

“This is something that’s not just in South Florida, this is across the nation … Chicago, Texas, California, up and down the Eastern Seaboard have been stressed to the limit for the most part — not enough rooms, not enough providers with the volume of respiratory infections that we’re seeing since the pandemic ended,” said Dr. David Hooke, an attending physician who works in the emergency room at Joe DiMaggio Children’s Hospital in Hollywood.

At Salah Foundation Children’s Hospital at Broward Health in Fort Lauderdale, the pediatric intensive care unit filled up with sick patients earlier in October, pushing staff to open overflow areas. Broward Health estimates over 70% of its pediatric patients at the time were diagnosed with some kind of respiratory issue.

Why are kids getting sick?

Some doctors interviewed by the Miami Herald say it’s possible the COVID-19 precautions families took over the past two years, like wearing masks and staying home more, likely reduced young children’s exposure to common viruses. Now, kids are back at school and daycare and almost everyone is back to their pre-pandemic ways.

“There are a lot of kids who haven’t had the normal viral infections that a 1- or 2-year-old gets every two to three months, and now they’re exposed to a myriad of viruses,” said Dr. Hector Chavez, the emergency department director at Holtz Children’s Hospital at Jackson Memorial Hospital in Miami.

“And they’re just responding in a normal way, but much, much more frequent because they haven’t built the immunity that normally will take years to build.”

When kids get sick, the immune system creates antibodies to help them recover and to help fight off the same germ again in the future.

While several viruses can make kids sick, doctors at Broward Health’s children’s hospital say Respiratory Syncytial Virus, or RSV, contributed to a weekend wave of sick patients this month.

Surveillance data from Florida’s health department shows that the state saw an increase of emergency department visits for RSV among children under 5 from Sept. 11-24, with RSV activity “notably above levels observed at this time in typical years.”

READ MORE: More kids are getting sick, and a Broward hospital just opened overflow ICU beds

What is RSV? Who is more at risk?

Doctors in at least 33 states have noticed an increase of kids ill with RSV, according to CBS News. It’s a common childhood virus — almost all kids will have an RSV infection before age 2 — that causes cold-like symptoms such as coughing and fever.

While most RSV infections are mild, some babies, young children and older adults can get severely ill, particularly those born premature or who have weaker immune systems or a medical condition such as asthma and chronic lung disease. RSV is the most common cause of bronchiolitis and pneumonia in children younger than 1. There is no RSV vaccine.

About 58,000 children younger than 5 are hospitalized every year due to the infection, according to the US. Centers for Disease Control and Prevention. Most recover, but about 100 to 300 kids younger than 5 die each year from RSV.

In most children, RSV “looks like a cold, maybe a bad cold, and they probably don’t even go to see the pediatrician. Then those who get medical attention, either in the pediatrician’s office or in the emergency department, most of them are sent home. ... A small percentage do get admitted,” said Dr. Mobeen Rathore, professor and associate chair of pediatrics at the University of Florida’s College of Medicine. Rathore is a member and former president of the American Academy of Pediatrics Florida Chapter.

How RSV spreads and how to treat it

The way RSV spreads is similar to other viruses — by an infected person coughing or sneezing, touching a contaminated surface like a doorknob and then touching your face, or by direct contact such as kissing a child with RSV. Ways to reduce the spread of RSV may also sound familiar: frequent hand-washing, avoiding close contact with sick people, cleaning frequently touched surfaces.

And Florida is in RSV season, which usually lasts longer than the rest of the country and varies by region, though in South Florida, the virus tends to circulate year-round.

“In South Florida, you’re going to have waves. We just don’t know exactly when it’s going to happen, until it does,” said Dr. Rodney Baker, the executive medical director of hospital operations at Nicklaus Children’s Hospital near South Miami. “But you know, we’re always prepared.”

Nicklaus, for example, saw a peak of RSV in June, when 11% of the hospital’s admitted patients were due to RSV. The number of admitted RSV patients then began to decrease until October. It’s started to tick up again — about 7% of pediatric admissions earlier this month were associated with RSV.

Chavez, the director of Holtz Children’s emergency department, similarly noted that there was a “really strong summer peak” nationwide of RSV and flu, which isn’t normally seen until winter. At Joe DiMaggio, Hooke said there was an “unprecedented volume” of kids ill with respiratory illnesses in May and June.

Rathore, who serves as the chief of pediatric infectious diseases and immunology at Wolfson Children’s Hospital in Jacksonville, has also noticed an “unusually high number of kids” infected with RSV admitted to the hospital for this time of year. He also noted that some RSV seasons are worse than others. During the pandemic in 2020, for example, there was very little RSV in the state, he said.

And because RSV symptoms are similar to those of other viruses, parents won’t know their child is infected with RSV unless they get tested. There aren’t RSV-specific treatments yet, so parents should treat it like a cold, ensuring children stay hydrated and give them acetaminophen or ibuprofen, as needed, to help with fever or other symptoms.

Parents should speak with their child’s pediatrician if they have any questions or concerns and should seek medical attention if they notice that their child’s symptoms begin to worsen or if they have difficulty breathing.

What could winter bring?

RSV is not the only infection doctors are on the lookout for.

“It’s not just infections like RSV that we deal with on a regular basis. It’s also the other players,” Hooke said. “We have rhinovirus, enterovirus and adenovirus. These are routine childhood illnesses, but they’ve had an increased impact in the last six, eight months.”

There’s also the flu.

“It’s quite possible that this year the influenza season is going to be much worse because a lot of people — children and others — were not exposed to influenza last year,” Rathore said. There’s also a possibility that the country will see another COVID winter surge.

Hooke, the ER doctor, is also asking families to have patience if they walk into a crowded emergency room.

“If you think your child is sick, please wait to see a doctor,” he said. “Don’t leave without being seen.”