Not just COVID: Another virus is filling Acadiana hospitals. Here's what makes it unusual. - The Advocate
Lilliana Credeur's mother grew more and more worried about her as the 3-week-old infant's breath sped up.
"She was breathing really, really fast and she would stop breathing," said Ashley Credeur, 38, of St. Martinville. "I was too scared to have to wait for an ambulance, she was so limp and lethargic."
Lilliana Credeur of St. Martinville was hospitalized at just three weeks old amid outbreaks of the virus RSV, which is surging across Louisiana this summer.
Credeur packed up her baby and sped to Iberia Medical Center, where they stabilized Liliana before transporting her to Our Lady of Lourdes Women's and Children's Hospital in Lafayette. Liliana had already been diagnosed with respiratory syncytial virus, better known as RSV, and it was wreaking havoc through her tiny body.
The diagnosis was a paradox, both surprising and anticlimactic at the same time. RSV cases are surging across Southern states — Louisiana's Department of Health has officially deemed it RSV season, and the Centers for Disease Control and Prevention issued a warning about the spread.
RSV infections on the rise
But RSV does not usually skyrocket in the summer — in fact, it's known as a winter virus and the leading cause of hospitalization among babies under age 1. For hospitals to be chock-full of little ones with RSV in the middle of July is unprecedented, providers say.
"This is the first time that I've ever seen a large-scale outbreak in the summertime in the past 20 years," said Dr. Jay Hescock, who works for Children's Hospital in New Orleans as an LSU Health Hospitalist Section chief.
Pediatricians say they are drained, working longer hours and extra shifts, burning through personal protective equipment and wondering if the surge in cases will let up. Louisiana children's hospitals are scrambling to find enough beds and staffers to take care of all of the RSV cases, and many have had to stop accepting transfers from other hospitals with their own buildings brimming past capacity.
As the coronavirus delta variant moves through Louisiana — largely affecting adults so far — RSV is sweeping through children, many of whom have been cooped up for more than a year amid coronavirus restrictions that have recently been lifted.
A 24-year-old Lafayette nurse and a 30-year-old Eunice pastor died over the weekend after seeking hospital treatment for COVID-19, according t…
"The cases we're seeing right now are definitely more than what we're used to seeing during regular season, and the severity is definitely worse than before," said Dr. Reynaldo dela Rosa, a Lafayette pediatric intensivist who oversees the pediatric intensive care unit at Our Lady of Lourdes Women's and Children's Hospital.
"We're hoping it will trickle down, but there's no signs of it," he added.
Our Lady of the Lake Children's Hospital, for example, has been averaging 90 inpatients in recent weeks, with as many as 10 to 15 waiting for inpatient rooms to free up at any given time. At this time last summer, though, the hospital was averaging numbers that were half — or even three-fourths — lower, with their average census ranging from 32 to 45.
The state's Department of Health deems it RSV season when the percent positivity rate of RSV tests is more than 10%. The state stayed under that number until mid-May, when positive RSV cases jumped nearly 10 percentage points to just under 20%. Cases have continued to climb, and positive RSV cases at the beginning of July reached nearly 30%.
Those numbers still don't capture the full picture of the state's outbreak. Hospitalized children are tested for the virus, but some pediatricians don't recommend testing for milder cases because there is no cure for RSV. Confirming its diagnosis does not usually change the treatment for typical symptoms of a virus: making sure children are properly hydrated, not struggling to breathe and keeping their airways clear.
'One thing after another'
As people wore masks, avoided large gatherings and washed their hands more than usual to stem the spread of the coronavirus last year, other viruses fell off as well. RSV was one of them, as was the flu.
But "as soon as things loosened up with COVID restrictions, we've had one thing after the other," said Dr. Ashley Lucas, Our Lady of the Lake's medical director of pediatric primary care.
First it was croup, a virus that affects upper airways. Then it was hand, foot and mouth disease, also caused by viruses that can lead to rashes around the mouth along with coldlike symptoms.
They were fishermen, artists, basketball coaches, bus drivers.
