Pioneer Valley hospitals grapple with spike in pediatric respiratory cases

  • Dr. Charlotte Boney, pediatrician-in-chief at Baystate Children’s Hospital, says her hospital is coordinating capacity with hospitals in neighboring states. STAFF FILE PHOTO

  • From left, Laura Clubb, Dean Singer and Deanna Welch at Bridge Primary at One Arch Place in Greenfield. Staff File Photo/Paul Franz

Staff Writer
Published: 10/26/2022 6:14:29 PM
Modified: 10/26/2022 6:14:14 PM

As pediatric emergency departments across the country are inundated with young patients dealing with respiratory illnesses, including RSV, or respiratory syncytial virus, hospitals and primary care offices in the Pioneer Valley are handling an unprecedented spike in similar cases.

At the height of this fall’s significant uptick in respiratory illness among children, between 140 and 170 youngsters were seen daily at Baystate Children’s Hospital in Springfield, easily outpacing the 100 or so children who might need treatment each day in the middle of a traditional winter.

“Our region is seeing a surge in respiratory viruses that more typically peak in the winter,” commented Dr. Charlotte Boney, pediatrician-in-chief at Baystate Children’s Hospital. “This surge in respiratory viruses is unheard of for this time of year.”

Among these illnesses are RSV, enterovirus and rhinovirus. While most cases are mild to moderate, sometimes more severe symptoms have to be addressed, Boney said.

“Children who may not have had recent exposures to these viruses are now getting sick from them, and many are getting sicker than usual,” Boney said.

Almost all of the most seriously ill are under 1, and all of those who have been admitted to the hospital for treatment are under 2, she said. For those dealing with RSV, oxygen or other respiratory support is provided.

Over a two-week period, Cooley Dickinson Hospital in Northampton diagnosed 14 positive RSV cases, 11 of which were in children.

“We’re definitely seeing a large amount of RSV and a little bit of flu,” agreed Dr. Sari Miettinen, chief medical officer at Cooley Dickinson. Miettinen is a pediatrician who oversees Sugarloaf Pediatrics in South Deerfield.

Dr. Dean Singer of Greenfield’s Bridge Primary, which moved into its office at One Arch Place in July, said while the clinic is taking on more pediatric cases in general as the practice grows, doctors there are seeing more persistent respiratory illness in children.

“The symptoms are definitely worse and last longer,” Singer said. “Typically, kids will get over it in two to three days. … Now it seems to be lasting one to two weeks.”

He noted Bridge Primary isn’t testing for RSV, in particular, at this point.

“If it gets to be a situation where it’s hard to tell the difference (between different viral illnesses) … we will start doing it,” Singer said.

The strain on emergency departments — with some of these facilities running out of beds and needing to make transfers for the necessary care — is prompting hospitals to suggest that families seek emergency services only if necessary, and to otherwise consult with pediatricians, which can be done by phone.

At Baystate, the pediatric emergency department has 45 beds, with an additional seven beds in the pediatric ICU. Many days every bed has been occupied.

Boney said Baystate has also been taking transfers from eastern Massachusetts and Rhode Island, as well as some child patients from Vermont and New Hampshire.

“We’re working very closely with other children’s hospitals to have sufficient awareness of pediatric capacity,” Boney said.

By having families check with their pediatrician before heading to the emergency departments, they may avoid the long wait times that are now common, and be able to give their children fluids and symptom relief.

Miettinen said there are indications parents should pay attention to some of the serious signs for their children, including experiencing respiratory distress, such as if a child is showing fast, heavy breathing, has a nose flaring, or the belly is rocking up and down and ribs are showing.

For those with fever, getting control is a key, as a child’s breathing rate will go up during a fever, Miettinen said.

Similarly, Boney said parents should head to the emergency department if a child is having difficulty breathing, is unable to drink fluids, and has not had a wet diaper or urinated at least once in the past day. Also, if a fever is not being reduced by fever-reducing medicine, or the child has an underlying medical condition such as asthma, medical help should be sought.

For children under the age of 6, families shouldn’t use cough or cold medicine, Miettinen advised. Instead, they can turn to other remedies such as humidifiers, saline water gargling and baby aspirators. When administering over-the-counter cold medicine, parents should check ingredients, making sure their kids are not being exposed to too much Tylenol and ibuprofen. For young children, parents may also be able to soothe them using honey.

RSV is common, usually causing a cold, or cold-like symptoms, though it can be more serious for infants and older adults. It is the most common cause of bronchiolitis and pneumonia for those under 1.

Rhinoviruses cause the common cold, but also can trigger asthma attacks and have been linked to sinus and ear infections. Non-polio enteroviruses usually cause mild illness, but can also cause fever, runny nose, sneezing, cough, skin rash, mouth blisters, and body and muscle aches.

Boney noted that in the fall and winter of 2020-2021, Baystate saw no cases of RSV, but then in the spring and summer of 2021 RSV cases returned, going away in the fall of 2021. In January of this year, the omicron variant of COVID-19 became predominant, and appeared to displace RSV, though RSV then came back over the summer and went up in September.

“The hospital was the fullest it’s ever been in September, and half the cases were respiratory illnesses,” Boney said.

Whether this is a preview of the flu season is uncertain. Australia had its winter from June through August and saw the worst flu season in five years, according to that country’s Department of Health and Aged Care.

With higher rates of respiratory illnesses and decreased masking, Miettinen said, some of the best defenses against the spread of illness are to keep children home if they get sick and to practice good hand washing and other hygiene measures.

That is leading to a recommendation that all members of families get their flu shots and updated COVID-19 boosters.

“Please, please, please get vaccinated for both flu and COVID,” Boney said.

Scott Merzbach can be reached at Mary Byrne contributed reporting.


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