This 1981 photo provided by the Centers for Disease Control and Prevention shows an electron micrograph of respiratory syncytial virus, also known as RSV. Children's hospitals around the country are seeing a distressing surge in RSV, a common respiratory illness that can cause severe breathing problems for babies.

Macomb County boy, 6, dies of RSV amid surge of infections

A 6-year-old Macomb County boy has died from respiratory syncytial virus, better known as RSV, Oakland County’s chief medical examiner said Wednesday, amid a surge of infections among Michigan children that has pediatric hospitals across the state at or near capacity.

The young boy was hospitalized at Corewell Health Beaumont Troy Hospital, and died at 3:41 a.m. Wednesday, the Oakland County Medical Examiner’s Office told the Free Press.

“The child was diagnosed in the hospital and survived in the hospital for several hours, I believe, with severe respiratory distress,” said Dr. Ljubisa Dragovic, the medical examiner. “He had an RSV infection because it was documented and tested positive in the hospital.”

The boy is among hundreds of Michigan children who have needed hospital care amid a wave of cases of RSV, which causes the most serious illness in infants and young children, people with compromised immune systems and elderly people.

More:Wave of Michigan RSV cases taxes pediatric hospitals

More:Amoxicillin shortage in Michigan, US fueled by surge in pediatric RSV cases: What to know

Who is at risk for RSV?

It’s a very common respiratory virus that in most people causes mild, cold-like symptoms “typical of other respiratory diseases — runny nose, coughing, sneezing, fevers, all of those things,” Dr. Natasha Bagdasarian, the state’s chief medical executive, told the Free Press in a previous interview. “Most people who have RSV infections, they get better on their own at home.”

A subset of the population — especially babies, toddlers, senior citizens and people with compromised immune systems — can have a harder time fighting the virus and can get very ill. When they get the virus, it can cause wheezing and respiratory distress.

RSV is not an illness that must be reported to public health agencies, so the statewide tally of cases and deaths is unknown. However, Lynn Sutfin, a spokesperson for the state Department of Health and Human Services told the Free Press: “Over the past three weeks there has been a sustained increase in pediatric emergency room visits, largely due to respiratory illness.

“We are urging all Michigan families to take steps to prevent the spread of respiratory illnesses. This includes staying home if you are unwell and avoiding contact with individuals at risk of severe RSV illness; washing your hands often; getting vaccinated for influenza and COVID-19; having a supply of COVID-19 tests and masks at home; and finding out if you are eligible for treatment options if you do become unwell.”

The Oakland County Health Division issued a statement Wednesday urging people with cold-like symptoms to avoid interaction with small children to limit the spread of RSV.

Michigan hospitals packed with sick children

The swell of sick kids with RSV is putting a crunch on hospital emergency departments and pediatric intensive care units across the state.

At Corewell Health Helen DeVos Children’s Hospital in Grand Rapids, all of the intensive care unit beds were full Wednesday. The hospital had to add about five additional ICU beds to a dedicated overflow unit, said Dr. Hossain Marandi, hospital president, to continue to care for the sickest children.

“We are also evaluating every admission to assure that when a critically ill child needs care, we can say yes,” Marandi said.

Helen DeVos Children's Hospital

The University of Michigan Health C.S. Mott Children’s Hospital in Ann Arbor is “extremely full,” said spokesperson Beata Mostafavi. Decisions are being made “on a case-by-case basis because of the capacity issues.”

Bagdasarian said infections of RSV and other respiratory viruses among kids in the state “have escalated in the last week” even above already high thresholds.

“What we are seeing with the trends right now is that not only are RSV surveillance numbers in terms of positive tests are going up, but the number of patients who are presenting to urgent cares, in emergency departments with RSV are also going up. And this is primarily in the under-4 age group,” she said Wednesday.

Dr. Natasha Bagdasarian, the state's chief medical executive, stands outside of the Michigan Department of Health and Human Services in Lansing on Tuesday, October 26, 2021.

“We are really hearing from all of our pediatric hospitals that they are struggling right now. They are struggling with ICU beds. They are struggling in terms of pediatric staffing. Many of them are not accepting transfers, which is a problem. … Many of them have emergency department borders or lodgers (who are) … children who can’t be moved up to a more permanent bed because there are simply so many cases.”

