Kansas hospitals see off-season surge of RSV cases, sickening children and straining system

TOPEKA – In late August, four-month-old daughter Kinsley contracted Kansas City resident Victoria Biggs, which she believed were allergies.

When the runny and stuffy nose lingered longer than expected, Biggs took her to the doctor. Kinsley was almost immediately diagnosed with respiratory syncytial virus, or RSV.

Kinsely’s case was mild, Biggs said, and she was able to treat it with home remedies. Kinsley was on the mend after a few weeks. Biggs, a new mom, said she was aware of RSV but didn’t know it was on the rise in Kansas.

The highly contagious RSV is usually a winter virus, meaning doctors in Kansas typically see fewer cases in the summer. This year, however, data from the Centers for Disease Control and Prevention shows that state cases of RSV in Kansas started in August.

Stephanie Kuhlmann, a pediatric hospital at Wesley Children’s Hospital in Wichita, said the unexpected influx of RSV cases has put a strain on the hospital system.

“We are dealing with such severe staffing shortages, nurse staffing issues and respiratory therapy staff shortages due to the pandemic,” Kuhlmann said. “Having a bunch of kids with RSV now is just a bit of a strain on some of our hospital resources.”

Usually, RSV is easy to predict, she said. Because the summer wave was unexpected, doctors were unable to plan for the waves of cases.

In August, the University of Kansas Health System saw 48 positive RSV tests and 14 RSV admissions. For the past two weeks, providers have seen a slight downward trend. (University of Kansas Health System)

Mike Lewis, a pediatrician at the University of Kansas Health System who oversees the pediatric intensive care unit, noted the virus’s usual predictability, saying that during a typical RSV season, there is a three to four week peak in cases before a decline.

“In the summer you might see an RSV kid every now and then, but nowhere comes this close,” Lewis said. “In addition, RSV and flu were virtually non-existent last winter. Occasionally there were cases. And that is not only locally, but also throughout the country.”

The low flu activity was likely due to efforts to reduce COVID-19. Those were probably also responsible for the quiet RSV season, Kuhlmann said. As mitigation efforts eased, RSV cases increased.

“I know pediatric clinics have really struggled to keep up because with all the RSV, summer is a really busy time for outpatient pediatricians,” Lewis said. “We have a lot of kids who come to visit once a year to go back to school.”

RSV usually presents as a cold, with symptoms such as a runny nose and fever. However, the virus can cause respiratory complications in younger and older patients. On average, RSV is responsible for approximately 58,000 hospitalizations in children under 5 years of age in the United States.

Kuhlmann said there have been a few pediatric COVID-19 cases in hospital in recent weeks, although the big effects come from resource pressures.

“The hospital where I work serves both adult patients and pediatric patients, and so if you have a high percentage of… those resources that are being used by adult COVID patients, that certainly consumes the resources we also need for a busy pediatric population.” department,” she said.

At the end of August, hospitals in Kansas were approaching or had already reached capacity due to a COVID-19 spike.

Wesley has spent the last few weeks closing transfers, meaning it was unable to get patients from referring areas. Kuhlmann also indicated that they spent some time on distraction, meaning they couldn’t admit patients locally and could only treat emergencies.

“A lot of it is (because) some days all our beds are full because of RSV and other related illnesses,” she said. “Sometimes it’s (because) we’re out of capacity due to nursing shortages alone.”

Lewis said many people wonder if there will be another spike in RSV later this year, and if so, how hospital systems are coping with it.

“There have been many sleepless nights among pediatric hospital doctors trying to find a place to take a child,” he said. “We’ve had to get kids out of Wichita, which has a very robust pediatric hospital system.”

In August, the University of Kansas Health System saw 48 positive RSV tests and 14 RSV admissions. Over the past two weeks, Lewis said, providers have seen a slight downward trend in cases.

Kuhlmann said that while she saw cases drop two or three weeks ago, in the past week they have risen again.

There is no vaccine for RSV, although that could change. The Alliance for Multispecialty Research is conducting clinical research studies on a potential RSV vaccine in the United States, with testing at one location in Kansas City.

The virus is highly contagious and spreads through respiratory droplets, Kuhlmann said, so regularly disinfecting surfaces helps reduce the risk of contamination with the virus.

“Definitely keeping children at home and adults staying at home when they are sick and unwell will help prevent,” said RSV. “It’s like all the other COVID mitigating factors with masking, distancing (and) washing hands.”