LAKE COUNTY, Calif. — The Lake County Health Service director reported that health officials are concerned about the possibility of a significant annual increase in respiratory illnesses early this holiday season.
Jonathan Portney said increases in respiratory syncytial virus, or RSV, activity along with influenza, the common cold and SARS-CoV-2 have the potential to impede access to local healthcare.
“Of particular concern is how coincident waves of these diseases may prevent vulnerable young children and older members of our community from receiving care,” Portney said. “At this time, healthcare facilities are being advised to expand their capacity to assess and treat pediatric patients to accommodate an increase in patient traffic.”
Portney said health care facilities in neighboring Sonoma County report experiencing more than three times the number of RSV in the second half of October compared to the same period last year. This early wave has resulted in increased hospitalizations among children and has contributed to strains on the pediatric healthcare system.
Because hospitals are not required to report RSV cases, the number of cases in Lake County cannot be estimated. Typically, respiratory illnesses emerge between fall and spring, peaking in late December, Portney said.
“The current risks contrast with the lower activity of these viruses observed in recent years when various mitigation measures for SARS-CoV2 suppressed transmission,” Portney said.
He said statewide RSV levels are currently similar to seasonal peaks seen in previous 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. The virus typically causes the common cold, but in children under the age of 1 year, RSV is the most common cause of bronchiolitis and pneumonia.
To mitigate potentially serious consequences, it is very important that the local health and childcare communities emphasize the importance of influenza and SARS-CoV2 vaccinations for every member of our community as young as 6 months, Portney said.
Although there’s no vaccine for the common cold or RSV, Portney said everyday preventive measures like staying home if you’re sick, washing your hands frequently, covering up when you cough or sneeze, avoiding contact with anyone who is sick, and wearing a mask in indoor public places can help can help protect our community.
Portney said respiratory illnesses have overlapping symptoms, so parents and caregivers of children should watch for associated symptoms of RSV, including breathing faster than usual, labored breathing, nasal blowing, and long pauses between breaths. Irritability, increased activity, and decreased appetite are also signs of infection in infants that parents should seek advice upon discovery.
Currently, the American Academy of Pediatrics recommends the use of prophylactic palivizumab for infants and young children at high risk of RSV, Portney said.
Health care providers who care for children and adults with respiratory illnesses in inpatient and community settings should test for respiratory viruses, including influenza, SARS-COV-2 and RSV, Portney said. High-risk patients with suspected influenza are recommended to start antiviral influenza treatment immediately, without delay by laboratory confirmation of influenza.
The California Department of Health recommends physicians prescribe antiviral influenza chemoprophylaxis for outbreaks in long-term care facilities.
“As RSV and other respiratory virus activity continues to evolve and new evidence emerges, the County of Lake Health Services will be working with local healthcare providers and child care 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 -on-the-use-of-palivizumab-prophylaxis-to-prevent-hospitalization/
California Department of Health and Human Services (CDPH) Pediatric Immunizations: 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