Nov 3, 2022 - COVID

Threat of "tripledemic" looms with RSV, COVID and flu

Illustration of a stethoscope in the shape of a pair of lungs

Illustration: Sarah Grillo/Axios

Respiratory illnesses in children are on the rise, with physicians reporting more cases of the respiratory syncytial virus, or RSV, in recent weeks.

Why it matters: Officials across the country are worried about the impact of a possible "tripledemic," in which a rise of seasonal influenza, RSV and COVID-19 may collide this fall and winter.

Catch up quick: RSV is a common respiratory virus among children that produces symptoms such as coughing, fever, congestion, loss of appetite and pale skin.

  • While most symptoms resolve within a week or two, for some infants, children and young adults — especially those with pre-existing health conditions — the illness can put them in the hospital, according to the Centers for Disease Control and Prevention.

State of play: Hospitals nationwide have been filling up with sick kids, many with RSV, public health and hospital officials tell Axios.

  • Seattle Children's saw roughly double the number of patients it normally would in October, and its emergency room is now at 200% of its physical capacity, said Russell Migita, attending physician and a clinical leader of emergency services at the hospital.
  • About half of those emergency department patients have symptoms attributable to a respiratory virus, Migita wrote in a statement to Axios.

By the numbers: As of Oct. 26, the UW Medicine Virology Lab reported nearly 90 cases of RSV in samples from throughout the Puget Sound region, up from an average of zero to three prior to 2020.

The big picture: While the RSV season normally runs from December to April, peaking in February and March, this season is different, with volumes peaking earlier and cases proving more severe, Migita said.

How we got here: Migita said the success of masking and social distancing limited infections that children contracted in their first two years of life — but now, "those viral infections are all being clustered at the same time."

  • "Having more than one infection at the same time can cause more severe illness," he wrote.

Be smart: If you notice your child has a decrease in urine, high fever or difficulty breathing, you should take them to the doctor or the hospital, said Sparrow Helland, assistant nurse manager of the pediatric clinic at Harborview Medical Center.

  • Giving cough drops to children with RSV symptoms isn't recommended, as it can suppress the ability to clear mucus, which is a top priority during home treatment, Hellend said.

Go deeper: Here's what caregivers should consider when assessing their children's health this winter


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