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Texas children’s hospitals head into winter with surge of RSV cases


It's a common respiratory virus that presents with cold-like symptoms, including coughing, congestion and fever. In infants and older adults, this can lead to breathing issues and hospitalization.

Pediatricians in North Texas say the virus’ peak is abnormally early this year.

“Typically we would see a peak in December, January, and I think this year we’ve seen the peak in October and the early part of November,” said pediatrician Stephanie Atiyeh with Medical City Children’s Dallas. “Back in 2019, we had a pretty bad RSV season then.”

Atiyeh says the virus is cyclical, meaning every three to five years, there’s a more intense strain.

Pediatrician Laura Romano with Cook Children’s Medical Center says this early peak makes charting the next few months challenging.

“Since it’s not following a pattern, it’s going to be very hard to predict how long this’ll last,” Romano said. “We don’t know if it’s going to peak next week, and then cases will start going down. We don’t know if there will be a plateau, and we don’t know if we should expect a second peak later in winter.”

"I'm hoping that we're at the peak of RSV right now, and that specific virus will start to die down," said Atiyeh. "But I think we will be seeing some flu and other respiratory viruses that go around, as well."
Mary Altaffer/AP
"I'm hoping that we're at the peak of RSV right now, and that specific virus will start to die down," said Atiyeh. "But I think we will be seeing some flu and other respiratory viruses that go around, as well."

Statewide capacity might become a concern

For the week of Nov. 12, the state reported an 18% positivity rate in antigen detection tests, according to CDC data. That’s compared to more than 25% about four weeks ago.

But the spread of the illness — combined with the ongoing COVID-19 pandemic and an early start to the flu — has hospital officials concerned as winter approaches.

Chris Van Deusen, the director of communications with the Texas Health and Human Services, said that as of Wednesday, there were about 300 pediatric hospital beds available statewide. But the number of staffed pediatric intensive care beds available is 67.

“There is still some capacity there. And of course, hospitals also have emergency plans and resources that they can call on if they need to in an emergency or in a disaster situation,” he said.

Van Deusen said that the state is still contending with hundreds of COVID cases, but the amount has stabilized.

“We've been kind of hovering right around about 1,000 people with COVID hospitalized. And for children, that's just 44 right now,” he said.

Van Deusen said RSV and flu cases increased in Texas earlier this season than in past years, which could create problems for hospitals if those trends continue.

“Like RSV, we saw the flu start earlier in Texas this year. And I think the concern is we saw RSV go up and then start to come back down and we saw flu go up,” he said. “But if we get both of those things going up at the same time, that obviously ups the concern as far as the health care system and hospital capacity. Fortunately, it looks like they're moving in different directions at this moment.”

Flu, COVID-19 and RSV cases are affecting kids all at once

Both Atiyeh and Romano are also concerned about flu and COVID-19 cases, which are still putting people in the hospital.

“This is creating a very big strain on the hospital system, and it’s not just Cook Children’s that’s affected,” Romano said. “Every single hospital system in the country right now is feeling the weight of RSV and the flu on top of them.”

Romano says she’s already treated patients with the flu and COVID, and RSV and COVID.

“It’s very difficult, especially in little babies, to try and tease out which symptoms might be due to which virus,” she said. “If it’s a fever, it could be due to all three, and little kids can’t tell you that they’re having difficulty smelling or they have muscle aches.”

While some symptoms can be managed at home, Atiyeh says if children are having difficulty breathing, that’s a sign to take them to the ER. In infants, RSV might affect their feeding and ability to stay hydrated. Romano says dryer diapers, babies not producing tears when they cry and sunken soft spots are all signs of dehydration and RSV.

If younger kids have any cold symptoms, Romano and Atiyeh recommend keeping them home to stop the spread of the virus, in addition to good hand hygiene and mask usage.

Julian Aguilar contributed to this report.

Got a tip? Email Elena Rivera at erivera@kera.org. You can follow Elena on Twitter @elenaiswriting.

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Elena Rivera is the health reporter at KERA.