But the RSV surge has been the worst yet. For adults and older children who've had it before, RSV generally feels like a regular cold. But for babies and toddlers, it can lead to pneumonia and bronchiolitis.
"We knew RSV was coming back and it would be bad," said Dr. Andres Carrion, a pediatric pulmonologist for Our Lady of the Lake Children's Hospital. "We're seeing it early. The thing that worries me is we may not have a flattening — it could be a very long winter."
Parents and guardians should keep a close eye on babies if they aren't eating, have high fever or seem to be straining when they try to breathe, dela Rosa advised. Seeing muscles contract in their backs or chest as they breathe is a sign that "the baby's trying as much as they can to suck in air to breathe and survive."
Lilliana Credeur of St. Martinville was hospitalized at just three weeks old amid outbreaks of the virus RSV, which is surging across Louisiana this summer.
That's what Credeur was observing in Lilliana, who was born four weeks early and was already at higher risk of struggling with RSV. A sibling picked up the virus at day care, which is probably how it spread to the newborn.
But at the same time that Lilliana needed to be hospitalized, so did many other children struggling to fight off RSV.
"We had to stay in the emergency room for two days because there were no beds available," Credeur said. That's become a recurring theme of the latest outbreak: Hospitals don't necessarily have enough beds, or enough staff, to immediately admit patients from their emergency rooms.
"They've all been full," said Dr. Catherine O'Neal, Our Lady of the Lake's chief medical officer. "No beds available for weeks, because they are full of critically ill kids who have respiratory viruses, most of it RSV."
And while cases in adults are usually milder, they're getting sick with RSV, too, O'Neal said. She said that as patients are confused about whether their symptoms are for COVID-19 or RSV, it puts "blinders on a little bit to the rising COVID that's here."
Louisiana health officials sounded the alarm on rising COVID cases among unvaccinated people on Tuesday, releasing a flurry of worrisome stati…
"Most hospitals that take care of pediatric patients were not necessarily well equipped to deal with this summertime surge," Hescock said. "It's creating problems with finding places that'll care for kids with this as well as other conditions."
Our Lady of Lourdes Women's and Children's providers gave Lilliana oxygen, steroids and breathing treatments, her mom said. Credeur said she did not have the heart to leave her side.
"Poor baby couldn't eat for four days — they just had her on fluids," Credeur said.
'They haven't been exposed'
Most children get RSV for the first time before they turn 2 years old. But the providers seeing them say that their patients span the gamut of newborn to toddler to child, largely because most haven't been through the cycle of outbreaks — and immune system building — during the winter months.
"These kids have been so well-protected, they haven't been exposed," said Dr. Erin Hauck, the vice chief of Our Lady of the Lake's pediatrics division.
Dr. Brooke Dismukes, a pediatrician at Ochsner Hospital for Children in Jefferson, said she's seeing more 3- and 4-year-olds with more severe cases of RSV this summer who have never had it before.
Dr. Frank Courmier says his son will get his first dose of the coronavirus vaccine on his 12th birthday in January.
"This looks exactly how it would look in our winter months," she said.
RSV spreads easily — through respiratory droplets, such as coughs, and on infected surfaces. In Denham Springs, Victoria Smith Robinson said she started warning her friends and neighbors after her 20-month-old godson was hospitalized with the virus that they should keep their babies home and out of crowds.
"Them babies are so precious," Robinson said. "I've been trying to warn people: Stay away."
Despite its high hospitalization rate, RSV is rarely fatal in the United States, though it can be particularly serious in children who already struggle to breathe, and the sickest might require intubation. Even for those with milder cases, it can be a miserable slog with no easy remedies. Children who have it often have fever, coughs and little appetite.
Ashley Credeur holds her one-month-old daughter Lilliana Tuesday, July 13, 2021, at their home in St. Martinville, La.
As Credeur waited for Lilliana to be released from the hospital, she dreamed about taking her home to spend time with her six siblings. She went to the hospital's gift shop and bought her a frothy white dress with a big bow on it.
Lilliana was released from the hospital, and on went the new dress.
Staff Writer Emily Woodruff contributed to this report.
Comments
Post a Comment