RSV, flu, COVID-19 guide for parents

SANDWICH – Back to school means back to the doctor for some, as three viral respiratory illnesses – influenza, RSV and COVID-19 – are again expected to dominate seasonal sickness trends this year, and area health officials said to expect an uptick in October.

Last year, the fall was the beginning and the peak of the respiratory illness season. According to the Center for Disease Control and Prevention, the total percentage of emergency department visits for respiratory viruses in Illinois rose in September 2022 and peaked in mid-November 2022, with 9.8% of emergency department visits being respiratory virus-related. That peak was driven by a surge in influenza cases, according to the data, and as those cases dwindled, COVID-19 ED visits increased.

On the other hand, August’s end brought with it COVID-19-related ED visits, health officials said. Those visits grew and then began a downward trend in early September, according to the CDC’s data. Medical professionals said it’s still too early to see a significant swing in RSV and flu cases, but parents should be on the lookout.

Dr. Blair Wright, a Northwestern Medicine pediatrician at Sandwich’s Valley West Hospital, said the COVID-19 pandemic threw the typical viral illness season out of whack.

“A typical season, the worst would be like October through April, and then 2020 happened, and [COVID-19] hit, and our whole pediatric illness schedule kind of got thrown,” Wright said. “Last season, we did see things kind of go back to ‘normal,’ where kids were getting sicker in the winter season.

“But for a little bit after [COVID-19′s] initial peak, we were seeing flu in the summer. Our whole pediatric schedule got mixed up. Right now, our best prediction is it’ll hit again October through April, but time will tell, and I’m sure that’ll change as the season goes on.”

According to the National Human Genome Research Institute, a virus is an infectious microbe of nucleic acid surrounded by protein, and a respiratory virus is one that infects a human’s upper or lower respiratory system. These viruses are spread via aerosolized droplets such as saliva that land on people and surfaces.

Washing your hands, covering your nose and mouth with the inside of your elbow when you sneeze or cough, and not touching things that seem icky or gross are commonly understood as basic best practices when it comes to preventing viral and bacterial infections.

Those habits, however, might not be the easiest to live by for the littlest members of the community when you’re adjusting to preschool or kindergarten. This makes respiratory viruses a common occurrence for children. Doctors said a child’s sickness shouldn’t be taken lightly.

Right now, our best prediction is it’ll hit again October through April, but time will tell, and I’m sure that’ll change as the season goes on.”

—  Dr. Blair Wright, a Northwestern Medicine pediatrician in Sandwich

Dr. Melissa Manrique, a pediatric hospitalist at Central DuPage Hospital in Winfield, said she saw a moderate increase in viral respiratory illnesses in mid-September.

“Right now, we’re just seeing a moderate increase,” Manrique said. “Last year, we really had peak levels of RSV at this time of year, where right now we’re just seeing more of a moderate, gradual increase in our pediatric patients testing positive for RSV. And we really haven’t seen much influenza as of yet.”

Should I take my child to the hospital for RSV, COVID-19 or the flu?

According to the CDC, children younger than 5 are at risk of severe illness when they’re infected by respiratory viruses because they have smaller lungs and airways, and their immune systems are still developing.

For these reasons, parents are advised to take their child to a medical professional if they suspect their child is sick with a respiratory illness.

“If parents are concerned at all, I’d recommend being seen,” Wright said. “Parents have a really good kind of instinct about whether things are kind of right or not right, and if they have a feeling they are not right, I’d just go be seen.”

It can be difficult for medical professionals to determine whether a child has RSV, COVID-19 or influenza without a test. Manrique, who works in the pediatric intensive care unit at Central DuPage Hospital, said each virus has its telltale signs.

“RSV tends to cause a lot more congestion and [a] cough with very thick mucus and trouble breathing, versus flu can include some cough and trouble breathing but has more fever and myalgia – kind of that body-ache feeling,” Manrique said. “And then, of course, things with [COVID-19] can be very similar again, where they can have fever and fatigue and headaches, as well as the body aches.”

Respiratory syncytial virus (RSV)

Respiratory syncytial virus, known as RSV, causes mild cold symptoms for most, but for children and older adults, the common virus can sometimes require hospitalization.

cording to the CDC, a runny nose, decrease in appetite, coughing, sneezing, fever and wheezing are common symptoms of RSV. A vaccine protecting against RSV in adults is now available, but Wright said she’s looking forward to a novel monoclonal antibody treatment that will be used as a preventive measure.

“That will be new this fall. [The] jury is still out on when that will be rolled out. It’s been approved now, but Northwestern is still ironing out all of the details, making sure we can have an effective rollout of that,” Wright said. “But that will be a game-changer for our babies in their first RSV season, to hopefully prevent them from getting RSV at all, and if they do, preventing them from getting these severe illnesses with it where they are needing to be in the hospital.”

What does COVID-19 look like this fall?

The virus that causes the disease known as COVID-19 continues to sicken people across the world as it evolves into new variants and individual immunity wanes. The Illinois Department of Public Health stopped reporting data on COVID-19 in May, but CDC data recorded a bump in COVID-19-related hospital visits for Illinois in August.

On Monday, the White House announced that every home in the U.S. is eligible to receive another four free at-home COVID-19 test kits. The tests can be ordered at covid.gov/tests. Medical professionals have championed accessibility to tests that can detect the virus since the onset of the COVID-19 pandemic in 2020 because the virus presents with symptoms common from other viruses.

Here are symptoms of COVID-19, according to the CDC:

• Fever or chills.
• Cough.
• Shortness of breath or difficulty breathing.
• Fatigue.
• Muscle or body aches.
• Headache.
• New loss of taste or smell.
• Sore throat.
• Congestion or runny nose.
• Nausea or vomiting.
• Diarrhea.

Influenza

Seasonal influenza activity is currently low across the country, according to the CDC, but this is the virus parents have the most familiarity with. The well-known respiratory disease can cause a fever, coughing, a sore throat, runny or stuffy nose, muscle or body aches, headaches, fatigue, and diarrhea and vomiting in children, and it has the capacity to hospitalize a child, health officials said.

Children younger than 5 are more susceptible to flu-related complications such as pneumonia, brain dysfunction, and the worsening of heart disease and asthma, according to the CDC. The agency also reported that 66% of the children hospitalized with the flu during the 2022-23 flu season had at least one underlying health condition.

What doctors say about vaccination and prevention

Flu vaccines and COVID-19 boosters are available through various pharmacies at businesses such as CVS, Hy-Vee, Walmart, Jewel-Osco and Walgreens.

The DeKalb County Health Department also provides vaccinations; however, it temporarily paused administration of COVID-19 vaccines in September as the department awaited the arrival of a monovalent COVID-19 vaccine recently approved by the Food and Drug Administration.

[ Here’s how to get a new COVID-19 shot ]

The new COVID-19 vaccine is out now. It was specifically updated to target the strains of COVID-19 that are circulating now, including the “kraken” strain of the virus, XBB.1.5.

Health officials recommend getting the COVID-19 and flu vaccines at the same time.

Wright said she is advocating for parents to vaccinate their children to protect against COVID-19 and influenza this fall.

“For kids, we know that it decreases their risk of severe illness significantly, both for flu and [COVID-19] – RSV, the preliminary studies are showing that too, but this will be our first nationwide season with that monoclonal antibody injection,” she said. “But yes, for flu and [COVID-19], I definitely recommend.

“We certainly have families that do, families that don’t. We’re happy to see those kids when they do get sick, and [there’s] no judgment when you come in. We’re just trying to take the best care of your child, too. But I do recommend [the vaccines].”