The parents of a 5-week-old girl were concerned when she had a runny nose, congestion and difficulty eating. They became alarmed when she began to have trouble breathing, so they brought her to the emergency department.

“She was ultimately admitted to St. Luke’s Pediatric ICU for high flow oxygen,” said Christopher Plymire, MD, medical director of the Pediatric Intensive Care Unit (PICU) at St. Luke’s University Hospital – Bethlehem. “High-flow oxygen can be delivered very easily and safely at St. Luke’s, and for most children, that’s the level of breathing support that lets them rest and get better. She was in the pediatric ICU for two days, and then two days in the pediatric unit, before going home.

The infant, born at St. Luke’s Anderson Campus, was diagnosed with respiratory syncytial virus (RSV), a common virus that usually causes mild, cold-like symptoms. Physicians have treated RSV since the 1950s.

While treatments have advanced, most children still receive supportive care, such as extra oxygen and IV fluids that allow the child to recover.

“Studies show more than 95% of children get RSV by age 2. It is one of the most common cold viruses,” he said. But the important thing to remember is that only one out of 100 children who get RSV needs to be admitted to the hospital. And of those, only one in 50 needs intensive care. So, it’s very uncommon overall for children to need hospitalization, and almost every child that gets RSV will recover and do fine.”

Premature babies, babies less than six months old and children with a medical condition, such as a heart or chronic respiratory disease, including asthma, are at highest risk for developing complications. This year, the number of children requiring hospitalization has surged nationwide with the situation locally better than some areas, but worse than others. Efforts to manage the spread of COVID-19 contributed to the increase. In 2020 and 2021, fewer children were exposed to RSV due to masking, social distancing and the fact many children were not in school or day care.

“It’s not that the children who get RSV this year are significantly sicker,” he explained. “It’s just that more kids have it.”

For example, if 100 kids in 2019 had RSV, there are 300 or 400 kids this year. So, the increase in hospitalization results from the increased number of kids with RSV, while the percentage needing hospitalization is the same.

Typically, children are exposed to these viruses a little at a time and build up immunity. Often, siblings who attend day care or elementary school will bring a virus home. Since this didn’t occur as much in recent years, St. Luke’s has hospitalized more three- and four-year-old’s than usual.

Besides RSV, physicians are seeing more ill children with rhinovirus, which causes colds in adults and human Metapneumovirus, another cold-type variant.

Surges in hospitalizations usually occur in the winter, so it’s earlier this year, he said.

To reduce your child’s risk of becoming ill, Dr. Plymire suggests strict hand-washing practices and covering mouths when coughing and sneezing.

Keep children home when sick and contact their pediatrician or family doctor.

Routine testing for RSV is not recommended for most children over six weeks because the treatment is the same whether the test is positive or negative.

If you have an infant or a child with a medical condition, limit their exposure to people outside their family and school.

Should your child have difficulty breathing, see your doctor or go to the ER, he advised. Babies may have trouble eating and fewer wet diapers, signs you should go to the hospital.

Also, Dr. Plymire encourages flu shots. While the ability to handle sick children is manageable, he fears it may worsen during flu season.

St. Luke’s is ready to handle the increased numbers of ill children. Besides the PICU beds and Inpatient Pediatric Unit at St. Luke’s Bethlehem Campus, all St. Luke’s emergency rooms, including St. Luke’s Carbon and Miners Campuses, are prepared to care for sick children.

“The ERs have pediatric equipment and staff well trained to provide these kids with excellent care,” he said. “We’re in good shape.”