Respiratory viruses, such as COVID-19, influenza (flu), and respiratory syncytial virus (RSV), cause severe disease in children. Preventable deaths and hospitalizations are our chief concern, but when millions of children are ill with these respiratory viruses, schools and community functions are disrupted, susceptible elders get infected, and healthcare systems are strained.
Where I am from, each year, parents and pediatricians rejoice when (euphemistically named) ‘Spring Break’ comes in February. Spring break provides an opportunity to remove children from the classroom where viruses spread faster than grease on a hot griddle. By removing our young vectors from the viral spreading zone (school), respiratory virus spread decreases, giving everyone a chance to recuperate.
However, most clinicians who see children are aware that this year was different. In the United States in 2022, RSV peaked before Thanksgiving, and among children, influenza-positive specimens peaked right around Thanksgiving, as reported by public health laboratories. Most of us are aware that the Centers for Disease Control and Prevention (CDC) tracks COVID-19, flu, and RSV hospitalizations through sentinel surveillance systems, but did you hear that this important CDC information is now available for easy online viewing? You can monitor respiratory illnesses right from your nearest internet-connected device.
To inspire you to look at the new CDC dashboards, let’s use a couple of scenarios.
Scenario 1
On New Year’s Eve 2022, while working in the Emergency Department (lucky you), you saw a 2- year-old child experiencing difficulty breathing. Knowing it could be COVID-19, flu, or RSV, you did the appropriate testing. Later while grabbing your dinner in the cafeteria, you wondered which of these was most likely to lead to hospitalization of a child 0 to 4 years of age at that time.
The Respiratory Virus Hospitalization Surveillance Network (RESP-NET) would help you to quickly answer your question. This interactive dashboard displays data from three networks that conduct population-based surveillance for laboratory-confirmed COVID-19-, influenza-, and RSV-associated hospitalizations across the lifespan. The networks gather data from acute care hospitals in 13 states covering more than 29 million people and representing an estimated 8% to 10% of the U.S. population. This dashboard is updated each week.
Try it! To find the answer to your question, look to the left side and click on “Weekly Rates,” choose the season (“2022-2023”), and select “Pathogens – All.” Then look in the upper tab and choose “Age (0-4 years).” You should see that on 12/31/2022, per 100,000 people, the COVID-19 rate was 4.2, flu was 5.1, and RSV was the highest for this age bracket at 13.4.
- For comparison, look at the same date for people 65 and older. The story was quite different with much higher rates of hospitalization overall, and higher rates for COVID-19 (47.0) than for flu (18.5) or RSV (3.1).
- While you’re here, check the same date and compare all-age hospitalization rates for White, Non-Hispanic people [COVID-19 (12), flu (4.9), RSV (1.2)] with those of Black, Non-Hispanic people [COVID-19 (13.9), flu (4.7), RSV (0.9)]. The higher rate of hospitalization among Black people was due to COVID-19.
Scenario 2
It seems like it has been a long fall and winter. During your departmental meeting, the infectious diseases (ID) division chief is discussing the respiratory illnesses that have been keeping the emergency department (ED) full. Someone asks which week has been the worst so far when it comes to ED visits for children up to 1 year of age.
While local trends may differ somewhat, the ID division chief shares that the CDC recently released a dashboard that shows national ED visit data for COVID-19, flu, and RSV. The ED visit rates are tracked by the National Syndromic Surveillance Program (NSSP), a collaboration between CDC, other federal partners, state and local health departments, and academic and private sector partners. Data are monitored for a subset of U.S. ED from all 50 states, the District of Columbia and Guam.
Try it! After the presentation, you decide to check out the dashboard. Looking first at the graph called, “Weekly Emergency Department Visits by Age Group,” you drop down to “00-01 Years” and click “Apply Filters.” This shows that the peak for the number of ED visits for the three respiratory viruses combined in this age bracket was the week ending on 12/03/2022 when there were 27,322 ED visits.
Scrolling down to the second graph, you see the “Weekly Emergency Department Visits by Age Group and Respiratory Illness, as a Percent of All Emergency Department Visits.” Selecting “combined” for the filter and looking at the orange line for the under 1 age group, you quickly see that the peak for the fall and winter combined weekly count of ED visits in this age bracket was the week ending on 12/03/2022. During that week, 24% of all ED visits for children in this age bracket were for respiratory viral infections.
Other respiratory virus dashboards
These are not the only dashboards that the CDC shares to help understand the impact of respiratory viruses. Others that you may find useful include:
For all of you who were exhausted by caring for patients through the successive waves of respiratory viral illness, we wish you a hiatus. May vaccine immunity and natural immunity work together to unburden our children and their caregivers, both personal and professional.
