Jonathan Portney said iIncreases in the activity of respiratory syncytial virus, or RSV, along with influenza, the common cold, and of SARS-CoV-2, have the potential to inhibit access to healthcare locally.
“Of particular concern is how coinciding waves of these illnesses may prevent vulnerable young children and elderly members of our community from receiving care,” Portney said. “At this time, it is advised that healthcare facilities consider expanding their capacity to evaluate and treat pediatric patients in order to manage an increase in patient volume.”
Portney said health care facilities in neighboring Sonoma County report experiencing more than three times the amount of RSV during the latter half of October than was experienced during the same period last year. This early wave has led to increased hospitalizations among children and has contributed to stresses in the pediatric health care system.
Because there is no requirement that hospitals report cases of RSV, the number of cases Lake County is experiencing cannot be estimated. Typically, respiratory illnesses are most common between fall and spring, peaking in late December, Portney said.
“The current risks stand in contrast to the lower activity of these viruses seen during the past couple of years when various mitigation measures for SARS-CoV2 were suppressing transmission,” Portney said.
He said that statewide levels of RSV currently are similar to seasonal peaks witnessed in prior years as many children are being exposed to other respiratory viruses for the first time. Most children experience a mild version of RSV before the age of 2 years. The virus typically leads to a cold, but in children younger than 1 year, RSV is the most common cause of bronchiolitis and pneumonia.
In order to mitigate any potentially severe outcomes, Portney said it is very important that the local health care and childcare communities stress the importance of influenza and SARS-CoV2 vaccinations for every member of our community that is 6 months and older.
While there is no vaccine for the common cold or RSV, Portney said everyday preventive actions like staying home when sick, frequent hand washing, covering your cough or sneeze, avoiding contact with sick individuals, and wearing a mask in public indoor spaces can help protect our community.
Portney said respiratory illnesses have overlapping symptoms, so parents and caregivers of children should watch for concerning symptoms of RSV including breathing more quickly than usual, labored breathing, nose flaring, and long pausing between breaths. Irritability, increased activity, and decreased appetite are also concerning signs of infection in infants which parents should seek advice for upon discovery.
Currently, the American Academy of Pediatrics is recommending the application of prophylactic palivizumab for infants and young children at high risk for RSV, Portney said.
Health care providers caring for children and adults with respiratory illnesses in inpatient and congregate settings should test for respiratory viruses, including influenza, SARS-COV-2, and RSV, Portney said. For high-risk patients with suspected influenza, it is advised they begin influenza antiviral treatment immediately, without the delay of laboratory confirmation of influenza.
The California Department of Public Health recommends clinicians prescribe the influenza antiviral chemoprophylaxis during outbreaks in long-term care facilities.
“ As RSV and other respiratory virus activity continues to evolve and new evidence emerges, County of Lake Health Services will collaborate with local health care providers and childcare facilities to assess and provide additional updates as they become available,” Portney said.
American Academy of Pediatrics (AAP) Use of Palivizumab Propylaxis to Prevent Hospitalization From Severe Respiratory Syncytial Virus Infection: www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/interim-guidance-for-use-of-palivizumab-prophylaxis-to-prevent-hospitalization/
California Department of Public Health (CDPH) Pediatric Vaccinations: www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/Babies.aspx
Centers for Disease Control and Prevention (CDC) COVID-19: www.cdc.gov/coronavirus/2019-ncov/index.html
Centers for Disease Control and Prevention (CDC) Influenza: www.cdc.gov/Flu/Index.htm
Centers for Disease Control and Prevention (CDC) RSV: www.cdc.gov/rsv/index.html