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Houston pediatricians seeing unusual second spike in RSV cases as hospitals near capacity

HOUSTON, Texas (KTRK) — Houston pediatricians are keeping a close eye on hospitalizations, after seeing unusual peaks in respiratory syncytial virus cases among children this year and bed space nearing capacity. Experts said surges typically happen in the winter, but this year, they’ve already seen them in the summer and now the fall.

RSV is a contagious virus that causes respiratory infections and symptoms very similar to the flu and COVID-19, such as a runny nose, coughing, sneezing, fever, and wheezing. According to the CDC, it is the most common cause of bronchiolitis, an inflammation of the small airways in the lung and pneumonia, an infection of the lungs in children younger than a year old.

DeAndré Hutchison almost thought he would lose his 7-month-old son, DJ, in June. The Houston police sergeant said his baby was admitted into the pediatric intensive care unit (ICU) at Texas Children’s Hospital following erratic breathing patterns. DJ was ultimately diagnosed with RSV and put on a ventilator. After about a week of being intubated, Hutchison said his son finally began recovering and is now back to normal.

“I’ve been through high speed chases, fights with hostile individuals, found guns on suspects that intended to do us harm. But that’s nothing in comparison to what I experienced with my son in the hospital. It was one of the scariest times of my entire life and very traumatic for my family. All we could do is pray,” he said. “Post-COVID, everybody knows what a ventilator means. Like, that’s close to the end. We’re just so proud and so thankful that God chose to spare him from his RSV experience.”

DJ’s case was part of an unusual RSV surge doctors saw this past summer. Dr. Melanie Kitagawa, who is the medical director of pediatric ICU at Texas Children’s Hospital, said they’re now seeing a second surge in the fall — something very uncommon for a virus that typically only peaks once a year in the winter. Currently, they have 40 children hospitalized with RSV with more than 10 in the ICU.

“The unpredictability of viral patterns that were so unusual is what really alerted us to be aware and prepared to talk about the impacts of the virus on our kids,” Dr. Kitagawa said.

Dr. Michael Chang, who is a specialist in pediatric infectious diseases with UTHealth Houston McGovern Medical School and Children’s Memorial Hermann Hospital, said RSV cases were nearly nonexistent during the first two years of the COVID-19 pandemic. But in July 2021, they saw RSV cases surge again, making this summer’s spike not as surprising as the last.

There are a few theories as to what’s causing the surges. Now that the COVID-19 vaccine is available, medical experts said they’re seeing less people practicing preventive behaviors such as wearing masks, social distancing, washing their hands, and staying home when they’re sick.

“People forget a lot of the time that those infection prevention strategies also helped prevent the flu and RSV. There was a whole kind of cohort of children and babies that had not been exposed to RSV. Similarly, there were older kids and adults who had not been exposed for that year, so their immunity had waned. Now, we’re behaving in a way that’s actually helping the virus to spread,” Dr. Chang said.

Houston Health Department does not keep track of RSV-specific data. But in an e-mail, a representative told ABC13 that flu-like illnesses are continuing to increase in the Houston and Harris County area. For the week leading up to Oct. 15, 2.17% of ER visits were made up of flu-like illnesses, up from 1.1% in mid-September. The previous four flu seasons at this time period had percentages below 1%. Children had a steeper increase in illness than adults this flu season at 2% compared to about .6% for adults.

According to federal data, Texas is one of the states that has reported 85-90% hospital occupancy. Dr. Chang said they’ve seen their own bed space at Children’s Memorial Hermann Hospital teeter around capacity several times during the past few weeks, with about one in five ending up in the ICU. Recently, they’ve seen cases plateau, but still not hitting baseline (zero cases).

“We are lucky to live in the Greater Houston area, where we have two children’s hospitals here in the region that are really well-prepared. While we are always keeping an eye on our bed capacity, we’re also well-equipped so far to deal with any continued surge,” he said.

Dr. Kitagawa said TCH is also ready to deal with spikes in RSV cases, as it’s been something they’ve experienced every year and they’ve learned a lot with surge management through COVID. Right now, she said it’s hard for medical experts to predict what these surges will mean long-term, as they are still studying the numbers and won’t be able to tell what the patterns are for some time.

Currently, there is no specific treatment or medications for RSV, although researchers are working to develop vaccines and antivirals. Experts said most RSV infections will go away on their own in a week or two for healthy adults and infants. But infants younger than six months and adults over 65 years old with underlying health conditions may need to be hospitalized if they have trouble breathing or are dehydrated, according to the CDC.

Dr. Chang said he hopes they won’t see a substantial spike in the winter, since most families have already been sick with some sort of respiratory virus this year. His biggest concern is the general public underestimating the potential impact of RSV. The best way for families to keep their children safe is to follow preventative measures often practiced during the COVID-19 pandemic: Cover your coughs and sneezes with a tissue or your upper shirt sleeve, wash your hands often with soap and water for at least 20 seconds, avoid close contact with others, and clean frequently touched surfaces.