Respiratory viruses, such as COVID-19, influenza (flu), and respiratory syncytial virus (RSV), cause severe disease in children. Preventable deaths and hospitalizations are our chief concern, but when millions of children are ill with these respiratory viruses, schools and community functions are disrupted, susceptible elders get infected, and healthcare systems are strained.
Where I am from, each year, parents and pediatricians rejoice when (euphemistically named) ‘Spring Break’ comes in February. Spring break provides an opportunity to remove children from the classroom where viruses spread faster than grease on a hot griddle. By removing our young vectors from the viral spreading zone (school), respiratory virus spread decreases, giving everyone a chance to recuperate.
However, most clinicians who see children are aware that this year was different. In the United States in 2022, RSV peaked before Thanksgiving, and among children, influenza-positive specimens peaked right around Thanksgiving, as reported by public health laboratories. Most of us are aware that the Centers for Disease Control and Prevention (CDC) tracks COVID-19, flu, and RSV hospitalizations through sentinel surveillance systems, but did you hear that this important CDC information is now available for easy online viewing? You can monitor respiratory illnesses right from your nearest internet-connected device.
To inspire you to look at the new CDC dashboards, let’s use a couple of scenarios.
Scenario 1
On New Year’s Eve 2022, while working in the Emergency Department (lucky you), you saw a 2- year-old child experiencing difficulty breathing. Knowing it could be COVID-19, flu, or RSV, you did the appropriate testing. Later while grabbing your dinner in the cafeteria, you wondered which of these was most likely to lead to hospitalization of a child 0 to 4 years of age at that time.
The Respiratory Virus Hospitalization Surveillance Network (RESP-NET) would help you to quickly answer your question. This interactive dashboard displays data from three networks that conduct population-based surveillance for laboratory-confirmed COVID-19-, influenza-, and RSV-associated hospitalizations across the lifespan. The networks gather data from acute care hospitals in 13 states covering more than 29 million people and representing an estimated 8% to 10% of the U.S. population. This dashboard is updated each week.
Try it! To find the answer to your question, look to the left side and click on “Weekly Rates,” choose the season (“2022-2023”), and select “Pathogens – All.” Then look in the upper tab and choose “Age (0-4 years).” You should see that on 12/31/2022, per 100,000 people, the COVID-19 rate was 4.2, flu was 5.1, and RSV was the highest for this age bracket at 13.4.
- For comparison, look at the same date for people 65 and older. The story was quite different with much higher rates of hospitalization overall, and higher rates for COVID-19 (47.0) than for flu (18.5) or RSV (3.1).
- While you’re here, check the same date and compare all-age hospitalization rates for White, Non-Hispanic people [COVID-19 (12), flu (4.9), RSV (1.2)] with those of Black, Non-Hispanic people [COVID-19 (13.9), flu (4.7), RSV (0.9)]. The higher rate of hospitalization among Black people was due to COVID-19.
Scenario 2
It seems like it has been a long fall and winter. During your departmental meeting, the infectious diseases (ID) division chief is discussing the respiratory illnesses that have been keeping the emergency department (ED) full. Someone asks which week has been the worst so far when it comes to ED visits for children up to 1 year of age.
While local trends may differ somewhat, the ID division chief shares that the CDC recently released a dashboard that shows national ED visit data for COVID-19, flu, and RSV. The ED visit rates are tracked by the National Syndromic Surveillance Program (NSSP), a collaboration between CDC, other federal partners, state and local health departments, and academic and private sector partners. Data are monitored for a subset of U.S. ED from all 50 states, the District of Columbia and Guam.
Try it! After the presentation, you decide to check out the dashboard. Looking first at the graph called, “Weekly Emergency Department Visits by Age Group,” you drop down to “00-01 Years” and click “Apply Filters.” This shows that the peak for the number of ED visits for the three respiratory viruses combined in this age bracket was the week ending on 12/03/2022 when there were 27,322 ED visits.
Scrolling down to the second graph, you see the “Weekly Emergency Department Visits by Age Group and Respiratory Illness, as a Percent of All Emergency Department Visits.” Selecting “combined” for the filter and looking at the orange line for the under 1 age group, you quickly see that the peak for the fall and winter combined weekly count of ED visits in this age bracket was the week ending on 12/03/2022. During that week, 24% of all ED visits for children in this age bracket were for respiratory viral infections.
Other respiratory virus dashboards
These are not the only dashboards that the CDC shares to help understand the impact of respiratory viruses. Others that you may find useful include:
For all of you who were exhausted by caring for patients through the successive waves of respiratory viral illness, we wish you a hiatus. May vaccine immunity and natural immunity work together to unburden our children and their caregivers, both personal and professional.