‘Like February in August’: Hospitals report spike in sick kids

Want a sense of how many kids are sick right now?

Dr. Jennifer Haggar, a Sanford pediatrician, did an interview for this story at home with her sick five-year-old on her lap.

“It feels, in the clinic, like February in August,” said Haggar, who works out of Sanford’s clinic at 26th Street and Sycamore Avenue.

“We’re seeing kids with respiratory and other illnesses we see in the winter and the normal things we see in the summer like hand foot and mouth.”

At Avera McKennan, Dr. Rick Kooima was on call one weekend recently and experienced the increased severity of what’s going around of late.

“I’ve been doing this a quarter of a century and the last time I was on call I had to transfer two kids into the intensive care unit over a weekend,” he said. “That’s pretty unique, so it seems like a more severe season than our baseline February and March would be.”

Here’s a look at what’s going around:

RSV

RSV, or Respiratory syncytial virus, typically surfaces in the winter. This year, similar to influenza, there were not as many cases.

Now, “it’s really significant,” Haggar said. “Even our in-patient volume, the number of kids currently hospitalized is high. Unheard of high this time of year.”

There’s no solid evidence why, though the suggestion is that “we had such low volume with people staying home and masking and we opened up and had this susceptible population that didn’t have immunity and the virus has the ability to spread,” she said.

The main worry for kids with RSV is their breathing, Haggar said.

“They might be pulling at their ribs like they just ran a big race, almost panting,” she said. “For some kids, they have so much congestion and are working so hard to drink what they need to stay hydrated.”

One test can confirm RSV or COVID-19, Kooima said.

“More of the kids I’ve been seeing have been testing positive for RSV,” he said. “In the 23 years I’ve been doing this this is the first summer we’ve seen this amount of RSV.”

Most kids get worse for three to five days and then get better, though cough can linger for weeks.

Hand, foot and mouth disease

Hand, foot and mouth disease is more common during the warmer months – and it’s definitely here.

“It’s super common, and this is the normal time we see it,” Haggar said. “We see it in the spring and the autumn. It’s really common there will be a number of cases from one daycare. Someone will get it and nearly everyone will get it at that daycare.”

That includes adults, she said, adding it’s highly contagious and spread mostly through touching common surfaces.

“When adults get it, it’s painful,” Haggar added.

The first symptom often is fever. Sores then can appear on the palms of the hands, or inside the fingers, and feet as well as in the mouth. Many kids get a diaper rash that looks more like spots.

“Hand washing continues to play an important role,” she said, adding diaper changes represent a particular challenge in containing spread.

Fever usually clears up in a day or two, though the sores can last for weeks.

This year’s strain also seems more severe, Kooima said.

“So it’s not just hands and feet but we’re seeing rashes up the legs onto the chest. When it’s severe, kids will get sores in their mouths, but mainly it’s the rash we’ve been seeing.”

Croup, COVID and colds

There also are some cases of Croup, an infection of the upper airway, Haggar said.

“It’s a barking cough … where it’s like a seal bark, a very dry cough,” she said. “That can be serious if it ends up impacting their ability to breathe. We have been seeing some cases of that as well which we typically see in the winter months.”

Because symptoms can be hard to distinguish, pediatricians have been testing kids for COVID-19 – and finding some positives.

“We haven’t seen a big uptick in kids yet, although I wouldn’t be surprised in the next week or two if we start seeing more coronavirus,” Kooima said, adding kids who recently had other illnesses such as RSV might be looking at a worse case of COVID if they come down with it.

“It seems like each time they get a cold after that it tends to settle in the chest a lot faster. They tend to have more cough and wheezing, so it would stand to reason if they get COVID after RSV it could be more severe.”

Sanford also is starting to see cases of kids with COVID, Haggar said.

“We had a couple this week, and additionally where a teacher will have COVID and they’re out because they need to do isolation,” she said. “The percentage of positive cases that are kids is higher right now. There’s likely a big vaccine impact on that. I’m primarily testing because of symptoms and there’s very few illnesses where I can say something is not COVID without a test. Even a mild cold could be COVID. I’ve had plenty of kids with a snotty nose who had COVID.”

And, of course, there are still more common colds circulating.

“There’s plenty of colds, and throughout the summer we’ve seen a fair number of folks with allergies,” Kooima added. “I think for some of the folks with allergies, when we have days of poor air quality with the smoke and haze in the air it seems to exacerbate folks with allergies as well.”

He advises wearing face coverings at school even if kids are vaccinated.

And seek care if kids have a persistent fever, are irritable or extremely tired, Haggar added.

“A lot of these kids have been well so long and they’re getting all these things back to back to back,” she said. “It’s just so hard as a parent to have your kid go through that cycle.”