The University of Iowa Hospitals and Clinics — alongside hospitals around the country — reported an increase of children coming in with respiratory infections early in the winter months.

In September, the Centers for Disease Control and Prevention released an emergency preparedness and response that stated severe respiratory illnesses are on the rise.

Padget Skogman, a Mercy Medical Center pediatric hospitalist in Cedar Rapids, said she has seen a variety of respiratory viruses impacting children.

“I think half our census is RSV, but there’s also COVID, there’s adenovirus, and there’s several rhino enteroviruses,” Skogman said.

RSV is a respiratory syncytial virus that attacks the airways in the lungs and causes epithelial cells to die. The cells clump up in the lungs and can make it very hard for young infants to breathe.

Skogman said these respiratory illnesses are hard on kids. Infants are more vulnerable because they have lower immune systems compared to older children.

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Skogman thinks the rise in pediatric respiratory illnesses is partially due to seasonal variation.

“I would say the bigger problem is not just RSV, but just that we’re headed back into respiratory illness season,” Skogman said.

Physicians are concerned about the increase’s timing, as the spike in illness has arrived earlier in the winter season than normal.

Derek Zhorne, UI Stead Family Children’s Hospital associate chief medical officer, said the hospital has seen more early cases of respiratory illness.

“There’s a pretty clear upward trend in the number of positive RSV tests here in the Midwest that started in September,” he said.

Zhorne said the Stead Family Children’s Hospital is well-prepared and experienced in handling high demands for care.

“What we are concerned about is instead the volume that children’s hospitals are experiencing now at this time in the winter season,” Zhorne said.

COVID-19 may have caused the increase of illnesses because of shifted patterns of immunity, he said.

“The COVID-19 mitigation strategies that were used — such as encouraging social distancing, having people wear masks, isolation protocols, and even remote learning — were associated with notable reduction in volume of pediatric respiratory illnesses such as RSV and influenza while those measures were in place,” Zhorne said.

Now that these mitigation strategies have been reduced, Zhorn believes it has effected the sudden surge of familiar viruses that pediatricians have seen in the past.

Brooks Jackson, UI vice president for Medical Affairs and Carver College of Medicine dean, said during a Nov. 9 state Board of Regents meeting that immunity buildup contributes to more children getting sick.

“Many infected children are becoming severely ill because they have little immunity,” Jackson said. “This is either because they were not exposed to these viruses before the pandemic or because it has waned in this context.”

Skogman agreed the overall decrease in COVID-19 precautions has impacted the early volumes of these illnesses.

“When we had COVID because everyone stayed home, all the viruses shut down. We didn’t have a lot of RSV in August of 2021,” Skogman said. “But now, as we’re headed back into early winter, we are seeing a bigger surge of them.”

As Johnson County heads into the winter season, Skogman and Zhorne stressed using many methods to prevent these respiratory illnesses.

Both physicians said they encourage continuing standard COVID-19 precautions, including masking, hand washing, staying home when you are sick, and receiving vaccinations.

“We don’t have a vaccine for RSV. However, we do have influenza vaccines, and we have COVID-19 vaccines,” Zhorne said. “So, taking those steps can help prevent severe illnesses from those viruses, and they can overall help reduce pressure on the health care system.”