California child dies of flu and RSV

On Monday, the California Department of Public Health reported the first death of a season of a child under the age of 5 due to influenza and respiratory syncytial virus, or RSV.

The state’s flu season has come alive in recent weeks, reaching levels not seen in years and threatening to strain a health care system already struggling with an onslaught of RSV cases and still-powerful circulation. of the coronavirus.

“This tragic event is a stark reminder to us that respiratory viruses can be deadly, especially in very young children and infants,” said Dr. Tomás Aragón, California Director of Public Health and Chief Health Officer, of the pediatric death.

Influenza activity was considered high in California during the week ending November 5, the most recent period for which data is available, according to the US Centers for Disease Control and Prevention. It is the second most serious category on the agency’s five-point scale.

Two weeks ago, statewide flu-like illness activity was considered low.

The CDC’s assessment is based on surveillance for respiratory illnesses that include a fever plus a cough or sore throat, not just lab-confirmed cases of the flu.

California’s last flu positivity rate was 14%, well above current levels in each of the past five years, according to the state Department of Public Health. The rate is even worse in LA County — 25%, down from 13% last week.

So far, the California flu hotspot has been in the southeast corner, covering San Diego, Orange, Riverside, San Bernardino and Imperial counties, according to state data.

In a recent communication, the Los Angeles County Department of Public Health wrote that health care providers “must prepare for the possibility of a severe influenza season this fall and winter.”

“All patients – especially those aged 65 and over – should be urged at every medical visit to receive both their influenza vaccine and their updated fall COVID-19 booster as soon as possible” , continues the message.

Thirteen flu deaths have been reported in California since early October, eight of them among the elderly.

California is the only West Coast state with an increased degree of influenza activity this early in the season, according to the CDC. However, several states — including New York, Connecticut, New Mexico, Colorado, Nebraska, Ohio and Illinois — have high or very high levels.

Authorities have consistently warned of the possibility of a possible serious flu rebound this year after two pandemic-blunted seasons, and urged residents to get vaccinated and take other steps to protect themselves.

Those calls have taken on heightened urgency, given an early punch from RSV and the general expectation that the coronavirus could rise again this fall and winter.

“Knowing that we face the possibility of multiple respiratory illnesses circulating at once and straining our healthcare system, we can all be sure to do the things we know work to prevent the spread of respiratory illnesses: washing hands, wiping on frequently touched surfaces, staying home if we’re not feeling well, and wearing a well-fitting, high-filtration mask indoors, especially if you’re around those most vulnerable to serious illness said LA County Public Health Director Barbara Ferrer. Thursday.

Children’s hospitals continue to be busy dealing with RSV, which can cause serious illness and even death in young children and the elderly.

“Specifically, in California, we’re seeing higher rates in Southern California,” Dr. Rohan Radhakrishna, deputy director of the California Department of Public Health, said during a briefing to health professionals the last week.

In early November, 33% of child samples statewide tested positive for RSV, the highest such rate in California since the fall of 2019, according to data presented by Radhakrishna.

Orange County – the third most populous in California – has declared a health emergency amid high levels of RSV and other respiratory illnesses “requiring the hospitalization of children beyond the capacity and infrastructure of our hospitals to named children”. Orange County is particularly vulnerable because it has only two primary children’s hospitals, both operated by Children’s Health of Orange County. Hospitals in the region are not always able to accept pediatric patients transferred from other regions.

A rise in flu cases — and adult hospitalizations — threatens to make the situation even worse, according to the Orange County Health Care Agency.

“Flu hospitalizations are not consistently reported, so we cannot specifically say that we are seeing more flu hospitalizations,” the agency wrote in a statement to The Times. “But based on the increase in flu case reports, we can anticipate flu hospitalizations [among adults] will increase in the coming weeks. These will occupy beds that would normally also be used for the elderly [pediatric] the patients.”

Given current and anticipated hospital demands, state health officials are also recommending that healthcare facilities “explore short-term measures to expand capacity to assess and treat pediatric patients,” according to a statement. from the California Department of Public Health.

“We are entering a busy winter virus season – with the spread of RSV, influenza and COVID-19 – and urge parents and guardians to vaccinate their children as soon as possible against influenza and COVID-19,” said Aragon. “It’s also important to follow basic prevention tips like frequent hand washing, wearing a mask and staying home when sick to slow the spread of germs.”

Compared to Orange County, LA County reports relatively less strain, in part because it has more children’s hospitals. Yet one of the leading children’s hospitals – Children’s Hospital Los Angeles – says that while it can admit patients, its emergency room is so overstretched it can’t always accommodate transfers from d other hospitals.

About 62% of pediatric hospital beds in LA County are occupied, up from 54% in early August. Additionally, 70% of pediatric intensive care unit beds are in use, up from 61% a month ago.

“These numbers do not translate into a dire situation in hospitals right now. But we hear anecdotally that hospitals and healthcare workers are feeling stressed,” Ferrer said.

Five RSV deaths have been reported in California since October – two in children and three in the elderly. These numbers, as with the flu, are likely an undercount.

Officials also note that hospital capacity can quickly deteriorate in many facilities that have only a few beds designed to treat children.

“As few as nine or 10 new hospitalizations can have the potential to bring a hospital to full capacity for their pediatric patients,” Ferrer said.

Los Angeles Times

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