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Doctors see a summer surge in children's cold, virus symptoms

Pediatrician Dr. Eve Meltzer Krief examines Lila, 5,

Pediatrician Dr. Eve Meltzer Krief examines Lila, 5, for a sore throat at Huntington Village Pediatrics on Thursday. Credit: Newsday/J. Conrad Williams Jr.

Pediatricians and urgent care centers around Long Island are seeing an unusual surge this summer in children with cold and virus symptoms normally reserved for the fall and winter months.

Since many cold symptoms — such as fever, cough and fatigue — also are possible signs of COVID-19, children are now being tested right away to rule out the disease.

WHAT TO KNOW

More children are coming down with colds and respiratory viruses than doctors normally see during the summer months.

Health experts believe the lack of exposure to common cold viruses, plus the relaxation of pandemic restrictions such as wearing masks and social distancing, have fueled the uptick in child illnesses this summer.

Any child with a cold symptom that is also a COVID-19 symptom such as fever, cough and fatigue should immediately be evaluated by a doctor and probably will need to be tested for COVID-19.

While the majority of illnesses seen by pediatricians have been relatively mild, the Centers for Disease Control and Prevention recently issued an alert about an increase in respiratory syncytial virus, known as RSV, which can cause bronchiolitis and pneumonia in young children.

Health experts say the increase in sick kids is being fueled by the relaxation of COVID-19 pandemic restrictions such as mask-wearing, as well as the reopening of camps and other summer activities. CDC researchers also believe a lack of "natural exposure" to these viruses in 2020 may have reduced "population immunity" to them.

"We’re definitely seeing increased spread of typical cold viruses that we normally see earlier in the year and a lot of croup, which is more of a winter-type virus," said Dr. Eve Meltzer Krief of Huntington Village Pediatrics. "There’s a lot of run-of-the-mill sore throats."

In the past, parents were generally told to treat these cold and virus symptoms by having their children drink lots of fluids and rest. Many who had a relatively mild illness didn’t even visit their pediatricians.

"Now we really have to see them immediately, especially given the rise of [COVID-19)] rates in our area and the increased transmissibility of the delta variant," said Meltzer Krief, who sits on the executive council of the Long Island-Brooklyn/Queens chapter of the American Academy of Pediatrics.

Dr. Christina Johns, senior medical adviser for PM Pediatrics, which has facilities on Long Island and across the country, said the pediatric urgent care centers have seen a 50% increase in testing for symptoms, which highlights other circulating viruses that mimic COVID-19 and require evaluation.

"We are seeing numbers similar to what we see during our busy winter flu season," Johns said. "We’re seeing a little bit of it all … fevers, running nose, upper respiratory infections. It’s really the gamut, which has been just unbelievable."

In a study released Thursday, CDC researchers looked at how respiratory viruses, including influenza, RSV, parainfluenza viruses, human metapneumoviruses, respiratory adenoviruses, and rhinoviruses/enteroviruses, circulated during the pandemic.

Some of those viruses can cause the common cold, but because they circulated at "historically low levels" during the pandemic — likely due to precautions such as social distancing and mask wearing — the population immunity to the viruses may have been reduced, researchers said.

Meltzer Krief said she did not see any strep throats or ear infections in the fall and winter months.

"I barely saw kids wheezing. All the normal stuff that we see as pediatricians was just absent," she said.

Dr. Neal Shipley, medical director of the New York Market for Northwell Health-GoHealth Urgent Care, said they are advising providers to be on the lookout for RSV in pediatric patients.

"We are checking pediatric patients' oxygen levels and making sure they don’t have pneumonia," he said. "It’s important to understand these viruses. It’s not like they travel to Florida for the summer and come back in the winter. They are not reverse snowbirds."

Shipley pointed out last winter that most people were staying indoors, not traveling, and taking precautions such as wearing masks and washing their hands.

"There was lack of community exposure to RSV in the previous season, which now means we have a whole bunch of kids who probably have — especially in younger infants — diminished immunity," he said. "I think this seasonal shift is probably due to relaxing of these control measures and diminished immunity in the target population."

In the study, CDC researchers warned doctors and public health experts to keep an eye on RSV activity and watch out for more flu and other respiratory viruses.

"Any child with a fever and a cough these days should be evaluated for any one of a number of things including RSV, COVID, influenza and other common cold viruses," Shipley said. "Come October, flu is going to be back. Don’t think that’s not going to happen."

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