Respiratory ED update: Influenza, RSV, and COVID-19

In this Contemporary Pediatrics video interview, Steven Selbst, MD, attending physician, pediatric emergency medicine, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, provides a brief update as to what he is seeing in relation to influenza, respiratory syncytial virus, and COVID-19.

Interview transcript:

Contemporary Pediatrics:

What trends are you noticing currently for emergency department-related pediatric influenza cases?

Steven Selbst, MD:

We're still certainly seeing influenza. I don't know that it's as bad a season as we've had in the past, but we've certainly seen a lot of influenza. We had influenza A first now we're seeing a lot of influenza B. I don't know the statistics, but I would bet it's not as bad as previous seasons. I'd say in most cases, [the children] not vaccinated.

I think, unfortunately, many people get their kids vaccinated for other illnesses ,but when it comes to flu and COVID, they usually report to us "they didn't get their flu this year, they didn't get their COVID."

We actually have an active campaign in our emergency department to give out flu vaccine and pretty much every child, when they come to the emergency department, the parents are asked, "is this a good time to give your child a flu vaccine," so we're giving out quite a few.

I think we've been more successful with that this year than we have in previous years because the nursing staff, physician staff, are reminded to inquire about it and offer the vaccine to parents and many of them are getting vaccinated in the emergency department for flu.

Contemporary Pediatrics:

For RSV, have you seen any patients in the emergency department that have received nirsevimab amid limited availability?

Selbst:

I think I had 1 who told me they had the vaccines, but maybe those are the ones that aren't coming to the emergency department, the ones that have been vaccinated. We see the population is not vaccinated for the most part. So I'm not at all surprised that the patients coming to us have not received the RSV vaccine. We saw a lot of RSV, it's starting to die down a little bit. Now, we're seeing much more COVID than RSV right now.

[I'm] still hopeful that the pregnant mothers will get the RSV vaccine so that we won't see this in children. That's certainly probably the best way to prevent this infection for the very young infants who are at the greatest risk. I think we have to get used to this is probably going to happen every year. We're going to see all three of these viruses every year.

Hopefully people will get vaccinated and at least the seriousness of the illness will be lessened. We don't get too many children with COVID who need to be admitted to the hospital, fortunately. That's pretty much always been the case.

Most children with COVID do fairly well. But they're doing better if they got vaccinated for COVID, and so I'm not terribly surprised that we're seeing all three of these viruses and probably going to be like this every year.