Calls are streaming in from other Michigan hospitals and from out of state asking whether the University of Michigan Health at Sparrow Children’s Center in Lansing has room to accept more sick children as transfers, said spokesperson Corey Alexander.

“We will continue to monitor our capacity limits and will take appropriate action,” he said.

And at the eight southeastern Michigan hospitals that are part of Corewell Health East, the new name for Beaumont Health, the availability of hospital beds for children fluctuates between being “at” or “reaching capacity,” said Dr. Mathew Denenberg, system chief of pediatrics.

Picking the right level of care for symptoms

John Karasinski, a spokesperson for the Michigan Health and Hospital Association, said staffing shortages that have risen out of the COVID-19 pandemic have continued. That means that even if there are open beds within a hospital, there may not be enough nurses and other staff to care for patients in them.

“That’s a big factor in what’s going on right now. … There’s not enough staff to account for all the physical beds that hospitals could have available,” he said.

Karasinski urged people to help ease the burden on hospitals by choosing the right level of health care based on the severity of symptoms.

“Given the surge of patients that are coming to hospital emergency departments for RSV, anyone that’s experiencing worsening symptoms such as difficulty breathing, dehydration, they certainly should seek care immediately” at a hospital emergency department, he said.

“Individuals that have mild symptoms, we want to encourage them to reach out to the local urgent care, a pediatrician’s office, family practice office. Use those alternative care sites to try to alleviate some of the pressure that is on hospitals right now.”

What are the signs that my child needs to go to the emergency room with RSV?

Infants can’t tell their parents when they’re struggling to breathe. Doctors told the Free Press that caretakers should watch for the following symptoms:

  • Rapid breathing
  • Wheezing or grunting noise
  • Nostrils flaring and/or muscles in the neck, chest or abdomen are strained when trying to breathe
  • Not eating well
  • Excessive fussiness or excessive lethargy
  • Bluish coloration of the skin, lips or nailbeds
  • Dehydration, which shows up in infants as fewer wet diapers
  • Apnea episodes
  • “When the respiratory rate is above 60, a lot of times they’re so busy trying to take a breath to get oxygen into their body that they don’t often eat well,” said Dr. Rudolph Valentini, a pediatric nephrologist at Children’s Hospital of Michigan and group chief medical officer for the Detroit Medical Center.

    “They’re vulnerable to dehydration. So if they’re not eating well, if they’re fussy, if they have a fever, if you see the abdominal breathing or the grunting, you need to get to a hospital,” he said.

    Dr. Rudolph Valentini, a pediatric nephrologist who also is the Detroit Medical Center's Group Chief Medical Officer.

    “Not every cough or cold with a little bit of wheezing warrants a hospital visit. If your baby is feeding comfortably but seems a little bit uncomfortable, you could pick up the phone and contact your pediatrician for some guidance.

    “But certainly, when they have those symptoms of breathing difficulty where they’re grunting, or you see the abdominal breathing or they’re having trouble feeding, you need to get (medical) attention.”

    Other ways to help the health care system through RSV crisis

    Bagdasarian said it’s not only RSV that’s circulating now, making adults and children sick. Influenza cases are beginning to pop up, along with coronaviruses, rhinovirus, adenovirus and others.

    “What we are telling people is to really think about this as viral respiratory season,” she said. “We’re really asking people to just use commonsense strategies, use the tools that we have to keep health care systems functioning and … available for those who need urgent medical care.

    “We want to ensure that if someone has a heart attack or a stroke or someone is in a motor vehicle accident that they have access to the excellent health care that they that they normally would have access to.”

    This photo provided by Pfizer shows kid-size doses of its COVID-19 vaccine in Puurs, Belgium.

    That means being up to date on COVID-19 vaccines, she said, and getting a flu shot.

    “If you are feeling unwell, stay at home and away from other people … to stop the spread to others,” she said. “We have to remember that what might be a mild infection for someone in their 20s and 30s could be a life-threatening infection for a newborn or someone who’s elderly or immunocompromised.”

    Contact Kristen Jordan Shamus: [email protected] Follow her on Twitter @kristenshamus. Subscribe to the Free Press.

    Leave a Comment

    Your email address will not be published. Required fields are marked *