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N.H. hospitals are seeing more children with RSV infections

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Dan Tuohy
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NHPR
“There just aren't a lot of pediatric intensive care beds, nationally or in New England,” said Dr. Matt Dayno, section chief and medical director of emergency medicine at Elliot Hospital in Manchester. “And so that can be problematic in terms of finding a bed to transfer patients.”

New Hampshire hospitals are seeing an early increase in cases of respiratory syncytial virus, or RSV, this year. The cold-like infection is mild for most people but sometimes causes more severe respiratory illness in infants and very young children.

Health care workers said RSV typically starts to spread more widely around late fall or winter. But this year, hospitals around the state are already seeing more kids visiting emergency departments with the virus.

“It was more like after the holidays, we would see a surge of RSV,” said Lindsey Sliwerski, a registered nurse and the director of maternal child health at Southern New Hampshire Medical Center in Nashua. “And we're seeing the surge now.”

An early surge of RSV in Massachusetts has strained hospital capacity there, according to news reports. Jake Leon, a spokesperson for the New Hampshire Department of Health and Human Services, said Granite State hospitals don’t seem to be experiencing a rise to the same degree, but state health officials are trying to make sure they’re prepared.

“State and hospital partners are preparing for a potential increase in RSV cases, including frequent communications, monitoring inventories for pediatric equipment and ensuring workflows,” he said in an email.

Dr. Matt Dayno, section chief and medical director of emergency medicine at Elliot Hospital in Manchester, said New Hampshire hasn’t been hit as hard as Massachusetts. But with limited capacity to treat the sickest kids locally, New Hampshire could feel the ripple effects of pediatric beds in neighboring states filling up.

“There just aren't a lot of pediatric intensive care beds, nationally or in New England,” he said. “And so that can be problematic in terms of finding a bed to transfer patients.”

RSV is a common seasonal virus that infects most kids by the time they’re 2, according to the Centers for Disease Control and Prevention. But many kids weren’t exposed to various common pathogens in the past two years because of COVID-related mitigation measures like masking and social distancing.

“There are kids who weren't seeing a lot of illness because they either weren't in school or daycare and things like that,” said Dr. Gerri Rubin, a pediatrician at Cheshire Medical Center in Keene. “And they're just getting hit with all these viruses that, typically, they probably would have had some level of immunity to.”

While most children visiting the hospital for RSV are infants or toddlers, Rubin said they are seeing some school-aged kids get pretty sick, “which is unusual.”

RSV can spread through respiratory droplets from coughs and sneezes, direct contact or touching a surface with the virus on it. Most children will experience mild symptoms, like cough, runny nose and fever, that go away in a week or two.

But it can be more serious for some infants, including leading to pneumonia or bronchiolitis, an inflammation of airways in the lungs. Children with weakened immune systems and older adults are also at higher risk.

Sliwerski recommended that people with very young or vulnerable children at home take basic precautions including hand-washing, sanitizing surfaces, covering coughs and sneezes, and keeping babies and infants away from adults and older children who are sick.

If an infant is having difficulty breathing, she said parents should seek medical attention.

“We look for things like if their nostrils are flaring. If, when you lift their shirt, you can see them sucking in between their rib cages. If they're not eating, because they're struggling to breathe,” she said. “Those are all things that, you know, would require a call to the provider or maybe even a visit to the emergency room.”

Rubin noted that increasing RSV cases are coming at the same time other respiratory viruses like enterovirus and rhinoviruses — which cause common colds — are circulating. Flu and COVID cases are also expected to rise this fall and winter.

While there’s not a vaccine for RSV yet — scientists are working on it — Rubin said it’s important to get kids vaccinated against other viruses, like flu and COVID-19, to ease the overall strain on the health care system.

“We want to try to keep the hospitals open for the kids who really need to be there,” she said.