Respiratory illnesses have spiked among children. Here's what parents need to know.

Children’s hospitals in major U.S. cities have been reporting unusually high numbers of sick patients with respiratory illnesses caused by viruses other than the coronavirus. These include respiratory syncytial virus (RSV), enteroviruses (EV) and rhinovirus (RV), which mostly cause cold-like symptoms such as a runny nose, coughing, sneezing and fever.

Yahoo News spoke to Dr. Michael Chang, pediatric infectious diseases specialist at UTHealth Houston and Children’s Memorial Hermann Hospital about why these winter viruses may be surging earlier than usual, as well as what parents can do to best protect their children.

Video transcript

MICHAEL CHANG: With school coming back, weather changing, people getting indoors more, we're seeing a big spike in RSV, or respiratory syncytial virus. And it's not just us. We're hearing about it from our colleagues all across the country. In the state of Texas, we have something like 20% of our tests for RSV are positive, which is well above the 10% threshold that we consider an epidemic level of RSV.

So that's been going on for a couple of weeks already. And so we're in the middle of a big RSV surge. We're starting to see a trickle of flu cases as well. Luckily, sars-cov-2 is going down. The number of enterovirus D68 detections has gone up and is at a higher rate than baseline. Now, it's not as high as some previous surges as we've seen, but at the same time, we're not exactly sure how far into it we are. It's kind of happening at an unusual time.

Generally speaking, for pediatric patients, we always worry about something called respiratory viral season. Historically, this has usually been maybe late October through early March. And the respiratory viruses that we typically see during that time are flu, of course, which usually starts in December through February, and then RSV. That's usually a little bit earlier, maybe around Halloween to Thanksgiving starts.

And so for really decades and really as long as we've known about these viruses, we saw that every year. And that was just the classical pattern. So then, of course, starting spring of 2020, COVID started spreading all across the globe. And that really changed everything because we started using all these kind of classical infection prevention techniques to try to prevent the spread of COVID, isolation, masks, hygiene, physical distancing.

All these things that worked for COVID also worked for all the other respiratory viruses, really. And so what happened during the pandemic in the last three years is that we saw significant decrease in cases of respiratory viruses, like flu and RSV. So essentially, that first winter, where we were really focused on COVID, that first big winter surge, and it was like the lowest influenza season ever historically that we had recorded in history. And it was the same for RSV.

So fast forward to today, across the United States, certainly, and in many parts of the globe, coronavirus cases are still falling. Hospitalizations are falling. Pretty much across the United States, at least, we've really relaxed all our infection prevention techniques. However, the problem is, they worked for those other viruses too. And so now we're seeing all these other viruses come back.

And then what we think is happening with RSV and potentially flu too is that basically for two years, two winters, where kids and adults would have been infected by RSV or by the flu, they didn't have it. And so some of that immunity that we would have had from infection before, we don't have it now. And so we're seeing these larger surges than we would expect at unusual times of the year.

For most parents, all these viruses are pretty much going to be indistinguishable, so runny nose, sore throat, coughing. Symptoms could last three to five days, sometimes peaking on day five before they start to get better. And for most parents, their child's going to recover fully from these with no long term complications.

So a couple of things to look out for, though, if you're a parent of a child that has asthma or reactive airway disease, you do need to be more cautious about enterovirus D68. There is an association with more severe disease in kids who have asthma.

Certainly any time that you notice that they're having difficulty with shortness of breath at rest, or if they're having trouble completing their sentences, if they're wheezing a lot, coughing is more severe, and then any type of chest pain, you're going to want to go see a health care provider and seek medical attention.

Parents who have kids less than the age of two, and especially kids who are less than the age of one, and have a history of either being premature or having a history of underlying congenital heart disease, those kids are at increased risk of severe illness from RSV. And so the main things you want to look out for are difficulty with feeding, difficulty with kind of catching their breath, if they're taking a bottle or breast feeding, certainly decreased feeding, decreased appetite.

Everybody who qualifies for flu shot, which is pretty much everyone from six months to adult, should go and get their seasonal flu vaccine as soon as possible. If you haven't been immunized against sars-cov-2, again, the best way to minimize the risk of severe illness and hospitalization, whatever your age, whatever your underlying conditions, is to get fully up to date on your sars-cov-2 immunizations, including the new bivalent boosters.